Through the HoloLens™ looking glass: augmented reality for extremity reconstruction surgery using 3D vascular models with perforating vessels.
Through the HoloLens™ looking glass: augmented reality for extremity reconstruction surgery using 3D vascular models with perforating vessels.
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DOI：
10.1186/s41747-017-0033-2
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发表时间：
2018
影响因子：
3.8
通讯作者：
Amiras D
中科院分区：
文献类型：
--
作者：
Pratt P;Ives M;Lawton G;Simmons J;Radev N;Spyropoulou L;Amiras D
精确度和计划是重建手术的关键。增强现实 (AR) 可以将术前计算机断层扫描血管造影 (CTA) 成像中的信息变为现实，使外科医生能够“透视”患者的皮肤并了解底层的解剖结构，而无需做任何切口。这项工作表明，AR 可以协助重建手术期间准确识别、解剖和执行带蒂血管皮瓣。根据术前 CTA 扫描描绘出不同体积的骨、血管、皮肤、软组织结构和相关血管穿支，以使用两个互补的分割软件包生成三维图像。这些模型被转换为多边形模型，并通过 HoloLens™ 立体头戴式显示器中的自定义应用程序进行渲染。术中，手术外科医生结合跟踪手势和语音命令，将模型手动注册到各自的受试者； AR 用于辅助导航和准确解剖。将通过 AR 叠加识别血管穿支的地下位置与通过可听多普勒超声获得的位置进行比较。通过 HoloLens 辅助的初步病例系列，手术外科医生能够演示穿支血管的精确有效定位。
Precision and planning are key to reconstructive surgery. Augmented reality (AR) can bring the information within preoperative computed tomography angiography (CTA) imaging to life, allowing the surgeon to ‘see through’ the patient’s skin and appreciate the underlying anatomy without making a single incision. This work has demonstrated that AR can assist the accurate identification, dissection and execution of vascular pedunculated flaps during reconstructive surgery. Separate volumes of osseous, vascular, skin, soft tissue structures and relevant vascular perforators were delineated from preoperative CTA scans to generate three-dimensional images using two complementary segmentation software packages. These were converted to polygonal models and rendered by means of a custom application within the HoloLens™ stereo head-mounted display. Intraoperatively, the models were registered manually to their respective subjects by the operating surgeon using a combination of tracked hand gestures and voice commands; AR was used to aid navigation and accurate dissection. Identification of the subsurface location of vascular perforators through AR overlay was compared to the positions obtained by audible Doppler ultrasound. Through a preliminary HoloLens-assisted case series, the operating surgeon was able to demonstrate precise and efficient localisation of perforating vessels.