Discussion: Mixed Reality with HoloLens: Where Virtual Reality Meets Augmented Reality in the Operating Room.
Discussion: Mixed Reality with HoloLens: Where Virtual Reality Meets Augmented Reality in the Operating Room.
复制标题
讨论：HoloLens 混合现实：手术室中虚拟现实与增强现实的结合。
DOI：
10.1097/prs.0000000000003817
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发表时间：
2017
影响因子：
3.6
通讯作者：
Samuel J. Lin
中科院分区：
文献类型：
--
作者：
Austin D. Chen;Samuel J. Lin
www.PRSJournal.com 1071我很高兴地回顾了泰珀等人写的题为“全息透镜的混合现实：虚拟现实在手术室遇到增强现实”的文章。虚拟现实和增强现实的应用已经进入了整形外科领域，并以可穿戴计算机工具的形式更广泛地进入了多个外科学科，比如Oculus Rift （Oculus VR，加州门洛帕克）和谷歌Glass（谷歌Inc.，加州山景城）。1-3这些工具在外科教育、交流或手术计划方面起到了辅助作用。然而，正如作者所指出的，这两种类型的现实有一定的局限性，影响在外科领域的实施；虚拟现实在使用来自实际环境的信息方面存在挑战，而增强现实在访问和显示环境外部的数据方面存在困难。这项研究的作者旨在介绍一种新的可穿戴计算机设备，微软HoloLens（微软公司，华盛顿州雷德蒙德），它可以通过结合虚拟现实和增强现实的各个方面来解决这些限制，形成混合现实。为此，他们概述了虚拟现实和增强现实的功能，在手术室中优化使用两者的某些方面的必要性，并描述了通过HoloLens在术中环境中实现混合现实的实际情况。在这个时代，不断变化的技术环境为外科医生提供了一系列选择，以更好地提供患者护理，从用于患者教育的社交媒体到用于外科教育和术前规划的三维成像。3-5然而，一个一直存在的问题是，这些技术的实施是否对外科医生和患者都有益。此外，当这些工具的使用可能直接影响患者的预后时，术中适用性一直是一个问题。通常会有一种由好奇心和好奇驱动的心态，认为任何新工具都会“改变游戏”。对于整形外科医生来说，在使用技术的背后一定要深思熟虑，并有证据支持其使用。其中一个例子是采用荧光血管造影术，这已被报道并具有临床效益；它的最佳使用场景正在扩大。在我看来，尽管虚拟现实和增强现实可能永远不会适用于手术室，但鉴于作者所描述的局限性，这两者似乎仍然在更非直接的环境中发挥作用，可能在外科教育或术前计划中。作者提出的混合现实与HoloLens，包含虚拟现实和增强现实的功能，似乎是可穿戴计算机技术在术中实施的有力一步。除了他们的观点和混合现实三维成像的好处之外，另一种可能性是它在显微外科手术中用于更符合人体工程学的血管可视化除了三维成像之外，一个值得考虑的有趣的观点是，其他数据来源是否可以以类似的方式使用。考虑到组织血氧仪的公认优势和虚拟现实中描述的这些技术，我认为这种潜在的用途可能包括监测皮瓣灌注。7-9此外，如果术中发生变化，在混合现实中也可能有更灵活的三维打印的作用
www.PRSJournal.com 1071 I had the pleasure of reviewing the article entitled “Mixed Reality with HoloLens: Where Virtual Reality Meets Augmented Reality in the Operating Room” by Tepper et al. Use of virtual reality and augmented reality has made its way into the field of plastic surgery, and more broadly into multiple surgical disciplines, in the form of wearable computer tools such as Oculus Rift (Oculus VR, Menlo Park, Calif.) and Google Glass (Google Inc., Mountain View, Calif.), respectively.1–3 These tools have served to assist in aspects of surgical education, communication, or operative planning. However, as the authors note, the two types of reality have certain limitations that affect implementation in the surgical field; virtual reality has challenges in using information from the actual environment, whereas augmented reality has difficulties in accessing and displaying data external to the environment. The authors of this study aimed to introduce a new wearable computer device, the Microsoft HoloLens (Microsoft Corp., Redmond, Wash.), that can address these limitations by combining aspects of both virtual reality and augmented reality, forming a mixed reality. To this end, they have provided an overview of the functionalities of both virtual reality and augmented reality, the necessity for certain aspects of both for optimal use in the operating room, and descriptions of the actual implementation of mixed reality through HoloLens in the intraoperative setting. In this day and age, the changing technological landscape provides a range of options for surgeons to explore in efforts to better provide patient care, ranging from social media for patient education to three-dimensional imaging in surgical education and preoperative planning.3–5 However, one ever-present question is whether implementation of these technologies is actually beneficial both for the surgeon and for the patient. Moreover, there is always a concern with regard to intraoperative applicability when use of such tools may directly influence patient outcomes. There is often a mindset driven by curiosity and wonder that any new tool will, in a manner of speaking, “change the game.” For plastic surgeons, there must always be thoughtfulness behind using technology, backed by evidence to support its use. One such example is the adoption of fluorescent angiography, which has been reported and has clinical benefit; the optimal scenarios for its use are expanding. In my eyes, although virtual reality and augmented reality may not ever be applicable in the operating room given the limitations described by the authors, the two do still appear to have roles with regard to a more nondirect setting, perhaps in surgical education or preoperative planning. What the authors propose as mixed reality with HoloLens, containing functions of both virtual reality and augmented reality, appears to be a strong step forward in the intraoperative implementation of wearable computer technology. In addition to their points and example of the benefits of mixed reality three-dimensional imaging, another possibility is its use in microsurgery for a more ergonomic visualization of the vessels.6 Apart from three-dimensional imaging, an interesting perspective to consider, moving forward, is whether other sources of data could be used in a similar manner. I imagine that such potential uses could involve monitoring flap perfusion, given both the recognized advantages of tissue oximetry and such technologies being described in virtual reality.7–9 Moreover, there may also be a role in mixed reality for more flexible three-dimensional printing in the event of intraoperative changes in
影响因子：
3.5
作者：
Gioux, Sylvain;Mazhar, Amaan;Frangioni, John V.
通讯作者：
Frangioni, John V.