Exoscope System for Advancing Research in Image and Molecularly Guided Surgery - PROJECT SUMMARY/ABSTRACT
This high-end instrumentation project proposal (S10) will purchase the Synaptive Surgical System which is an
image-guided, coregistered exoscope with advanced visualization, navigation and intraoperative image cap-
ture. The unit, referred to as Modus VTM, is a fully-automated, hands-free, robotically-controlled digital micro-
scope with integrated image visualization for surgical guidance enabled by tool/microscope tracking, fluores-
cence imaging, and other advanced features such as 3D viewing. Our analysis suggests no other exoscope
system is available commercially with the same level of advanced functionality, especially in terms of integrat-
ed tool-tracking, coregistered image-based navigation and fluorescence imaging. While literature review and
case-series publications1-10 favor one commercial exoscope over another (and some1,24-25 prefer Modus VTM),
we conclude that Modus VTM best meets the needs of our Major Users because of its integration of navigation,
visualization and fluorescence imaging into a single exoscope platform/footprint that is readily adapted to the
multiple surgical specialties and procedures represented within our Major User NIH-funded research portfolio.
Further, use of the same exoscope across these research initiatives will increase image/data rigor and repro-
ducibility while accelerating investigator/research project productivity because commonality will allow user
groups to leverage advances made within one research team across all Major User research projects in both
novel software (e.g., novel image-processing/image analysis software/algorithms, etc.) and hardware (e.g.,
novel fluorescence imaging modules, etc.) developments. We will also enjoy a research relationship with Syn-
aptive (see Letter of Support) that will benefit both parties because our investigators will gain first access to the
latest Modus VTM advances even before they are commercially available, and the Company will gain from tech-
nical innovations our investigators are realizing at Dartmouth (e.g., in quantitative fluorescence imaging). The
proposed instrumentation will be assigned to and housed in a state-of-the-art research facility – the Center for
Surgical Innovation (CSI) – which is an NIH-funded research resource that offers intraoperative Magnetic Res-
onance (iMR) and Computed Tomography (iCT) during the same surgery in a dual-use OR that allows both
human and animal studies to occur in the same space. The instrumentation will support NIH-funded investiga-
tors exploring image- and molecularly-guided surgical interventions in neurosurgery, orthopedic surgery, head
and neck surgery, extremity surgery and breast surgery, among other specialties.