Intraoperative 3D Hologram Support With Mixed Reality Techniques in Liver Surgery.


Journal

Annals of surgery
ISSN: 1528-1140
Titre abrégé: Ann Surg
Pays: United States
ID NLM: 0372354

Informations de publication

Date de publication:
01 2020
Historique:
pubmed: 20 8 2019
medline: 8 5 2020
entrez: 20 8 2019
Statut: ppublish

Résumé

The aim of this study was to investigate the potential of an intraoperative 3D hologram, which was a computer graphics model liver, with mixed reality techniques in liver surgery. The merits for the application of a hologram for surgical support are: 1) no sterilized display monitor; 2) better spatial awareness; and 3) 3D images shared by all the surgeons. 3D polygon data using preoperative computed tomography data was installed into head mount displays, HoloLens (Microsoft Corporation, Redmond, WA). In a Wi-Fi-enabled operative room, several surgeons wearing HoloLens succeeded in sharing the same hologram and moving that hologram from respective operators' angles by means of easy gesture-handling without any monitors. The intraoperative hologram contributed to better imagination of tumor locations, and for determining the parenchymal dissection line in the hepatectomy for the patients with more than 20 multiple colo-rectal liver metastases. In another case, the hologram enabled a safe Gliisonean pedicle approach for hepato-cellular carcinoma with a hilar anatomical anomaly. Surgeons could easily compare the real patient's anatomy and that of the hologram just before the hepatic hilar procedure. This initial experience suggested that an intraoperative hologram with mixed reality techniques contributed to "last-minute simulation," not for "navigation." The intraoperative hologram might be a new next-generation operation-supportive tool in terms of spatial awareness, sharing, and simplicity.

Sections du résumé

OBJECTIVE
The aim of this study was to investigate the potential of an intraoperative 3D hologram, which was a computer graphics model liver, with mixed reality techniques in liver surgery.
SUMMARY BACKGROUND DATA
The merits for the application of a hologram for surgical support are: 1) no sterilized display monitor; 2) better spatial awareness; and 3) 3D images shared by all the surgeons.
METHODS
3D polygon data using preoperative computed tomography data was installed into head mount displays, HoloLens (Microsoft Corporation, Redmond, WA).
RESULTS
In a Wi-Fi-enabled operative room, several surgeons wearing HoloLens succeeded in sharing the same hologram and moving that hologram from respective operators' angles by means of easy gesture-handling without any monitors. The intraoperative hologram contributed to better imagination of tumor locations, and for determining the parenchymal dissection line in the hepatectomy for the patients with more than 20 multiple colo-rectal liver metastases. In another case, the hologram enabled a safe Gliisonean pedicle approach for hepato-cellular carcinoma with a hilar anatomical anomaly. Surgeons could easily compare the real patient's anatomy and that of the hologram just before the hepatic hilar procedure.
CONCLUSIONS
This initial experience suggested that an intraoperative hologram with mixed reality techniques contributed to "last-minute simulation," not for "navigation." The intraoperative hologram might be a new next-generation operation-supportive tool in terms of spatial awareness, sharing, and simplicity.

Identifiants

pubmed: 31425293
doi: 10.1097/SLA.0000000000003552
pii: 00000658-202001000-00032
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e4-e7

Commentaires et corrections

Type : CommentIn

Références

Condino S, Turini G, Parchi PD, et al. How to build a patient-specific hybrid simulator for orthopaedic open surgery: benefits and limits of mixed-reality using the Microsoft HoloLens. J Healthc Eng 2018; 2018:5435097.
Tepper OM, Rudy HL, Lefkowitz A, et al. Mixed reality with HoloLens: where virtual reality meets augmented reality in the operating room. Plast Reconstr Surg 2017; 140:1066–1070.
Incekara F, Smits M, Dirven C, et al. Clinical feasibility of a wearable mixed-reality device in neurosurgery. World Neurosurg 2018; 118:e422–e427.
Queisner M, Pratschke J, Sauer IM. Response: ‘Mixed and Augmented Reality-Why Surgeons Should Care’. Ann Surg 2018; [Epub ahead of print].
Iannessi A, Marcy PY, Sugimoto M, et al. A review of existing and potential computer user interfaces for modern radiology. Insights Imaging 2018; 9:599–609.
Hoffman MA, Provance JB. Visualization of molecular structures using HoloLens-based augmented reality. AMIA Jt Summits Transl Sci Proc 2017; 2017:68–74.
Huber T, Hadzijusufovic E, Hansen C, et al. Head-mounted mixed-reality technology during robotic-assisted transanal total mesorectal excision. Dis Colon Rectum 2019; 62:258–261.
Sauer IM, Queisner M, Tang P, et al. Mixed reality in visceral surgery: development of a suitable workflow and evaluation of intraoperative use-cases. Ann Surg 2017; 266:706–712.

Auteurs

Yu Saito (Y)

Department of Surgery, Tokushima University, Tokushima, Japan.

Maki Sugimoto (M)

Department of Surgery, Tokushima University, Tokushima, Japan.
Research Center for Advanced Science and Technology, Tokyo University, Meguro-ku, Tokyo, Japan.

Satoru Imura (S)

Department of Surgery, Tokushima University, Tokushima, Japan.

Yuji Morine (Y)

Department of Surgery, Tokushima University, Tokushima, Japan.

Tetsuya Ikemoto (T)

Department of Surgery, Tokushima University, Tokushima, Japan.

Shuichi Iwahashi (S)

Department of Surgery, Tokushima University, Tokushima, Japan.

Shinichiro Yamada (S)

Department of Surgery, Tokushima University, Tokushima, Japan.

Mitsuo Shimada (M)

Department of Surgery, Tokushima University, Tokushima, Japan.

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Classifications MeSH