Intraoperative holography navigation using a mixed-reality wearable computer during laparoscopic cholecystectomy

Kitagawa, Michiko; Sugimoto, Maki; Higashi, Hidenori; Umezawa, Akihiro; Kurokawa, Yukinori

doi:10.1016/j.surg.2021.10.004

Cited by 21 publications

(17 citation statements)

References 14 publications

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“…Reconstructive surgery included orbital floor reconstruction [ 69 ] and radiotherapy applications involved AR-based patient positioning [ 70 , 71 ]. Laparoscopic surgery applications included cholecystectomy [ 72 ] and general laparoscopic surgery [ 73 ]. Heart surgery related applications included guiding the targeted delivery of media to the surface of the infarcted heart in regenerative medicine [ 33 ].…”

Section: Resultsmentioning

confidence: 99%

“…The majority of papers made use of preoperative CT data as the input to the surgical guidance strategy, corresponding with the frequent application space of orthopedic surgery and the enhanced ability of CT to generate geometrically accurate representations of rigid anatomical structures, such as bone [ 45 , 76 , 77 ]. The second most frequently used data type was MRI, either as a standalone data type [ 62 , 72 , 78 ] or in combination with CT [ 49 , 52 , 53 ]. Magnetic resonance imaging has better sensitivity than CT when imaging soft tissue structures; however, it is less geometrically precise [ 79 ] and has less signal intensity when imaging bony structures.…”

Section: Resultsmentioning

confidence: 99%

“…Several groups reported successful guidance based on the OST-HMD camera and surface registration with markers [ 46 , 47 , 74 , 86 ] and point registration based on feature matching [ 48 , 50 , 87 , 99 ]. The final overlay strategy discussed is manual placement of virtual content; in this case it was up to either the surgeon [ 72 , 81 ] or a secondary user [ 55 , 74 ] to ensure comfortable placement of virtual content. After placement, virtual content remained anchored in place based on the SLAM predictions included with the HMD.…”

Section: Resultsmentioning

confidence: 99%

“…After phantom models, the next most frequently reported evaluation target was patients (

). Evaluation in patients primarily involved early feasibility assessments which included surgeon feedback and usability considerations, and typically the virtual information was not used to inform treatment decisions [ 46 , 62 , 63 , 72 , 96 ]. Several papers investigated the quantitative accuracy of OST-HMD led navigation in preliminary patient studies, including assessment of orthopedic pedicle screw navigation [ 47 ], neuronavigation [ 65 ], maxillofacial osteotomy tracing [ 90 ], and maxillofacial tumor resection [ 52 ].…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Augmenting Performance: A Systematic Review of Optical See-Through Head-Mounted Displays in Surgery

2022

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We conducted a systematic review of recent literature to understand the current challenges in the use of optical see-through head-mounted displays (OST-HMDs) for augmented reality (AR) assisted surgery. Using Google Scholar, 57 relevant articles from 1 January 2021 through 18 March 2022 were identified. Selected articles were then categorized based on a taxonomy that described the required components of an effective AR-based navigation system: data, processing, overlay, view, and validation. Our findings indicated a focus on orthopedic (n=20) and maxillofacial surgeries (n=8). For preoperative input data, computed tomography (CT) (n=34), and surface rendered models (n=39) were most commonly used to represent image information. Virtual content was commonly directly superimposed with the target site (n=47); this was achieved by surface tracking of fiducials (n=30), external tracking (n=16), or manual placement (n=11). Microsoft HoloLens devices (n=24 in 2021, n=7 in 2022) were the most frequently used OST-HMDs; gestures and/or voice (n=32) served as the preferred interaction paradigm. Though promising system accuracy in the order of 2–5 mm has been demonstrated in phantom models, several human factors and technical challenges—perception, ease of use, context, interaction, and occlusion—remain to be addressed prior to widespread adoption of OST-HMD led surgical navigation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…After phantom models, the next most frequently reported evaluation target was patients (

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Augmenting Performance: A Systematic Review of Optical See-Through Head-Mounted Displays in Surgery

2022

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“…Whereas in VR the user enters a completely simulated virtual environment, MR overlays the physical environment with digital content, offering the advantage for users to interact with these objects while still being able to see real objects. The use of MR in a medical context has previously been described in patient education, teaching and intraoperative navigation in a wide variety of surgical specialties such as orthopedics, neurosurgery, and plastic surgery [8][9][10][11][12][13][14][15][16][17][18][19][20]. Although the futuristic vision of MR as a navigational tool in surgery appears to be especially promising, there are currently many challenges remaining with regards to the technical feasibility and the accuracy of virtual model registration, in addition to the stabilization of the virtual model in a spatial environment.…”

Section: Introductionmentioning

confidence: 99%

Mixed-Reality-Assisted Puncture of the Common Femoral Artery in a Phantom Model

et al. 2022

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Percutaneous femoral arterial access is daily practice in a variety of medical specialties and enables physicians worldwide to perform endovascular interventions. The reported incidence of percutaneous femoral arterial access complications is 3–18% and often results from suboptimal puncture location due to insufficient visualization of the target vessel. The purpose of this proof-of-concept study was to evaluate the feasibility and the positional error of a mixed-reality (MR)-assisted puncture of the common femoral artery in a phantom model using a commercially available navigation system. In total, 15 MR-assisted punctures were performed. Cone-beam computed tomography angiography (CTA) was used following each puncture to allow quantification of positional error of needle placements in the axial and sagittal planes. Technical success was achieved in 14/15 cases (93.3%) with a median axial positional error of 1.0 mm (IQR 1.3) and a median sagittal positional error of 1.1 mm (IQR 1.6). The median duration of the registration process and needle insertion was 2 min (IQR 1.0). MR-assisted puncture of the common femoral artery is feasible with acceptable positional errors in a phantom model. Future studies should aim to measure and reduce the positional error resulting from MR registration.

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The intraoperative use of augmented and mixed reality technology to improve surgical outcomes: A systematic review

Bollen

Awad

Langridge

et al. 2022

Robotics Computer Surgery

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Background This systematic review aims to critically appraise the intraoperative use of augmented and mixed reality technology to improve surgical outcomes. Method A literature search of PubMed, Scopus, Cochrane Central Register of Controlled Trials, http://ClinicalTrials.gov and WHO ICTRP was performed in accordance with Cochrane Handbook for Systematic Reviews of Interventions. Results This review included 94 studies on 2473 patients, comprising 78 studies on augmented reality and 16 on mixed reality. This technology has seen broad intraoperative application. Augmented and mixed reality can reduce operative duration, blood loss, and the duration of inpatient care. Current evidence shows that they achieve this most in percutaneous surgery. Conclusions Augmented and mixed reality technology improve surgical outcomes by increasing navigational speed and reducing navigational error intraoperatively. However, they have technical limitations which are the subject of ongoing research. Further studies are necessary to define how this technology is best applied intraoperatively. Systematic Review Registration: PROSPERO CRD42020205892.

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Intraoperative holography navigation using a mixed-reality wearable computer during laparoscopic cholecystectomy

Cited by 21 publications

References 14 publications

Augmenting Performance: A Systematic Review of Optical See-Through Head-Mounted Displays in Surgery

Augmenting Performance: A Systematic Review of Optical See-Through Head-Mounted Displays in Surgery

Mixed-Reality-Assisted Puncture of the Common Femoral Artery in a Phantom Model

The intraoperative use of augmented and mixed reality technology to improve surgical outcomes: A systematic review

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