Immersive 3-Dimensional Virtual Reality Modeling for Case-Specific Presurgical Discussions in Cerebrovascular Neurosurgery

Abstract

BACKGROUND Adequate surgical planning includes a precise understanding of patient-specific anatomy and is a necessity for neurosurgeons. Although the use of virtual reality (VR) technology is emerging in surgical planning and education, few studies have examined the effectiveness of immersive VR during surgical planning using a modern head-mounted display. OBJECTIVE To investigate if and how immersive VR aids presurgical discussions of cerebrovascular surgery. METHODS A multiuser immersive VR system, BananaVisionTM, was developed and used during presurgical discussions in a prospective patient cohort undergoing cerebrovascular surgery. A questionnaire/interview was administered to multiple surgeons after the surgeries to evaluate the effectiveness of the VR system compared to conventional imaging modalities. An objective assessment of the surgeon's knowledge of patient-specific anatomy was also conducted by rating surgeons’ hand-drawn presurgical illustrations. RESULTS The VR session effectively enhanced surgeons’ understanding of patient-specific anatomy in the majority of cases (83.3%). An objective assessment of surgeons’ presurgical illustrations was consistent with this result. The VR session also effectively improved the decision-making process regarding minor surgical techniques in 61.1% of cases and even aided surgeons in making critical surgical decisions about cases involving complex and challenging anatomy. The utility of the VR system was rated significantly higher by trainees than by experts. CONCLUSION Although rated as more useful by trainees than by experts, immersive 3D VR modeling increased surgeons’ understanding of patient-specific anatomy and improved surgical strategy in certain cases involving challenging anatomy.

Navigation of frameless fixation for gamma knife radiosurgery using fixed augmented reality

“…Patient-specific planning based on individual characteristics and conditions is important for precise treatment in neurosurgery 21 , 22 . In radiosurgery, all patients have various lesions including malignant or benign tumors, vascular disease, and functional diseases.…”

Removal of a foreign body by rigid bronchoscope after virtual reality-aided presurgical planning: A case report

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Development of an inside-out augmented reality technique for neurosurgical navigation

“…Patient-specific surgical planning based on individual anatomical characteristics is an important element in current and future neurosurgery. [20][21][22][23][24] In brain tumor surgery, all patients have different tumors, in terms of size, location, extent, and characteristics, and thus personalized surgical plans are required for each patient. Despite using the most advanced neuronavigation systems for neurosurgery, neurosurgeons still require a lot of experience and training to derive an idea of the 3D reconstruction of lesions and structures from 2D data using their imagination.…”