Workstation for the MarginGuide

Abstract

With over 300.000 new cases each year, and a survival rate of 50%, oral cancer is a big problem for public health. The primary and best treatment option for oral cancer is surgery. In order to have the best prognosis and quality of life, international guidelines prescribe that the tumor should be removed including a margin of healthy tissue from at least 5mm. However, it is essential not to remove too much tissue, because this will negatively affect the quality of life of the patient.

Most of these procedures are very difficult due to the complex anatomical and functional structures in the oral cavity. Currently, surgeons can only judge the surgical margins by visual inspection and palpation, without much support of technology or other diagnostic techniques. Research has shown that this subjective method results in a very low percentage of successful surgeries. So there is a need for clear and objective information about the resection margins during the surgery.

SurGuide is therefore developing the MarginGuide system. This device uses an optical technique to distinguish healthy tissue from tumorous tissue. It will be used to inspect the margins directly after the tumor has been removed from the patient, which enables the surgeon to remove additional tissue if needed. The MarginGuide should therefore increase the success rate of oral cancer surgeries.

This project focusses on the workstation of the MarginGuide system. The workstation should support the operator in correctly (and easily) measuring and reporting the margins during the surgical procedure. During this project the importance of correct information flow became clear, shifting the focus to software, protocols and the workflow of the workstation.

To establish the different needs and requirements for the workstation, the desired workflow, information flow, and communication of the measurement results are investigated. The research has been verified with surgeons, pathologists and researchers from the Erasmus-University Medical Center.

Based on the results, a software design has been developed. This software design includes the completely designed work- and information flow. This design is supported by anatomical templates, measurement methods, and measurement reports. The anatomical templates can be used by surgeons and pathologist to communicate and save information about the surgery and the resected tumor. Currently, the templates from this project are being used at the Erasmus-University Medical Center for real patients.

The various aspects of the software have been tested separately with the intended users. At the end of the project a complete prototype of the software, workflow, measurement method, measurement report and anatomical templates was developed to test and verify the final designs.

Simultaneously, a design of the physical aspects of the workstation and trolley has been made. The design has been visualised and was verified with the research team at the Erasmus-University Medical Center. However due to time constrains, no prototype has been made for this part of the design.