Automatic 3D augmented reality RAPN with Indocyanine green guidance: A novel technology for a more precise surgical resection

2021 ◽  
Vol 79 ◽  
pp. S805-S806
Author(s):  
F. Porpiglia ◽  
D. Amparore ◽  
F. Piramide ◽  
E. Checcucci ◽  
P. Verri ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Indocyanine Green ◽  
Surgical Resection ◽  
Novel Technology

scholarly journals INDOCYANINE GREEN ENHANCED LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE PATIENTS: DO WE NEED A REVISION OF THE SAFETY PARADIGMS?

2017 ◽  
Vol 64 (2) ◽  
pp. 151-154
Author(s):  
Catalin Alius ◽  
◽  
Eugen-Sebastian Gradinaru ◽  
Adriana Elena Nica ◽  
◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Augmented Reality ◽  
Surgical Technique ◽  
Indocyanine Green ◽  
Near Infrared ◽  
Fluorescent Dyes ◽  
Operating Time ◽  
Biliary Anatomy ◽  
Early Laparoscopic Cholecystectomy ◽  
Small Cohort

Introduction. Rapid developments in medical technology have allowed the incorporation of Indocyanine green (ICG) fluorescent cholangyography in the surgical technique armamentarium. The visualization of the biliary anatomy with augmented reality devices during surgery reduces complications and offer the perspective of challenging the safety paradigms which prohibited surgery in certain acute biliary conditions. Materials and methods. 43 consecutive patients were enrolled in a prospective interventional study and randomly divided into a cohort of 19 patients who had ICG injected prior to laparoscopic cholecystectomy and a cohort of 23 patients who received no fluorescent dye prior to surgery. In the ICG lot a Near Infrared Fluorescent System was used for the acquisition of fluorescent data in order to produce real time augmented reality imaging (ICG fluorescent cholangiography). The surgical technique and the indications for surgery were the same for the same in both cohorts of patients. Results and discussion. The cohort of patients receiving ICG had no complications and the mean operating time was 10 minutes less. The biliary anatomy was identified immediately in the ICG cohort with a specificity of 89.4% for the common bule duct and 73.6% for the cystic duct. In the non ICG cohort 21% of the CBDs and 43.4% of the cystic ducts were identified with difficulty during the procedure. Conclusion. We demonstrated in a small cohort of patients that early laparoscopic cholecystectomy is safe and can be performed quicker with the aid of fluorescent dyes. In order to challenge the safety paradigms around the early laparoscopic cholecystectomy a larger study is necessary.

Indocyanine green guidance during 3D augmented reality robot assisted partial nephrectomy: A step towards the “automatic” overlapping

2021 ◽  
Vol 79 ◽  
pp. S1771
Author(s):  
F. Porpiglia ◽  
D. Amparore ◽  
F. Piramide ◽  
E. Checcucci ◽  
P. Verri ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Indocyanine Green ◽  
Partial Nephrectomy ◽  
Robot Assisted

scholarly journals Successful Laparoscopic Resection of Gastric Lymphangioma Under the Intraoperative Guidance of Indocyanine Green Fluorescence Imaging: A Case Report

2020 ◽  
Author(s):  
Ryosuke Umino ◽  
Masayuki Urabe ◽  
Yu Ohkura ◽  
Akikazu Yago ◽  
Shusuke Haruta ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Fluorescence Imaging ◽  
Surgical Resection ◽  
Gastric Volume ◽  
Complete Resection ◽  
Pathological Examination ◽  
Abdominal Ultrasonography ◽  
Residual Gastric Volume ◽  
First Case ◽  
Intraoperative Guidance

Abstract Background: Gastric lymphangioma (GLA) is an extremely rare tumor without an established therapeutic strategy. Surgical resection is considered the mainstay of treatment, although there is a high risk of local recurrence if negative margins are not achieved. Thus, it would be useful to develop tools and strategies to achieve safe and complete resection. We describe our experience with the first case involving GLA resection under the intraoperative guidance of indocyanine green (ICG) fluorescence imaging, which allowed us to achieve limited but complete resection with negative margins.Case Presentation: A 51-year-old Japanese man with a history of alcoholic liver disease underwent routine abdominal ultrasonography, which incidentally detected a 20-mm tumor adjacent to the lesser curvature of the stomach. The mass was suspected to be GLA based on its polycystic appearance. After a 16-month monitoring period, the patient was referred to our hospital for further assessment because of tumor growth and involvement of the left gastric artery. We selected surgical resection to facilitate a pathological diagnosis and treatment of potential invasion to the surrounding organs. Intraoperative use of a ICG navigation system revealed lymphatic drainage from the tumor, which we used to help determine the optimal excision line and minimize the loss of gastric volume. Pathological examination confirmed complete resection with negative margins and supported a diagnosis of lymphangioma.Conclusions: We performed laparoscopic radical resection of GLA under guidance from intraoperative ICG fluorescence imaging, which allowed us to maximize residual gastric volume. Although further cases are needed to validate this strategy, it may be useful for guiding the resection of GLA.

scholarly journals Automatic 3D augmented reality robot assisted partial nephrectomy with indocyanine green guidance: a pilot study

2021 ◽  
Vol 32 ◽  
pp. S21
Author(s):  
F. Porpiglia ◽  
D. Amparore ◽  
F. Piramide ◽  
E. Checcucci ◽  
P. Verri ◽  
...  
Keyword(s):  
Pilot Study ◽  
Augmented Reality ◽  
Indocyanine Green ◽  
Partial Nephrectomy ◽  
Robot Assisted

scholarly journals Indocyanine Green Fluorescence in Surgical Practice – A Narrative Review of Clinical Applications

2017 ◽  
Vol 12 (2) ◽  
pp. 119-123
Author(s):  
Catalin ALIUS ◽  
◽  
Eugen-Sebastian GRADINARU ◽  
Adriana Elena NICA ◽  
◽  
...  
Keyword(s):  
Augmented Reality ◽  
Indocyanine Green ◽  
Clinical Applications ◽  
Intraoperative Cholangiography ◽  
Endocrine Surgery ◽  
Green Fluorescence ◽  
Surgical Practice ◽  
Indocyanine Green Fluorescence ◽  
Bowel Perfusion ◽  
Perfusion Assessment

The introduction in surgical practice of NIR fluorescent systems with their augmented reality enhanced the visual abilities of the surgeons who imagined over just a decade a myriad of uses for this emergent technology. We reviewed the clinical applications of Indocyanine Green from intraoperative cholangiography and SLN identification to bowel perfusion assessment, endocrine surgery and evaluation of Crohn’s disease and Barrett’s esophagus. The immense value of this new method of functional and anatomical assessment is unequivocal, but there are pitfalls and drawbacks of the commercially available systems. By presenting all these we hope to disseminate the importance and the potential of the technology and to promote the interest in usage and research in the field.

scholarly journals Augmented Reality-Assisted Spine Surgery: An Early Experience Demonstrating Safety and Accuracy with 218 Screws

2022 ◽  
pp. 219256822110693
Author(s):  
Fenil R. Bhatt ◽  
Lindsay D. Orosz ◽  
Anant Tewari ◽  
David Boyd ◽  
Rita Roy ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Spine Surgery ◽  
3D Imaging ◽  
Early Experience ◽  
Intraoperative 3D Imaging ◽  
Pelvic Fixation ◽  
Early Postoperative Complications ◽  
Novel Technology ◽  
Grading Scale

Study Design Prospective cohort study. Objectives In spine surgery, accurate screw guidance is critical to achieving satisfactory fixation. Augmented reality (AR) is a novel technology to assist in screw placement and has shown promising results in early studies. This study aims to provide our early experience evaluating safety and efficacy with an Food and Drug Administration-approved head-mounted (head-mounted device augmented reality (HMD-AR)) device. Methods Consecutive adult patients undergoing AR-assisted thoracolumbar fusion between October 2020 and August 2021 with 2 -week follow-up were included. Preoperative, intraoperative, and postoperative data were collected to include demographics, complications, revision surgeries, and AR performance. Intraoperative 3D imaging was used to assess screw accuracy using the Gertzbein-Robbins (G-R) grading scale. Results Thirty-two patients (40.6% male) were included with a total of 222 screws executed using HMD-AR. Intraoperatively, 4 (1.8%) were deemed misplaced and revised using AR or freehand. The remaining 218 (98.2%) screws were placed accurately. There were no intraoperative adverse events or complications, and AR was not abandoned in any case. Of the 208 AR-placed screws with 3D imaging confirmation, 97.1% were considered clinically accurate (91.8% Grade A, 5.3% Grade B). There were no early postoperative surgical complications or revision surgeries during the 2 -week follow-up. Conclusions This early experience study reports an overall G-R accuracy of 97.1% across 218 AR-guided screws with no intra or early postoperative complications. This shows that HMD-AR-assisted spine surgery is a safe and accurate tool for pedicle, cortical, and pelvic fixation. Larger studies are needed to continue to support this compelling evolution in spine surgery.

scholarly journals A State Validation System for Augmented Reality Based Maintenance Procedures

2019 ◽  
Vol 9 (10) ◽  
pp. 2115 ◽  
Author(s):  
Federico Manuri ◽  
Alessandro Pizzigalli ◽  
Andrea Sanna
Keyword(s):  
Augmented Reality ◽  
Automated Verification ◽  
The Novel ◽  
Novel Technology ◽  
Verification Tool ◽  
Vision Algorithm ◽  
Audio Computer ◽  
Elementary Action ◽  
Maintenance Process ◽  
To Receive

Maintenance has been one of the most important domains for augmented reality (AR) since its inception. AR applications enable technicians to receive visual and audio computer-generated aids while performing different activities, such as assembling, repairing, or maintenance procedures. These procedures are usually organized as a sequence of steps, each one involving an elementary action to be performed by the user. However, since it is not possible to automatically validate the users actions, they might incorrectly execute or miss some steps. Thus, a relevant open problem is to provide users with some sort of automated verification tool. This paper presents a system, used to support maintenance procedures through AR, which tries to address the validation problem. The novel technology consists of a computer vision algorithm able to evaluate, at each step of a maintenance procedure, if the user correctly completed the assigned task or not. The validation occurs by comparing an image of the final status of the machinery, after the user has performed the task, and a virtual 3D representation of the expected final status. Moreover, in order to avoid false positives, the system can identify both motions in the scene and changes in the camera’s zoom and/or position, thus enhancing the robustness of the validation phase. Tests demonstrate that the proposed system can effectively help the user in detecting and avoiding errors during the maintenance process.

Mini-Pterional Craniotomy and Extradural Clinoidectomy for Clinoid Meningioma: Optimization of Exposure Using Augmented Reality Template: 2-Dimensional Operative Video

2020 ◽  
Author(s):  
Walter C Jean
Keyword(s):  
Augmented Reality ◽  
Paradigm Shift ◽  
Patient Specific ◽  
Pterional Approach ◽  
3 Dimensional ◽  
Novel Technology ◽  
Patient Consent ◽  
Keyhole Approach ◽  
Base Lesion ◽  
Daunting Challenge

Abstract A “keyhole” approach to a deep-lying skull base lesion, as such a clinoid meningioma, can be a daunting challenge.1-3 The minimally invasive exposure must be precisely placed and adequately wide to accomplish the surgical goal. Surgical rehearsal in virtual reality (VR) can not only increase the confidence of the surgeon through practice on patient-specific anatomy,4 but it can also generate navigation-integrated templates to ensure precise placement and adequate bone openings. In this operative video, we demonstrate the use of an augmented reality (AR) template in a 69-yr-old woman with a growing clinoid meningioma. The 3-dimensional, VR rendering (SNAP VR360, Surgical Theater Inc, Cleveland, Ohio) of her right clinoid meningioma was used in surgical rehearsal for the mini-pterional approach with extradural clinoidectomy. The optimal opening was saved as a VR file and, at surgery, projected into the eye-piece of the navigation-tracked microscope (Synchronized AR v3.8.0, Surgical Theater Inc). In this manner, the surgical opening in the template was visible in AR on the patient's anatomy in real time during surgery. The template enhanced the planning of the incision and soft-tissue exposure, guided the drilling of the sphenoid wing, facilitated the extradural clinoidectomy,5 and ultimately facilitated the accomplishment of the surgical goal of total resection of the meningioma. With this application of novel technology, the surgeon is no longer using navigation to get her/his bearings. Instead, the surgeon is using AR-enhanced navigation to duplicate a plan that is known to work. This is a fundamental paradigm shift.  Patient consent was obtained prior to the creation of the video and is available on request.

Sign in / Sign up

Export Citation Format

Share Document