Surgeons will soon guide their instruments not just by what a tumour looks like on a scan, but by what it is doing—its blood flow, its oxygen levels, its chemical activity—in real time. Current image-guided surgery relies heavily on pre-operative anatomical snapshots. This means surgeons operate with outdated information, unable to see how tissue changes during a procedure or to sense subtle physiological signals that distinguish healthy from diseased tissue. The Centre will fuse anatomical, physiological, and pathological data into a single live guidance system, while also redesigning instruments and the clinical workspace to reduce cognitive overload on surgical teams. If successful, the approach could cut complication rates and hospital stays by enabling more precise, less invasive interventions. It would also accelerate the translation of new surgical technologies from lab bench to operating theatre, by providing a central hub that handles everything from scientific design to manufacturing standards. The work is applied and translational, with immediate relevance to any surgical field that relies on imaging—from cancer removal to cardiac repair.
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Image-guided Intervention (IGI) has enabled greater surgical precision resulting in reduced tissue trauma, co-morbidity, complications, and hospitalisation time. However, significant limitations arise from the challenging use of IGI systems, and their predominant reliance on preoperative anatomical images. Disrupting existing IGI, we will deliver pathologically, anatomically, and physiologically optimal surgery by combining diagnostic-quality imaging/sensing with ergonomic smart instruments. The Wellcome Trust Centre for Surgical and Interventional Sciences (WTC-SIS) will launch a new phase in which anatomical cues, which have driven interventional therapies for centuries, are augmented by physiological and pathological insight. Three fundamental research themes will link the WTC-SIS interdisciplinary groups: Physiological navigation, focusing on fusing anatomical, physiological and pathological information for real-time guidance/monitoring. Clinician experience, focusing on optimising the clinical team cognitive/ergonomic workload. Precision instrumentation, focusing on designing interventional devices that both sense physiological/pathological information and interact with tissue. WTC-SIS will serve as a hub-and-spoke translational catalyst for indication-specific externally-funded projects across surgical domains. A single unified Centre (hub) will provide all relevant skills and know-how, from scientific expertise to good manufacturing principles. This will drive rapid translation in our clinical satellites (spokes) and industry engagement through the development of a Health Technology Assessment programme.
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