Evaluation of the effect of standard neuronavigation and augmented reality on the integrity of the perifocal structures during a neurosurgical approach

Davidovic, Alioucha; Chavaz, Lara; Meling, Torstein R.; Schaller, Karl; Bijlenga, Philippe; Haemmerli, Julien

doi:10.3171/2021.5.focus21202

Cited by 9 publications

(15 citation statements)

References 24 publications

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“…Previous studies have suggested that ARN is suitable for planning trajectories. 13 , 27 ) Observations can be made from the probe's eye view in ARN, allowing the surgeon to confirm the location of the trajectory within the target, as well as the absence of obstructions in the trajectory path ( Fig. 3 ).…”

Section: Augmented Reality In Frame-based Stereotaxymentioning

confidence: 99%

Augmented Reality in Stereotactic Neurosurgery: Current Status and Issues

Satoh

Nakajima

Watanabe

et al. 2023

Neurol. Med. Chir.(Tokyo)

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Stereotactic neurosurgery is an established technique, but it has several limitations. In frame-based stereotaxy using a stereotactic frame, frame setting errors may decrease the accuracy of the procedure. Frameless stereotaxy using neuronavigation requires surgeons to shift their view from the surgical field to the navigation display and to advance the needle while assuming a physically uncomfortable position. To overcome these limitations, several researchers have applied augmented reality in stereotactic neurosurgery. Augmented reality enables surgeons to visualize the information regarding the target and preplanned trajectory superimposed over the actual surgical field. In frame-based stereotaxy, a researcher applies tablet computer-based augmented reality to check for the setting errors of the stereotactic frame, thereby improving the safety of the procedure. Several researchers have reported performing frameless stereotaxy guided by head-mounted-display-based augmented reality that enables surgeons to advance the needle at a more natural posture. These studies have shown that augmented reality can address the limitations of stereotactic neurosurgery. Conversely, they have also revealed the limited accuracy of current augmented reality systems for small targets, which indicates that further development of augmented reality systems is needed.

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Section: Augmented Reality In Frame-based Stereotaxymentioning

confidence: 99%

Augmented Reality in Stereotactic Neurosurgery: Current Status and Issues

Satoh

Nakajima

Watanabe

et al. 2023

Neurol. Med. Chir.(Tokyo)

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“…For the purpose of this study, we used a 140 × 95 × 90 mm custom-made plastic box fixed to the experimental table (initially made for another experimental study [7]). Four metal cross-headed screws were fixed on the top of the box and were solidary to the box, which correspond to the 4 hallmark points (A1, B2, C3, D4) (Fig.…”

Section: Custom-made Modelmentioning

confidence: 99%

“…Errors of precision inherent in the neuronavigation system (referencing or calibration procedures) have already been reported [7,16,27]. This study aims to measure the global error is term of accuracy, or the distance-to-target.…”

Section: Reduction Of Measurement Errorsmentioning

confidence: 99%

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Evaluation of the precision of navigation-assisted endoscopy according to the navigation tool setup and the type of endoscopes

et al. 2022

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Object Preoperative image-based neuronavigation-assisted endoscopy during intracranial procedures is gaining great interest. This study aimed to analyze the precision of navigation-assisted endoscopy according to the navigation setup, the type of optic and its working angulation. Methods A custom-made box with four screws was referenced. The navigation-assisted endoscope was aligned on the screws (targets). The precision on the navigation screen was defined as the virtual distance-to-target between the tip of the endoscope and the center of the screws. Three modifiers were assessed: (1) the distance D between the box and the reference array (CLOSE 13 cm – MIDDLE 30 cm – FAR 53 cm), (2) the distance between the tip of the endoscope and the navigation array on the endoscope (close 5 cm – middle 10 cm – far 20 cm), (3) the working angulation of the endoscope (0°-endoscope and 30°-endoscope angled at 90° and 45° with the box). Results The median precision was 1.3 mm (Q1: 1.1; Q3: 1.7) with the best setting CLOSE/close. The best setting in surgical condition (CLOSE/far) showed a distance-to-target of 2.3 mm (Q1: 1.9; Q3: 2.5). The distance D was correlated to the precision (Spearman rho = 0.82), but not the distance d (Spearman rho = 0.04). The type of optic and its angulation with the box were also correlated to the precision (Spearman rho = − 0.37). The best setting was the use of a 30°-endoscope angled at 45° (1.4 mm (Q1: 1.0; Q3: 1.9)). Conclusion Navigated-assisted endoscopy is feasible and offers a good precision. The navigation setup should be optimized, reducing the risk of inadvertent perifocal damage.

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“…Although the NNS provides permanent intraoperative localization of structures of interest, it has the disadvantage of being expensive and less reliable in posterior fossa surgery [6] . Moreover, using NNS requires the neurosurgeon to shift their focus from surgery to other areas [7] .…”

Section: Introductionmentioning

confidence: 99%

The utility of augmented reality in retrosigmoid craniotomies: several innovations

Huang

Chen

et al. 2022

Preprint

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Objective: During retrosigmoid craniotomy, it is vital that the transverse-sigmoid sinus junction (TSSJ) is positioned correctly, as it improves surgical efficiency and prevents complications. To explore a clinical application scenario of mobile AR-based navigation system (MARNS), the authors examined whether it can be used to position the TSSJ during craniotomy in the retrosigmoid approach and summarize the experience. Methods: Seven patients who underwent retrosigmoid craniotomy had their TSSJ located by MARNS. The surgical incision and skull "keyhole" for drilling were determined separately based on the projections of TSSJ on the 3D model displayed by MARNS. As indicators of effectiveness, this method was assessed via matching error, positioning time, integrity of the bone flap, and incidence of TSS injury, as well as other complications. Results: In all cases, the inner edges of TSSJ were accurately located and exposed, and the bone flaps formed and remained almost intact. In terms of matching error and positioning time, MARNS had a higher matching error than neuro-navigation system(NNS) (t = 3.897, p = 0.0021), but took a shorter time to location (t = 5.005, p = 0.0003). Conclusion: In this study, MARNS was innovative in tattooed landmarks, coupled with digital surgical design and improved surgical skills, leading to a successful retrosigmoid craniotomy. This system offers convenience, accuracy, cost-effectiveness, and reliability for the planning of neurosurgical procedures.

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Evaluation of the effect of standard neuronavigation and augmented reality on the integrity of the perifocal structures during a neurosurgical approach

Cited by 9 publications

References 24 publications

Augmented Reality in Stereotactic Neurosurgery: Current Status and Issues

Augmented Reality in Stereotactic Neurosurgery: Current Status and Issues

Evaluation of the precision of navigation-assisted endoscopy according to the navigation tool setup and the type of endoscopes

The utility of augmented reality in retrosigmoid craniotomies: several innovations

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