Intraoperative 3D Hologram Support With Mixed Reality Techniques in Liver Surgery
Intraoperative 3D Hologram Support With Mixed Reality Techniques in Liver Surgery
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DOI：
10.1097/sla.0000000000003552
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发表时间：
2020-01-01
影响因子：
9
通讯作者：
Shimada, Mitsuo
中科院分区：
文献类型：
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作者：
Saito, Yu;Sugimoto, Maki;Shimada, Mitsuo
目的：本研究的目的是探讨术中3D全息图的潜力，这是一个计算机图形模型肝脏，与混合现实技术在肝脏手术。背景数据总结：应用全息图进行手术支持的优点是：1）无需无菌显示器; 2）更好的空间意识; 3）所有外科医生共享3D图像。研究方法：将使用术前计算机断层扫描数据的3D多边形数据安装到头戴式显示器HoloLens（Microsoft Corporation，雷德蒙，WA）中。结果如下：在一个支持Wi-Fi的手术室里，几位戴着HoloLens的外科医生成功地共享了同一张全息图，并在没有任何监视器的情况下，通过简单的手势操作，从各自的操作者的角度移动了全息图。术中全息图有助于更好地想象肿瘤的位置，并确定肝切除术中20多个结直肠肝转移瘤患者的实质解剖线。在另一个病例中，全息图为肝门解剖异常的肝细胞癌提供了安全的Gliisonean蒂入路。外科医生可以很容易地比较真实的病人的解剖结构和肝门手术前的全息图。结论：这一初步经验表明，术中全息图与混合现实技术有助于“最后一刻的模拟”，而不是“导航”。“术中全息图可能是一个新的下一代操作支持工具，在空间意识，共享和简单性方面。
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.