Are augmented reality headsets in surgery a dead end?

Ferrari, Vincenzo; Carbone, Marina; Condino, Sara; Cutolo, Fabrizio

doi:10.1080/17434440.2019.1693891

Cited by 26 publications

(19 citation statements)

References 15 publications

(15 reference statements)

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“…Augmented reality (AR) in surgery has enormous potentialities to help the surgeon in identifying tumor locations, delineating the planned dissection planes, and reducing the risk of injury to invisible structures [36][37][38]. Among possible AR display types, HMDs are emerging as the most efficient and promising medium to support complex manual surgical tasks typically performed under direct vision [36,39], since they allow the surgeon to maintain a "surgeon-centered' point of view and to leave his/her hands free to operate on the patient.…”

Section: Discussionmentioning

confidence: 99%

The Wearable VOSTARS System for Augmented Reality-Guided Surgery: Preclinical Phantom Evaluation for High-Precision Maxillofacial Tasks

Cercenelli

Carbone

Condino

et al. 2020

JCM

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Background: In the context of guided surgery, augmented reality (AR) represents a groundbreaking improvement. The Video and Optical See-Through Augmented Reality Surgical System (VOSTARS) is a new AR wearable head-mounted display (HMD), recently developed as an advanced navigation tool for maxillofacial and plastic surgery and other non-endoscopic surgeries. In this study, we report results of phantom tests with VOSTARS aimed to evaluate its feasibility and accuracy in performing maxillofacial surgical tasks. Methods: An early prototype of VOSTARS was used. Le Fort 1 osteotomy was selected as the experimental task to be performed under VOSTARS guidance. A dedicated set-up was prepared, including the design of a maxillofacial phantom, an ad hoc tracker anchored to the occlusal splint, and cutting templates for accuracy assessment. Both qualitative and quantitative assessments were carried out. Results: VOSTARS, used in combination with the designed maxilla tracker, showed excellent tracking robustness under operating room lighting. Accuracy tests showed that 100% of Le Fort 1 trajectories were traced with an accuracy of ±1.0 mm, and on average, 88% of the trajectory’s length was within ±0.5 mm accuracy. Conclusions: Our preliminary results suggest that the VOSTARS system can be a feasible and accurate solution for guiding maxillofacial surgical tasks, paving the way to its validation in clinical trials and for a wide spectrum of maxillofacial applications.

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Section: Discussionmentioning

confidence: 99%

The Wearable VOSTARS System for Augmented Reality-Guided Surgery: Preclinical Phantom Evaluation for High-Precision Maxillofacial Tasks

Cercenelli

Carbone

Condino

et al. 2020

JCM

Self Cite

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“…Particularly interesting are recently developed off-the shelf optical see-through head-mounted displays (OST-HMD). Their feasibility as a surgical navigation device has not been fully explored yet and is still under discussion [44,45]. Although preliminary studies showed promising results in various orthopedic interventions, for example, pedicle screw placement [46,47], percutaneous procedures [48][49][50] and hip resurfacing [51], OST-HMD may still suffer from a poor navigation accuracy dependent on the approach taken [44].…”

Section: Introductionmentioning

confidence: 99%

“…Their feasibility as a surgical navigation device has not been fully explored yet and is still under discussion [44,45]. Although preliminary studies showed promising results in various orthopedic interventions, for example, pedicle screw placement [46,47], percutaneous procedures [48][49][50] and hip resurfacing [51], OST-HMD may still suffer from a poor navigation accuracy dependent on the approach taken [44]. In order to render AR content correctly in space, OST-HMD need to know their pose w.r.t.…”

Section: Introductionmentioning

confidence: 99%

Augmented Reality Based Surgical Navigation of Complex Pelvic Osteotomies—A Feasibility Study on Cadavers

et al. 2021

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Augmented reality (AR)-based surgical navigation may offer new possibilities for safe and accurate surgical execution of complex osteotomies. In this study we investigated the feasibility of navigating the periacetabular osteotomy of Ganz (PAO), known as one of the most complex orthopedic interventions, on two cadaveric pelves under realistic operating room conditions. Preoperative planning was conducted on computed tomography (CT)-reconstructed 3D models using an in-house developed software, which allowed creating cutting plane objects for planning of the osteotomies and reorientation of the acetabular fragment. An AR application was developed comprising point-based registration, motion compensation and guidance for osteotomies as well as fragment reorientation. Navigation accuracy was evaluated on CT-reconstructed 3D models, resulting in an error of 10.8 mm for osteotomy starting points and 5.4° for osteotomy directions. The reorientation errors were 6.7°, 7.0° and 0.9° for the x-, y- and z-axis, respectively. Average postoperative error of LCE angle was 4.5°. Our study demonstrated that the AR-based execution of complex osteotomies is feasible. Fragment realignment navigation needs further improvement, although it is more accurate than the state of the art in PAO surgery.

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“…1e-f). This is imperative, since the user's view of the operating room is not blocked or dependent on device power [5]. Experiments compared outcomes based on image resolution and level of technical skill/experience.…”

Section: Discussionmentioning

confidence: 99%

Study on augmented reality for robotic surgery bedside assistants

et al. 2021

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Robotic surgery bedside assistants play an important role in robotic procedures by performing intra-corporeal tasks while accommodating the physical presence of the robot. We hypothesized that an augmented reality headset enabling 3D intracorporeal vision while facing the surgical field could decrease time and improve accuracy of robotic bedside tasks. Bedside assistants (one physician assistant, one medical student, three surgical trainees, and two attending surgeons) performed validated tasks within a mock abdominal cavity with a surgical robot docked. Tasks were performed with a bedside monitor providing 2D or 3D vision, or an optical see-through head-mounted augmented reality device with 2D or 3D vision. The effect of augmented reality device resolution on performance was also evaluated. For the simplest task of touching a straw, performance was generally high, regardless of mode of visualization. With more complex tasks, including stapling and pulling a ring along a path, 3D augmented reality decreased time and number of errors per task. 3D augmented reality allowed the physician assistant to perform at the level of an attending surgeon using 3D augmented reality (p = 0.08). All participants had improved times for the ring path task with better resolution (lower resolution 23 ± 11 s vs higher resolution 14 ± 4 s, p = 0.002). 3D augmented reality vision with high resolution decreased time and improved accuracy of more complex tasks, enabling a less experienced robotic surgical bedside assistant to function similar to attending surgeons. These data warrant further study with additional complex tasks and bedside assistants at various levels of training.

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Are augmented reality headsets in surgery a dead end?

Cited by 26 publications

References 15 publications

The Wearable VOSTARS System for Augmented Reality-Guided Surgery: Preclinical Phantom Evaluation for High-Precision Maxillofacial Tasks

The Wearable VOSTARS System for Augmented Reality-Guided Surgery: Preclinical Phantom Evaluation for High-Precision Maxillofacial Tasks

Augmented Reality Based Surgical Navigation of Complex Pelvic Osteotomies—A Feasibility Study on Cadavers

Study on augmented reality for robotic surgery bedside assistants

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