Project Image Guidance in Surgery

  • From 2013–2018 I was part of the research team of the project Image Guidance. Image Guidance was an image-critical research project that, on the basis of medical practice and under the conditions of clinical interventions, developed proposals for the design of therapeutic processes and applications. 
  • It was situated at the Cluster of Excellence »Image Knowledge Gestaltung« in the research area Image & Action an was funded by the German Research Foundation
  • The central focus of the project was the complex of visualisation practices that act as interfaces between doctor and patient, thereby guiding action. These were investigated in the form of case studies in order to test and evaluate image-led operations within an exchange involving the areas in which these techniques are applied and developed. 
  • The results of those case studies can be found in my portfolio.

Goals: Our aim in the analysis of the media-related framework conditions of image-led interventions was to uncover underlying forms of representation, perception and action, and to enable their transfer across disciplinary boundaries to situations and contexts in which the interaction of image and action is relatively close or even completely interwoven. Recent years have seen the emergence of a series of processes that takes the process of imaging and image guidance far beyond the scope of pure diagnosis, in particular in radiation oncology and surgery. Radiation systems such as CyberKnife synchronise between pre- and intraoperative visualisation practices in real time, and robot-assisted technologies such as the da Vinci surgical system enable surgical interventions to be performed on-screen. The techniques such operations entail – control and automation, visual recording, optics, radiation-based surgery and programming – are developed specifically within the context of image guidance. Surgical robots, endoscopic navigation systems and intraoperative augmented reality applications not only improve conventional methods and treatment options; they also fundamentally alter medical diagnosis and treatment. Given the visual regime that these developments are linked with, medical practice today no longer operates solely on the human body, but also on and with image forms, such as X-ray images, graphical user interfaces, 3D models and video images in which the medical intervention is defined and mediated via media. The practice of image guidance requires a form of image knowledge that to date has not been provided in the medical curriculum. 

Objectives: Against this background, the project pursued the overriding objective of investigating the scientific and cultural historical formation, specific design and application-oriented logic of image-guided surgery in greater detail, determining the implicit and imperative image knowledge that it involves and arriving at the consequences for medical training. Overall, the project seeks to anchor image guidance as a concept and process both conceptually and epistemologically and in medical practice, and to explore the possibilities for future optimisation and further development. Research in the project was concentrated on the following focal points on which work was undertaken in cooperation between medicine, art history, cultural and media studies:

  • Determining the aesthetic, operational and epistemic conditions under which visualisations become images of control and a guide for action in medical contexts
  • Systematically analysing current image-guided procedures in radiation oncology and radiosurgery, and identifying future development areas and exploring the possibilities for optimisation in respect of visualisation practices, software design and viewing techniques
  • Comparing on a procedural level the visual epistemics of medical image types and investigating their implications for medical practice
  • Comparing the aesthetic-epistemic strategies of imaging processes in medicine and their cross-disciplinary and cross-media use in literature and art
  • Anchoring image guidance as a concept in theory formation and the methods of medical practice
  • Establishing application-oriented visual literacy as an integral part of medical training