Our project aims to overcome a critical challenge in modern surgery the precise differentiation of cancerous tissues from healthy ones without damaging vital structures

We propose a cutting edge camera and integrated clinical workflow that seamlessly fits into both open and laparoscopic surgical procedures. This system will offer improved sensitivity and specificity for in vivo pathology at various scales ensuring precise surgical margins and clear identification of critical anatomical structures.currently surgical interventions are disrupted by the introduction of tools like drop in ultrasound probes which require halting the operation for image capture. Our technology circumvents this by incorporating photoacoustic PA ultrasound US and fluorescence FL imaging into existing surgical endoscopes allowing for real time noncontact visualization. This innovation is distinct in its holistic integration into surgical practice providing real time intraoperative imaging that highlights critical structures without disrupting the surgical process. Over a 5 year arpa H program period we plan to evolve from prototyping to preclinical testing in alignment with a structured development plan that includes feedback from end users. Our interdisciplinary team from johns hopkins university the university of texas southwestern and the NIH clinical center in partnership with industry leaders is uniquely positioned to drive this innovation forward. With a focus on reducing positive tumor margins and operative complications our project aligns with the arpa H mission for precision surgery.