One of the main challenges for computer-assisted surgery (CAS) is to determine the intra-operative morphology and motion of soft-tissues. This information is prerequisite to the registration of multi-modal patient-specific data for enhancing the surgeon's navigation capabilities by observing beyond exposed tissue surfaces and for providing intelligent control of robotic-assisted instruments. In minimally invasive surgery (MIS), optical techniques are an increasingly attractive approach for in vivo 3D reconstruction of the soft-tissue surface geometry. This paper reviews the state-of-the-art methods for optical intra-operative 3D reconstruction in laparoscopic surgery and discusses the technical challenges and future perspectives towards clinical translation. With the recent paradigm shift of surgical practice towards MIS and new developments in 3D optical imaging, this is a timely discussion about technologies that could facilitate complex CAS procedures in dynamic and deformable anatomical regions.

Polarization is a fundamental property of light and a powerful sensing tool that has been applied to many areas. A Mueller matrix is a complete mathematical description of the polarization characteristics of objects that interact with light, and is known as a transfer function of Stokes vectors which characterise the state of polarization of light. Mueller polarimetric imaging measures Mueller matrices over a field of view and thus allows for visualising the polarization characteristics of the objects. It has emerged as a promising technique in recent years for tissue imaging, improving image contrast and providing a unique perspective to reveal additional information that cannot be resolved by other optical imaging modalities. This review introduces the basis of the Stokes-Mueller formulism, interpretation methods of Mueller matrices into fundamental polarization properties, polarization properties of biological tissues, and considerations in the construction of Mueller polarimetric imaging devices for surgical and diagnostic applications, including primary configurations, optimization procedures, calibration methods as well as the instrument polarization properties of several widely-used biomedical optical devices. The paper also reviews recent progress in Mueller polarimetric endoscopes and fibre Mueller polarimeters, followed by the future outlook in applying the technique to surgery and diagnostics. Tissue polarization properties convey morphological, micro-structural and compositional information of tissue with great potential for label free characterization of tissue pathological changes. Recent progress in tissue polarimetric imaging and polarization resolved endoscopy paved the way for translation of polarimetric imaging to surgery and tissue diagnosis.

Recent technological developments have resulted in the availability of miniaturised spectral imaging sensors capable of operating in the multi- (MSI) and hyperspectral imaging (HSI) regimes. Simultaneous advances in image-processing techniques and artificial intelligence (AI), especially in machine learning and deep learning, have made these data-rich modalities highly attractive as a means of extracting biological information non-destructively. Surgery in particular is poised to benefit from this, as spectrally-resolved tissue optical properties can offer enhanced contrast as well as diagnostic and guidance information during interventions. This is particularly relevant for procedures where inherent contrast is low under standard white light visualisation. This review summarises recent work in surgical spectral imaging (SSI) techniques, taken from Pubmed, Google Scholar and arXiv searches spanning the period 2013-2019. New hardware, optimised for use in both open and minimally-invasive surgery (MIS), is described, and recent commercial activity is summarised. Computational approaches to extract spectral information from conventional colour images are reviewed, as tip-mounted cameras become more commonplace in MIS. Model-based and machine learning methods of data analysis are discussed in addition to simulation, phantom and clinical validation experiments. A wide variety of surgical pilot studies are reported but it is apparent that further work is needed to quantify the clinical value of MSI/HSI. The current trend toward data-driven analysis emphasises the importance of widely-available, standardised spectral imaging datasets, which will aid understanding of variability across organs and patients, and drive clinical translation.

Fluorescence lifetime imaging (FLIM) is a functional imaging methodology that can provide information, not only concerning the localisation of specific fluorophores, but also about the local fluorophore environment. It may be implemented in scanning confocal or multi-photon microscopes, or in wide-field microscopes and endoscopes. When applied to tissue autofluorescence, it reveals intrinsic excellent contrast between different types and states of tissue. This article aims to review our recent progress in developing time-domain FLIM technology for microscopy and endoscopy and applying it to biological tissue.

Glioblastoma multiforme (GBM) is the most common and aggressive brain tumor in humans, accounting for 52% of all brain tumor cases.^{1, 2} The median survival is $12\text{to}15\text{months}$ . Optimal therapy consists of maximal safe surgical resection, followed by adjuvant chemoradiotherapy.³ Several studies demonstrate that the extent of surgical resection is a determinant of progression-free and overall survival.² Achieving a gross total resection is surgically challenging, because the normal and tumor-bearing brain can be similar in intraoperative appearance.³ A conservative resection by the surgeon can lead to suboptimal tumor debulking, whereas an aggressive technique may encroach on functionally significant brain. Various techniques have been employed to aid the neurosurgeon during tumor resection, including intraoperative MRI, neuronavigation, functional mapping via cortical stimulation, and ultrasonography.³ None of these techniques allows the direct pathologic discrimination of tissue.³

Graded index (GRIN) lenses are commonly used for compact imaging systems. It is not widely appreciated that the ion-exchange process that creates the rotationally symmetric GRIN lens index profile also causes a symmetric birefringence variation. This property is usually considered a nuisance, such that manufacturing processes are optimized to keep it to a minimum. Here, rather than avoiding this birefringence, we understand and harness it by using GRIN lenses in cascade with other optical components to enable extra functionality in commonplace GRIN lens systems. We show how birefringence in the GRIN cascades can generate vector vortex beams and foci, and how it can be used advantageously to improve axial resolution. Through using the birefringence for analysis, we show that the GRIN cascades form the basis of a new single-shot Müller matrix polarimeter with potential for endoscopic label-free cancer diagnostics. The versatility of these cascades opens up new technological directions.