scholarly journals Patient-specific virtual reality technology for complex neurosurgical cases: illustrative cases

2021 ◽  
Vol 1 (23) ◽  
Author(s):  
Diana Anthony ◽  
Robert G. Louis ◽  
Yevgenia Shekhtman ◽  
Thomas Steineke ◽  
Anthony Frempong-Boadu ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Preoperative Planning ◽  
Surgical Navigation ◽  
Three Dimensional ◽  
Giant Aneurysm ◽  
Preoperative Imaging ◽  
Patient Specific ◽  
3D Navigation ◽  
Neurosurgical Treatment ◽  
3D Anatomy

BACKGROUND Virtual reality (VR) offers an interactive environment for visualizing the intimate three-dimensional (3D) relationship between a patient’s pathology and surrounding anatomy. The authors present a model for using personalized VR technology, applied across the neurosurgical treatment continuum from the initial consultation to preoperative surgical planning, then to intraoperative navigation, and finally to postoperative visits, for various tumor and vascular pathologies. OBSERVATIONS Five adult patients undergoing procedures for spinal cord cavernoma, clinoidal meningioma, anaplastic oligodendroglioma, giant aneurysm, and arteriovenous malformation were included. For each case, 360-degree VR (360°VR) environments developed using Surgical Theater were used for patient consultation, preoperative planning, and/or intraoperative 3D navigation. The custom 360°VR model was rendered from the patient’s preoperative imaging. For two cases, the plan changed after reviewing the patient’s 360°VR model from one based on conventional Digital Imaging and Communications in Medicine imaging. LESSONS Live 360° visualization with Surgical Theater in conjunction with surgical navigation helped validate the decisions made intraoperatively. The 360°VR models provided visualization to better understand the lesion’s 3D anatomy, as well as to plan and execute the safest patient-specific approach, rather than a less detailed, more standardized one. In all cases, preoperative planning using the patient’s 360°VR model had a significant impact on the surgical approach.

scholarly journals Immersive 3D virtual reality imaging in planning minimally invasive and complex adult cardiac surgery

2020 ◽  
Vol 1 (1) ◽  
pp. 62-70
Author(s):  
Amir H Sadeghi ◽  
Wouter Bakhuis ◽  
Frank Van Schaagen ◽  
Frans B S Oei ◽  
Jos A Bekkers ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Virtual Reality ◽  
Cardiac Surgery ◽  
Heart Surgery ◽  
Preoperative Planning ◽  
Operating Time ◽  
Three Dimensional ◽  
Cardiothoracic Surgery ◽  
Planning Tool ◽  
Computed Tomography Images

Abstract Aims Increased complexity in cardiac surgery over the last decades necessitates more precise preoperative planning to minimize operating time, to limit the risk of complications during surgery and to aim for the best possible patient outcome. Novel, more realistic, and more immersive techniques, such as three-dimensional (3D) virtual reality (VR) could potentially contribute to the preoperative planning phase. This study shows our initial experience on the implementation of immersive VR technology as a complementary research-based imaging tool for preoperative planning in cardiothoracic surgery. In addition, essentials to set up and implement a VR platform are described. Methods Six patients who underwent cardiac surgery at the Erasmus Medical Center, Rotterdam, The Netherlands, between March 2020 and August 2020, were included, based on request by the surgeon and availability of computed tomography images. After 3D VR rendering and 3D segmentation of specific structures, the reconstruction was analysed via a head mount display. All participating surgeons (n = 5) filled out a questionnaire to evaluate the use of VR as preoperative planning tool for surgery. Conclusion Our study demonstrates that immersive 3D VR visualization of anatomy might be beneficial as a supplementary preoperative planning tool for cardiothoracic surgery, and further research on this topic may be considered to implement this innovative tool in daily clinical practice. Lay summary Over the past decades, surgery on the heart and vessels is becoming more and more complex, necessitating more precise and accurate preoperative planning. Nowadays, operative planning is feasible on flat, two-dimensional computer screens, however, requiring a lot of spatial and three-dimensional (3D) thinking of the surgeon. Since immersive 3D virtual reality (VR) is an upcoming imaging technique with promising results in other fields of surgery, we aimed in this study to explore the additional value of this technique in heart surgery. Our surgeons planned six different heart operations by visualizing computed tomography scans with a dedicated VR headset, enabling them to visualize the patient’s anatomy in an immersive and 3D environment. The outcomes of this preliminary study are positive, with a much more reality-like simulation for the surgeon. In such, VR could potentially be beneficial as a preoperative planning tool for complex heart surgery.

scholarly journals Computer-Assisted Planning and Three-Dimensional-Printed Patient-Specific Instrumental Guide for Corrective Osteotomy in Post-Traumatic Femur Deformity: A Case Report and Literature Review

2018 ◽  
Vol 24 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Lau Chi-Kay ◽  
Chui King-him ◽  
Lee Kin-bong ◽  
Li Wilson
Keyword(s):  
Lower Limb ◽  
New Technologies ◽  
Preoperative Planning ◽  
Corrective Osteotomy ◽  
Three Dimensional ◽  
Patient Specific ◽  
Computer Assisted ◽  
Limb Deformity ◽  
Satisfactory Outcome ◽  
Post Traumatic

Post-traumatic limb deformity is often multiplanar and thus is a difficult pathology to deal with surgically. Precise preoperative planning and accurate intraoperative execution are two main important steps that lead to satisfactory outcome. Computer-assisted planning and three-dimensional-printed patient-specific instrumental guides provide excellent aid to the two steps, respectively. We report a case of posttraumatic lower limb deformity in a patient who underwent closing wedge corrective osteotomy with the aid of the aforementioned new technologies.

scholarly journals A Virtual Reality System for Improved Image-based Planning of Complex Cardiac Procedures

2021 ◽  
Author(s):  
Shujie Deng ◽  
Gavin Wheeler ◽  
Nicolas Toussaint ◽  
Lindsay Munroe ◽  
Suryava Bhattacharya ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Virtual Reality ◽  
Heart Disease ◽  
Congenital Heart ◽  
Three Dimensional ◽  
Patient Specific ◽  
Two Dimensional ◽  
Virtual Reality System ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography

The intricate nature of congenital heart disease requires understanding of complex, patient-specific three-dimensional dynamic anatomy of the heart, from imaging data such as three-dimensional echocardiography for successful outcomes from surgical and interventional procedures. Conventional clinical systems use flat screens and therefore display remains two-dimensional, which undermines the full understanding of the three-dimensional dynamic data. Additionally, control of three-dimensional visualisation with two-dimensional tools is often difficult, so used only by imaging specialists. In this paper we describe a virtual reality system for immersive surgery planning using dynamic three-dimensional echocardiography, which enables fast prototyping for visualisation such as volume rendering, multi-planar reformatting, flow visualisation, and advanced interaction such as three-dimensional cropping, windowing, measurement, haptic feedback, automatic image orientation, and multi-user interactions. The available features were evaluated by imaging and non-imaging clinicians, showing that the virtual reality system can help improve understanding and communication of the three-dimensional echocardiography imaging and potentially benefit congenital heart disease treatment.

scholarly journals Efficacy of a virtual reality–based basic and clinical fused curriculum for clinical education on the lumbar intervertebral disc

2021 ◽  
Vol 51 (2) ◽  
pp. E17
Author(s):  
Fangfang Qi ◽  
Yixiang Gan ◽  
Shengwen Wang ◽  
Yizhe Tie ◽  
Jiewen Chen ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Clinical Education ◽  
Structural Changes ◽  
Lumbar Disc ◽  
Three Dimensional ◽  
Patient Specific ◽  
Traditional Teaching ◽  
Traditional Group ◽  
Lumbar Intervertebral Disc ◽  
Surgical Preparation

OBJECTIVE Today, minimally invasive procedures have become mainstream surgical procedures. Percutaneous endoscopic transforaminal discectomy for lumbar disc herniation (LDH) requires profound knowledge of the laparoscopic lumbar anatomy. Immersive virtual reality (VR) provides three-dimensional patient-specific models to help in the process of preclinical surgical preparation. In this study, the authors investigated the efficacy of VR application in LDH for training orthopedic residents and postgraduates. METHODS VR images of the lumbar anatomy were created with immersive VR and mAnatomy software. The study was conducted among 60 residents and postgraduates. A questionnaire was developed to assess the effect of and satisfaction with this VR-based basic and clinical fused curriculum. The teaching effect was also evaluated through a postlecture test, and the results of the prelecture surgical examination were taken as baselines. RESULTS All participants in the VR group agreed that VR-based education is practical, attractive, and easy to operate, compared to traditional teaching, and promotes better understanding of the anatomical structures involved in LDH. Learners in the VR group achieved higher scores on an anatomical and clinical fusion test than learners in the traditional group (84.67 ± 14.56 vs 76.00 ± 16.10, p < 0.05). CONCLUSIONS An immersive VR-based basic and clinical fused curriculum can increase residents’ and postgraduates’ interest and support them in mastering the structural changes and complicated symptoms of LDH. However, a simplified operational process and more realistic haptics of the VR system are necessary for further surgical preparation and application.

Use of a Three-Dimensional Virtual Reality Model for Preoperative Imaging in DIEP Flap Breast Reconstruction

2010 ◽  
Vol 162 (1) ◽  
pp. 140-147 ◽  
Author(s):  
Purificación Gacto-Sánchez ◽  
Domingo Sicilia-Castro ◽  
Tomás Gómez-Cía ◽  
Araceli Lagares ◽  
Teresa Collell ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Breast Reconstruction ◽  
Three Dimensional ◽  
Preoperative Imaging ◽  
Diep Flap ◽  
Virtual Reality Model

scholarly journals Three dimensional printed models of the airway for preoperative planning of open Laryngotracheal surgery in children: Surgeon’s perception of utility

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Oshri Wasserzug ◽  
Gadi Fishman ◽  
Narin Carmel-Neiderman ◽  
Yael Oestreicher-Kedem ◽  
Maher Saada ◽  
...  
Keyword(s):  
Surgical Approach ◽  
Preoperative Planning ◽  
Three Dimensional ◽  
Patient Specific ◽  
Upper Airways ◽  
Pediatric Airway ◽  
Incision Location ◽  
Laryngotracheal Reconstruction ◽  
Dimensional Models ◽  
Three Dimensional Models

Abstract Background Preoperative planning of open laryngotracheal surgery is important for achieving good results. This study examines the surgeon’s perception of the importance of using life size 3D printed models of the pediatric airway on surgical decision making. Methods Life-size three-dimensional models of the upper airway were created based on CT images of children scheduled for laryngotracheal-reconstruction and cricotracheal resection with anastomosis. Five pediatric airway surgeons evaluated the three-dimensional models for determining the surgical approach, incision location and length, graft length, and need for single or double-stage surgery of seven children (median age 4.4 years, M:F ratio 4:3). They rated the importance of the three-dimensional model findings compared to the direct laryngoscopy videos and CT findings for each domain on a validated Likert scale of 1–5. Results The mean rating for all domains was 3.6 ± 0.63 (“moderately important” to “very important”), and the median rating was 4 (“very important”). There was full agreement between raters for length of incision and length of graft. The between-rater agreement was 0.608 (“good”) for surgical approach, 0.585 (“moderate”) for incision location, and 0.429 (“moderate”) for need for single- or two-stage surgery. Conclusion Patient-specific three-dimensional printed models of children’s upper airways were scored by pediatric airway surgeons as being moderately to very important for preoperative planning of open laryngotracheal surgery. Large–scale, objective outcome studies are warranted to establish the reliability and efficiency of these models. Graphical abstract

scholarly journals Augmented Reality as a Tool to Guide PSI Placement in Pelvic Tumor Resections

Sensors ◽  
2021 ◽  
Vol 21 (23) ◽  
pp. 7824
Author(s):  
Mónica García-Sevilla ◽  
Rafael Moreta-Martinez ◽  
David García-Mato ◽  
Alicia Pose-Diez-de-la-Lastra ◽  
Rubén Pérez-Mañanes ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Surgical Navigation ◽  
Tumor Resection ◽  
Three Dimensional ◽  
Target Surface ◽  
Patient Specific ◽  
Resection Margins ◽  
Navigation Systems ◽  
Pelvic Tumor ◽  
Similar Accuracy

Patient-specific instruments (PSIs) have become a valuable tool for osteotomy guidance in complex surgical scenarios such as pelvic tumor resection. They provide similar accuracy to surgical navigation systems but are generally more convenient and faster. However, their correct placement can become challenging in some anatomical regions, and it cannot be verified objectively during the intervention. Incorrect installations can result in high deviations from the planned osteotomy, increasing the risk of positive resection margins. In this work, we propose to use augmented reality (AR) to guide and verify PSIs placement. We designed an experiment to assess the accuracy provided by the system using a smartphone and the HoloLens 2 and compared the results with the conventional freehand method. The results showed significant differences, where AR guidance prevented high osteotomy deviations, reducing maximal deviation of 54.03 mm for freehand placements to less than 5 mm with AR guidance. The experiment was performed in two versions of a plastic three-dimensional (3D) printed phantom, one including a silicone layer to simulate tissue, providing more realism. We also studied how differences in shape and location of PSIs affect their accuracy, concluding that those with smaller sizes and a homogeneous target surface are more prone to errors. Our study presents promising results that prove AR’s potential to overcome the present limitations of PSIs conveniently and effectively.

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