Augmented Reality and Wearable Technology in Image-guided Navigation and Preoperative Planning

Rahman, Omar; Nahabedian, Maurice Y.; Sinkin, Jeremy C.

doi:10.1097/gox.0000000000001057

Cited by 7 publications

(4 citation statements)

References 4 publications

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“…It integrates computer-generated images with the surgeon’s view of the patient, making the unseen seen. Like other advances in preoperative imaging, the benefits include improved anatomical understanding, intra-operative guidance, potentially shorter surgical times and assistance with surgical education [ 104 , 105 , 106 ]. In the realm of breast reconstruction, wearable augmented reality devices such as HoloLens™ (Redmond, WA, USA) have been demonstrated to offer surgeons the ability to visualise perforators and anatomy before and during an operation [ 107 , 108 ].…”

Section: Development Of Imaging Adjunctsmentioning

confidence: 99%

A History of Innovation: Tracing the Evolution of Imaging Modalities for the Preoperative Planning of Microsurgical Breast Reconstruction

Cevik

Seth

Hunter-Smith

et al. 2023

JCM

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Breast reconstruction is an essential component in the multidisciplinary management of breast cancer patients. Over the years, preoperative planning has played a pivotal role in assisting surgeons in planning operative decisions prior to the day of surgery. The evolution of preoperative planning can be traced back to the introduction of modalities such as ultrasound and colour duplex ultrasonography, enabling surgeons to evaluate the donor site’s vasculature and thereby plan operations more accurately. However, the limitations of these techniques paved the way for the implementation of modern three-dimensional imaging technologies. With the advancements in 3D imaging, including computed tomography and magnetic resonance imaging, surgeons gained the ability to obtain detailed anatomical information. Moreover, numerous adjuncts have been developed to aid in the planning process. The integration of 3D-printing technologies has made significant contributions, enabling surgeons to create complex haptic models of the underlying anatomy. Direct infrared thermography provides a non-invasive, visual assessment of abdominal wall vascular physiology. Additionally, augmented reality technologies are poised to reshape surgical planning by providing an immersive and interactive environment for surgeons to visualize and manipulate 3D reconstructions. Still, the future of preoperative planning in breast reconstruction holds immense promise. Most recently, artificial intelligence algorithms, utilising machine learning and deep learning techniques, have the potential to automate and enhance preoperative planning processes. This review provides a comprehensive assessment of the history of innovation in preoperative planning for breast reconstruction, while also outlining key future directions, and the impact of artificial intelligence in this field.

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Section: Development Of Imaging Adjunctsmentioning

confidence: 99%

A History of Innovation: Tracing the Evolution of Imaging Modalities for the Preoperative Planning of Microsurgical Breast Reconstruction

Cevik

Seth

Hunter-Smith

et al. 2023

JCM

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show abstract

“…In plastic and reconstructive surgery, clinicians reported its benefits for viewing images and recording videos. [51][52][53][54] Unfortunately, in 2015 Google (B1) Segmented image of the abdominal wall and DIEA that spurned the idea of creating a template for preoperative planning.…”

Section: Recent Advances In Ar and Vrmentioning

confidence: 99%

Imaging and printing in plastic and reconstructive surgery part 2: emerging techniques

Chae¹,

Hunter-Smith²,

Rozen³

2019

Australas J Plast Surg

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Background: In the second of a two-part series, we evaluate emerging three-dimensional (3D) imaging and printing techniques based on computed tomography angiography (CT) and magnetic resonance angiography (MRA) for use in plastic and reconstructive surgery. Method: A review of the published English literature dating from 1950 to 2017 was taken using databases such as PubMed, MEDLINE®, Web of Science and EMBASE. Results: Image-guided navigation systems using fiducial markers have demonstrated utility in numerous surgical disciplines, including perforator-based flap surgery. However, these systems have largely been superseded by augmented reality (AR) and virtual reality (VR) technologies with superior convenience and speed. With the added benefit of tactile feedback, holograms also appear promising but have yet to be developed beyond the prototypic stage. Aided by a growing volume of digitalised clinical data, machine learning (ML) poses significant benefits for future image-based decision-making processes. Conclusion: Most studies of image-guided navigation systems, AR, VR, holograms and ML have been presented in small case series and they remain to be analysed using outcomes-based validation studies. However, together they illustrate an exciting future where clinicians will be armed with intuitive technologies for surgical planning and guidance.

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“…Through acoustic trilateration (see Supplementary Materials ) by an acoustic radar with three ultrasound transducers, the tumor can be located with 0.25-mm accuracy. AR techniques have recently been developed for intuitive surgical navigation by merging the real-time operation with virtual information segmented from preoperative images, which then leads to improved surgical outcomes and minimal interference to the surgical flow 19 – 21 . Here, we leveraged the AR technology to track the acoustic radar and thus transform the obtained tumor location into an intuitive and accurate visual cue on a tablet or an HMD (see Supplementary Materials ).…”

Section: Introductionmentioning

confidence: 99%

A fiber optoacoustic guide with augmented reality for precision breast-conserving surgery

Lan

Xia²,

Li³

et al. 2018

Light Sci Appl

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Lumpectomy, also called breast-conserving surgery, has become the standard surgical treatment for early-stage breast cancer. However, accurately locating the tumor during a lumpectomy, especially when the lesion is small and nonpalpable, is a challenge. Such difficulty can lead to either incomplete tumor removal or prolonged surgical time, which result in high re-operation rates (~25%) and increased surgical costs. Here, we report a fiber optoacoustic guide (FOG) with augmented reality (AR) for sub-millimeter tumor localization and intuitive surgical guidance with minimal interference. The FOG is preoperatively implanted in the tumor. Under external pulsed light excitation, the FOG omnidirectionally broadcasts acoustic waves through the optoacoustic effect by a specially designed nano-composite layer at its tip. By capturing the acoustic wave, three ultrasound sensors on the breast skin triangulate the FOG tip’s position with 0.25-mm accuracy. An AR system with a tablet measures the coordinates of the ultrasound sensors and transforms the FOG tip’s position into visual feedback with <1-mm accuracy, thus aiding surgeons in directly visualizing the tumor location and performing fast and accurate tumor removal. We further show the use of a head-mounted display to visualize the same information in the surgeons’ first-person view and achieve hands-free guidance. Towards clinical application, a surgeon successfully deployed the FOG to excise a “pseudo tumor” in a female human cadaver. With the high-accuracy tumor localization by FOG and the intuitive surgical guidance by AR, the surgeon performed accurate and fast tumor removal, which will significantly reduce re-operation rates and shorten the surgery time.

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Augmented Reality and Wearable Technology in Image-guided Navigation and Preoperative Planning

Cited by 7 publications

References 4 publications

A History of Innovation: Tracing the Evolution of Imaging Modalities for the Preoperative Planning of Microsurgical Breast Reconstruction

A History of Innovation: Tracing the Evolution of Imaging Modalities for the Preoperative Planning of Microsurgical Breast Reconstruction

Imaging and printing in plastic and reconstructive surgery part 2: emerging techniques

A fiber optoacoustic guide with augmented reality for precision breast-conserving surgery

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