Use of the Hybrid Operating Room for Pelvic and Acetabular Fracture Surgery

Davis, Jeffery T.; Movassaghi, Kamran; Refaat, Motasem; Lindvall, Eric M.

doi:10.1016/j.injury.2022.09.010

Cited by 4 publications

(2 citation statements)

References 27 publications

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“…Treating pelvic and acetabular fractures is challenging [ 1 , 2 ]. In recent years, percutaneous implant placement after closed fracture reduction has gained popularity due to the availability of advanced intraoperative imaging and navigation technologies [ 3 , 4 ]. Although standard X-rays and screw positions in the pelvis have been described in detail, understanding the 3-dimensional (3D) pelvic anatomy, planning of screw pathways, and intraoperative precision is challenging even for experienced pelvic surgeons.…”

Section: Introductionmentioning

confidence: 99%

Augmented reality-based surgical navigation of pelvic screw placement: an ex-vivo experimental feasibility study

Heining,

Raykov,

Wolff

et al. 2024

Patient Saf Surg

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Background Minimally invasive surgical treatment of pelvic trauma requires a significant level of surgical training and technical expertise. Novel imaging and navigation technologies have always driven surgical technique, and with head-mounted displays being commercially available nowadays, the assessment of such Augmented Reality (AR) devices in a specific surgical setting is appropriate. Methods In this ex-vivo feasibility study, an AR-based surgical navigation system was assessed in a specific clinical scenario with standard pelvic and acetabular screw pathways. The system has the following components: an optical-see-through Head Mounted Display, a specifically designed modular AR software, and surgical tool tracking using pose estimation with synthetic square markers. Results The success rate for entry point navigation was 93.8%, the overall translational deviation of drill pathways was 3.99 ± 1.77 mm, and the overall rotational deviation of drill pathways was 4.3 ± 1.8°. There was no relevant theoretic screw perforation, as shown by 88.7% Grade 0–1 and 100% Grade 0–2 rating in our pelvic screw perforation score. Regarding screw length, 103 ± 8% of the planned pathway length could be realized successfully. Conclusion The novel innovative system assessed in this experimental study provided proof-of-concept for the feasibility of percutaneous screw placement in the pelvis and, thus, could easily be adapted to a specific clinical scenario. The system showed comparable performance with other computer-aided solutions while providing specific advantages such as true 3D vision without intraoperative radiation; however, it needs further improvement and must still undergo regulatory body approval. Future endeavors include intraoperative registration and optimized tool tracking.

show abstract

Section: Introductionmentioning

confidence: 99%

Augmented reality-based surgical navigation of pelvic screw placement: an ex-vivo experimental feasibility study

Heining,

Raykov,

Wolff

et al. 2024

Patient Saf Surg

View full text Add to dashboard Cite

show abstract

“…Treating pelvic and acetabular fractures is challenging [1] [2]. In recent years, percutaneous implant placement after closed fracture reduction has gained popularity due to the availability of advanced intraoperative imaging and navigation technologies [3] [4]. Although standard X-rays and screw positions in the pelvis have been described in detail, understanding the 3-dimensional pelvic anatomy, planning of screw pathways, and intraoperative precision is challenging even for experienced pelvic surgeons.…”

Section: Introductionmentioning

confidence: 99%

Augmented Reality-Based Surgical Navigation of Pelvic Screw Placement. Feasibility, Technique, and Limitations

Heining,

Raykov,

Wolff

et al. 2023

Preprint

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Background Minimally invasive surgical treatment of pelvic trauma requires a significant level of surgical training and technical expertise. Novel imaging and navigation technologies have always driven surgical technique, and with head-mounted displays being commercially available nowadays, the assessment of such Augmented Reality (AR) devices in a specific surgical setting is appropriate. Methods In this experimental Level 2 study, an AR-based surgical navigation system was assessed in a specific clinical scenario with standard pelvic and acetabular screw pathways. The system has the following components: an optical-see-through Head Mounted Display (HMD, HoloLens 2), a specifically designed modular AR software (HoloMA), and surgical tool tracking using pose estimation with synthetic square markers (ArUco). Results The success rate for entry point navigation was 93.8%, the overall translational deviation of drill pathways was 3.99 ± 1.77mm, and the overall rotational deviation of drill pathways was 4.3 ± 1.8°. There was no relevant theoretic screw perforation, as shown by 88.7% Grade 0–1 and 100% Grade 0–2 rating in our pelvic screw perforation score. Regarding screw length, 103 ± 8% of the planned pathway length could be realized successfully. Conclusions The system proved feasible for the task of percutaneous screw placement in the pelvis and, thus, could easily be adapted to a specific clinical scenario. The system showed comparable performance with other computer-aided solutions while providing specific advantages such as true 3D vision without intraoperative radiation.

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