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.

scholarly journals Computer-Assisted Resection and Reconstruction of Pelvic Tumor Sarcoma

Sarcoma ◽  
2010 ◽  
Vol 2010 ◽  
pp. 1-8 ◽  
Author(s):  
Pierre-Louis Docquier ◽  
Laurent Paul ◽  
Olivier Cartiaux ◽  
Christian Delloye ◽  
Xavier Banse
Keyword(s):  
Surgical Navigation ◽  
Tumor Resection ◽  
Surgical Margin ◽  
Surgical Oncology ◽  
Tumor Location ◽  
Resection Margins ◽  
Computer Assisted ◽  
Navigation Systems ◽  
First Case ◽  
Saw Blade

Pelvic sarcoma is associated with a relatively poor prognosis, due to the difficulty in obtaining an adequate surgical margin given the complex pelvic anatomy. Magnetic resonance imaging and computerized tomography allow valuable surgical resection planning, but intraoperative localization remains hazardous. Surgical navigation systems could be of great benefit in surgical oncology, especially in difficult tumor location; however, no commercial surgical oncology software is currently available. A customized navigation software was developed and used to perform a synovial sarcoma resection and allograft reconstruction. The software permitted preoperative planning with defined target planes and intraoperative navigation with a free-hand saw blade. The allograft was cut according to the same planes. Histological examination revealed tumor-free resection margins. Allograft fitting to the pelvis of the patient was excellent and allowed stable osteosynthesis. We believe this to be the first case of combined computer-assisted tumor resection and reconstruction with an allograft.

Biomedical Information Processing and Visualization for Minimally Invasive Neurosurgery

2012 ◽  
pp. 36-46
Author(s):  
Hongen Liao
Keyword(s):  
Information Processing ◽  
Minimally Invasive ◽  
Medical Information ◽  
Surgical Navigation ◽  
Tumor Resection ◽  
Three Dimensional ◽  
Navigation Systems ◽  
Minimally Invasive Neurosurgery ◽  
Invasive Treatment ◽  
Magnetic Resonance Imaging Mri

This chapter demonstrates a particular application of biomedical information processing and visualization techniques for minimally invasive diagnosis and therapy in neurosurgery. Computer-assisted surgical navigation provides surgeons valuable information on the precision location of surgical targets and critical areas, as well as the positions of surgical instruments. However, most navigation systems use pre-/intra-operative images, which are displayed on a two-dimensional (2D) display situated away from the surgical field. These setups force the surgeon to take extra steps to match navigation information on the display with the actual surgical target of the patient. Two typical medical information-based navigation systems for neurosurgery are described in this chapter. First, an integration system with fluorescence-based intra-operative diagnosis and laser ablation-based, high-precision, minimally invasive treatment is introduced. Second, an autostereoscopic image-guided surgical system developed for minimally invasive neurosurgery is discussed. The autostereoscopic image and corresponding augmented reality with three-dimensional (3D) image overlay have been used in open magnetic resonance imaging (MRI)-guided neurosurgery. These techniques enable intra-operative visualization of surgical targets for precision tumor resection.

scholarly journals Three-dimensional–printed marker–based augmented reality neuronavigation: a new neuronavigation technique

2021 ◽  
Vol 51 (2) ◽  
pp. E20
Author(s):  
Gorkem Yavas ◽  
Kadri Emre Caliskan ◽  
Mehmet Sedat Cagli
Keyword(s):  
Augmented Reality ◽  
Mobile Device ◽  
Low Cost ◽  
Three Dimensional ◽  
Skin Incision ◽  
Optical Tracking ◽  
Patient Specific ◽  
Navigation Systems ◽  
Intracranial Tumors ◽  
3D Printed

OBJECTIVE The aim of this study was to assess the precision and feasibility of 3D-printed marker–based augmented reality (AR) neurosurgical navigation and its use intraoperatively compared with optical tracking neuronavigation systems (OTNSs). METHODS Three-dimensional–printed markers for CT and MRI and intraoperative use were applied with mobile devices using an AR light detection and ranging (LIDAR) camera. The 3D segmentations of intracranial tumors were created with CT and MR images, and preoperative registration of the marker and pathology was performed. A patient-specific, surgeon-facilitated mobile application was developed, and a mobile device camera was used for neuronavigation with high accuracy, ease, and cost-effectiveness. After accuracy values were preliminarily assessed, this technique was used intraoperatively in 8 patients. RESULTS The mobile device LIDAR camera was found to successfully overlay images of virtual tumor segmentations according to the position of a 3D-printed marker. The targeting error that was measured ranged from 0.5 to 3.5 mm (mean 1.70 ± 1.02 mm, median 1.58 mm). The mean preoperative preparation time was 35.7 ± 5.56 minutes, which is longer than that for routine OTNSs, but the amount of time required for preoperative registration and the placement of the intraoperative marker was very brief compared with other neurosurgical navigation systems (mean 1.02 ± 0.3 minutes). CONCLUSIONS The 3D-printed marker–based AR neuronavigation system was a clinically feasible, highly precise, low-cost, and easy-to-use navigation technique. Three-dimensional segmentation of intracranial tumors was targeted on the brain and was clearly visualized from the skin incision to the end of surgery.

scholarly journals Augmented reality in the operating room: a clinical feasibility study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Cyrill Dennler ◽  
David E. Bauer ◽  
Anne-Gita Scheibler ◽  
José Spirig ◽  
Tobias Götschi ◽  
...  
Keyword(s):  
Image Quality ◽  
Augmented Reality ◽  
Orthopedic Surgery ◽  
Low Cost ◽  
Three Dimensional ◽  
Patient Specific ◽  
Navigation Systems ◽  
Novel Technology ◽  
Orthopedic Surgeons ◽  
Orthopedic Surgical Procedures

Abstract Background Augmented Reality (AR) is a rapidly emerging technology finding growing acceptance and application in different fields of surgery. Various studies have been performed evaluating the precision and accuracy of AR guided navigation. This study investigates the feasibility of a commercially available AR head mounted device during orthopedic surgery. Methods Thirteen orthopedic surgeons from a Swiss university clinic performed 25 orthopedic surgical procedures wearing a holographic AR headset (HoloLens, Microsoft, Redmond, WA, USA) providing complementary three-dimensional, patient specific anatomic information. The surgeon’s experience of using the device during surgery was recorded using a standardized 58-item questionnaire grading different aspects on a 100-point scale with anchor statements. Results Surgeons were generally satisfied with image quality (85 ± 17 points) and accuracy of the virtual objects (84 ± 19 point). Wearing the AR device was rated as fairly comfortable (79 ± 13 points). Functionality of voice commands (68 ± 20 points) and gestures (66 ± 20 points) provided less favorable results. The greatest potential in the use of the AR device was found for surgical correction of deformities (87 ± 15 points). Overall, surgeons were satisfied with the application of this novel technology (78 ± 20 points) and future access to it was demanded (75 ± 22 points). Conclusion AR is a rapidly evolving technology with large potential in different surgical settings, offering the opportunity to provide a compact, low cost alternative requiring a minimum of infrastructure compared to conventional navigation systems. While surgeons where generally satisfied with image quality of the here tested head mounted AR device, some technical and ergonomic shortcomings were pointed out. This study serves as a proof of concept for the use of an AR head mounted device in a real-world sterile setting in orthopedic surgery.

scholarly journals Combining Augmented Reality and 3D Printing to Improve Surgical Workflows in Orthopedic Oncology: Smartphone Application and Clinical Evaluation

Sensors ◽  
2021 ◽  
Vol 21 (4) ◽  
pp. 1370
Author(s):  
Rafael Moreta-Martinez ◽  
Alicia Pose-Díez-de-la-Lastra ◽  
José Antonio Calvo-Haro ◽  
Lydia Mediavilla-Santos ◽  
Rubén Pérez-Mañanes ◽  
...  
Keyword(s):  
Augmented Reality ◽  
3D Printing ◽  
Surgical Navigation ◽  
Three Dimensional ◽  
Smartphone Application ◽  
Navigation Systems ◽  
Surgical Workflow ◽  
Orthopedic Oncology ◽  
Innovative Solution ◽  
3D Printed

During the last decade, orthopedic oncology has experienced the benefits of computerized medical imaging to reduce human dependency, improving accuracy and clinical outcomes. However, traditional surgical navigation systems do not always adapt properly to this kind of interventions. Augmented reality (AR) and three-dimensional (3D) printing are technologies lately introduced in the surgical environment with promising results. Here we present an innovative solution combining 3D printing and AR in orthopedic oncological surgery. A new surgical workflow is proposed, including 3D printed models and a novel AR-based smartphone application (app). This app can display the patient’s anatomy and the tumor’s location. A 3D-printed reference marker, designed to fit in a unique position of the affected bone tissue, enables automatic registration. The system has been evaluated in terms of visualization accuracy and usability during the whole surgical workflow. Experiments on six realistic phantoms provided a visualization error below 3 mm. The AR system was tested in two clinical cases during surgical planning, patient communication, and surgical intervention. These results and the positive feedback obtained from surgeons and patients suggest that the combination of AR and 3D printing can improve efficacy, accuracy, and patients’ experience.

scholarly journals The Accuracy of Three-Dimensional Planned Bone Tumor Resection Using Patient-Specific Instrument

2020 ◽  
Vol Volume 12 ◽  
pp. 6533-6540
Author(s):  
Daniel A Müller ◽  
Yannik Stutz ◽  
Lazaros Vlachopoulos ◽  
Mazda Farshad ◽  
Philipp Fürnstahl
Keyword(s):  
Bone Tumor ◽  
Tumor Resection ◽  
Three Dimensional ◽  
Patient Specific ◽  
Specific Instrument ◽  
Bone Tumor Resection

scholarly journals Pelvic Reconstruction With a Novel Three-Dimensional-Printed, Multimodality Imaging Based Endoprosthesis Following Enneking Type I + IV Resection

2021 ◽  
Vol 11 ◽  
Author(s):  
Zeping Yu ◽  
Wenli Zhang ◽  
Xiang Fang ◽  
Chongqi Tu ◽  
Hong Duan
Keyword(s):  
Multimodality Imaging ◽  
Three Dimensional ◽  
Patient Specific ◽  
Surgical Trauma ◽  
Type I ◽  
Complication Rates ◽  
Pelvic Tumor ◽  
Musculoskeletal Tumor Society ◽  
Rod System ◽  
3D Printed

Background and PurposePelvic tumor involving Type I + IV resections are technically challenging, along with various reconstructions methods presenting unsatisfactory outcomes and high complication rates. Since predominating studies preferred adopting pedicle screw-rod system (PRSS) to address this issue, we designed a novel three-dimensional-printed, multimodality imaging (3DMMI) based endoprosthesis with patient-specific instrument (PSI) assistance to facilitate the surgical reconstruction of pelvic tumor involving Enneking Type I + IV resection. We aimed to investigate the clinical effectiveness of this novel endoprosthesis and compare it with PRSS in Type I + IV reconstruction.MethodsWe retrospective studied 28 patients for a median follow-up of 47 months (range, 10 to 128 months) in this study with either 3D-printed endoprosthesis reconstruction (n = 10) or PRSS reconstruction (n = 18) between January 2000 and December 2017. Preoperative 3DMMI technique was used for tumor evaluation, PSI design, virtual surgery, and endoprosthesis fabrication. Clinical, oncological outcomes, functional assessments, and complications were analyzed between the two groups.ResultsMinor surgical trauma with mean operative duration of 251 ± 52.16 minutes (p = 0.034) and median intraoperative hemorrhage of 2000ml (range, 1600, 4000ml) (p = 0.032) was observed in endoprosthesis group. Wide margins were achieved in 9 patients of the endoprosthesis group compared with 10 in the PRSS group (p = 0.09). The 1993 version of the Musculoskeletal Tumor Society score (MSTS-93) was 23.9 ± 3.76 in endoprosthesis group, which was higher than PRSS group (p = 0.012). No statistical significance was found in relapse between two groups (p = 0.36). Complications were observed in two patients in endoprosthesis group compared with 12 patients in PRSS group (p = 0.046).ConclusionThe novel design of this 3D-printed endoprosthesis, together with 3DMMI and PSI assisted, is technically accessible with favorable clinical outcomes compared with PRSS. Further study is essential to identify its long-term outcomes.

scholarly journals A workflow to generate patient-specific three-dimensional augmented reality models from medical imaging data and example applications in urologic oncology

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Nicole Wake ◽  
Andrew B. Rosenkrantz ◽  
William C. Huang ◽  
James S. Wysock ◽  
Samir S. Taneja ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Patient Care ◽  
Three Dimensional ◽  
3D Models ◽  
Patient Specific ◽  
Imaging Data ◽  
Urologic Oncology ◽  
Case Examples ◽  
Microsoft Hololens ◽  
Enhance Patient Care

AbstractAugmented reality (AR) and virtual reality (VR) are burgeoning technologies that have the potential to greatly enhance patient care. Visualizing patient-specific three-dimensional (3D) imaging data in these enhanced virtual environments may improve surgeons’ understanding of anatomy and surgical pathology, thereby allowing for improved surgical planning, superior intra-operative guidance, and ultimately improved patient care. It is important that radiologists are familiar with these technologies, especially since the number of institutions utilizing VR and AR is increasing. This article gives an overview of AR and VR and describes the workflow required to create anatomical 3D models for use in AR using the Microsoft HoloLens device. Case examples in urologic oncology (prostate cancer and renal cancer) are provided which depict how AR has been used to guide surgery at our institution.

Augmented Reality for Retrosigmoid Craniotomy Planning

2021 ◽  
Author(s):  
Caio A. Neves ◽  
Christoph Leuze ◽  
Alejandro M. Gomez ◽  
Nassir Navab ◽  
Nikolas Blevins ◽  
...  
Keyword(s):  
Medical Imaging ◽  
Augmented Reality ◽  
Surgical Navigation ◽  
Internal Auditory Canal ◽  
Navigation Systems ◽  
Imaging Data ◽  
Dural Sinuses ◽  
Bone Removal ◽  
Surgical Navigation Systems ◽  
Medical Imaging Data

AbstractWhile medical imaging data have traditionally been viewed on two-dimensional (2D) displays, augmented reality (AR) allows physicians to project the medical imaging data on patient's bodies to locate important anatomy. We present a surgical AR application to plan the retrosigmoid craniotomy, a standard approach to access the posterior fossa and the internal auditory canal. As a simple and accurate alternative to surface landmarks and conventional surgical navigation systems, our AR application augments the surgeon's vision to guide the optimal location of cortical bone removal. In this work, two surgeons performed a retrosigmoid approach 14 times on eight cadaver heads. In each case, the surgeon manually aligned a computed tomography (CT)-derived virtual rendering of the sigmoid sinus on the real cadaveric heads using a see-through AR display, allowing the surgeon to plan and perform the craniotomy accordingly. Postprocedure CT scans were acquired to assess the accuracy of the retrosigmoid craniotomies with respect to their intended location relative to the dural sinuses. The two surgeons had a mean margin of davg = 0.6 ± 4.7 mm and davg = 3.7 ± 2.3 mm between the osteotomy border and the dural sinuses over all their cases, respectively, and only positive margins for 12 of the 14 cases. The intended surgical approach to the internal auditory canal was successfully achieved in all cases using the proposed method, and the relatively small and consistent margins suggest that our system has the potential to be a valuable tool to facilitate planning a variety of similar skull-base procedures.

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