scholarly journals Augmented reality in computer‐assisted interventions based on patient‐specific 3D printed reference

2018 ◽  
Vol 5 (5) ◽  
pp. 162-166 ◽  
Author(s):  
Rafael Moreta‐Martinez ◽  
David García‐Mato ◽  
Mónica García‐Sevilla ◽  
Rubén Pérez‐Mañanes ◽  
José Calvo‐Haro ◽  
...  
2021 ◽  
Vol 11 (3) ◽  
pp. 1038
Author(s):  
Sara Condino ◽  
Giuseppe Turini ◽  
Virginia Mamone ◽  
Paolo Domenico Parchi ◽  
Vincenzo Ferrari

Simulation for surgical training is increasingly being considered a valuable addition to traditional teaching methods. 3D-printed physical simulators can be used for preoperative planning and rehearsal in spine surgery to improve surgical workflows and postoperative patient outcomes. This paper proposes an innovative strategy to build a hybrid simulation platform for training of pedicle screws fixation: the proposed method combines 3D-printed patient-specific spine models with augmented reality functionalities and virtual X-ray visualization, thus avoiding any exposure to harmful radiation during the simulation. Software functionalities are implemented by using a low-cost tracking strategy based on fiducial marker detection. Quantitative tests demonstrate the accuracy of the method to track the vertebral model and surgical tools, and to coherently visualize them in either the augmented reality or virtual fluoroscopic modalities. The obtained results encourage further research and clinical validation towards the use of the simulator as an effective tool for training in pedicle screws insertion in lumbar vertebrae.


10.29007/svbd ◽  
2018 ◽  
Author(s):  
Vasilii Shishkin ◽  
Valeriy Golubev

Malunions of the distal radius are often treated with correction osteotomies, which can be challenging to perform.In this report, 23 patients with symptomatic distal radius malunions were treated using 3D printed patient-specific surgical guides to facilitate surgery. Patients were compared with a control group of 23 patients that underwent similar surgery with a conventional x-ray planning approach.Postoperatively all patients in the computer-assisted group showed recovery of ROM, with no anatomical abnormalities on x-ray examination. 6 patients in the conventional planning group had reduced ROM with a residual volar tilt on x-ray images.Computer-assisted planning with the use of 3D printed patient-specific surgical guides enhances results of corrective osteotomies of distal radius malunions.


OTO Open ◽  
2018 ◽  
Vol 2 (4) ◽  
pp. 2473974X1880449 ◽  
Author(s):  
Samuel R. Barber ◽  
Kevin Wong ◽  
Vivek Kanumuri ◽  
Ruwan Kiringoda ◽  
Judith Kempfle ◽  
...  

Otolaryngologists increasingly use patient-specific 3-dimensional (3D)–printed anatomic physical models for preoperative planning. However, few reports describe concomitant use with virtual models. Herein, we aim to (1) use a 3D-printed patient-specific physical model with lateral skull base navigation for preoperative planning, (2) review anatomy virtually via augmented reality (AR), and (3) compare physical and virtual models to intraoperative findings in a challenging case of a symptomatic petrous apex cyst. Computed tomography (CT) imaging was manually segmented to generate 3D models. AR facilitated virtual surgical planning. Navigation was then coupled to 3D-printed anatomy to simulate surgery using an endoscopic approach. Intraoperative findings were comparable to simulation. Virtual and physical models adequately addressed details of endoscopic surgery, including avoidance of critical structures. Complex lateral skull base cases may be optimized by surgical planning via 3D-printed simulation with navigation. Future studies will address whether simulation can improve patient outcomes.


2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Nicole Wake ◽  
Andrew B. Rosenkrantz ◽  
Richard Huang ◽  
Katalina U. Park ◽  
James S. Wysock ◽  
...  

2021 ◽  
Vol 51 (2) ◽  
pp. E21
Author(s):  
Yun-Sik Dho ◽  
Sang Joon Park ◽  
Haneul Choi ◽  
Youngdeok Kim ◽  
Hyeong Cheol Moon ◽  
...  

OBJECTIVE With the advancement of 3D modeling techniques and visualization devices, augmented reality (AR)–based navigation (AR navigation) is being developed actively. The authors developed a pilot model of their newly developed inside-out tracking AR navigation system. METHODS The inside-out AR navigation technique was developed based on the visual inertial odometry (VIO) algorithm. The Quick Response (QR) marker was created and used for the image feature–detection algorithm. Inside-out AR navigation works through the steps of visualization device recognition, marker recognition, AR implementation, and registration within the running environment. A virtual 3D patient model for AR rendering and a 3D-printed patient model for validating registration accuracy were created. Inside-out tracking was used for the registration. The registration accuracy was validated by using intuitive, visualization, and quantitative methods for identifying coordinates by matching errors. Fine-tuning and opacity-adjustment functions were developed. RESULTS ARKit-based inside-out AR navigation was developed. The fiducial marker of the AR model and those of the 3D-printed patient model were correctly overlapped at all locations without errors. The tumor and anatomical structures of AR navigation and the tumors and structures placed in the intracranial space of the 3D-printed patient model precisely overlapped. The registration accuracy was quantified using coordinates, and the average moving errors of the x-axis and y-axis were 0.52 ± 0.35 and 0.05 ± 0.16 mm, respectively. The gradients from the x-axis and y-axis were 0.35° and 1.02°, respectively. Application of the fine-tuning and opacity-adjustment functions was proven by the videos. CONCLUSIONS The authors developed a novel inside-out tracking–based AR navigation system and validated its registration accuracy. This technical system could be applied in the novel navigation system for patient-specific neurosurgery.


2021 ◽  
Vol 51 (2) ◽  
pp. E20
Author(s):  
Gorkem Yavas ◽  
Kadri Emre Caliskan ◽  
Mehmet Sedat Cagli

OBJECTIVE The aim of this study was to assess the precision and feasibility of 3D-printed marker–based augmented reality (AR) neurosurgical navigation and its use intraoperatively compared with optical tracking neuronavigation systems (OTNSs). METHODS Three-dimensional–printed markers for CT and MRI and intraoperative use were applied with mobile devices using an AR light detection and ranging (LIDAR) camera. The 3D segmentations of intracranial tumors were created with CT and MR images, and preoperative registration of the marker and pathology was performed. A patient-specific, surgeon-facilitated mobile application was developed, and a mobile device camera was used for neuronavigation with high accuracy, ease, and cost-effectiveness. After accuracy values were preliminarily assessed, this technique was used intraoperatively in 8 patients. RESULTS The mobile device LIDAR camera was found to successfully overlay images of virtual tumor segmentations according to the position of a 3D-printed marker. The targeting error that was measured ranged from 0.5 to 3.5 mm (mean 1.70 ± 1.02 mm, median 1.58 mm). The mean preoperative preparation time was 35.7 ± 5.56 minutes, which is longer than that for routine OTNSs, but the amount of time required for preoperative registration and the placement of the intraoperative marker was very brief compared with other neurosurgical navigation systems (mean 1.02 ± 0.3 minutes). CONCLUSIONS The 3D-printed marker–based AR neuronavigation system was a clinically feasible, highly precise, low-cost, and easy-to-use navigation technique. Three-dimensional segmentation of intracranial tumors was targeted on the brain and was clearly visualized from the skin incision to the end of surgery.


10.29007/dswz ◽  
2019 ◽  
Author(s):  
Hisham Iqbal ◽  
Fabio Tatti ◽  
Ferdinando Rodriguez Y Baena

The integration of augmented-reality (AR) in medical robotics has been shown to reduce cognitive burden and improve information management in the typically cluttered environment of computer-assisted surgery. A key benefit of such systems is the ability to generate a composite view of medical-informatics and the real environment, streamlining the pathway for delivering patient-specific data. Consequently, AR was integrated within an orthopaedic setting by designing a system that captured and replicated the user- interface of a commercially available surgical robot onto a commercial head mounted see through display. Thus, a clinician could simultaneously view the operating-site and real- time informatics when carrying out an assisted patellofemoral-arthroplasty (PFA). The system was tested with 10 surgeons to examine its usability and impact on procedure- completion times when conducting simulated PFA on sawbone models. A statistically insignificant mean increase in procedure completion-time (+23.7s, p=0.240) was found, and the results of a post-operative qualitative-evaluation indicated a strongly positive consensus on the system, with a large majority of subjects agreeing the system provided value to the procedure without incurring noticeable physical discomfort. Overall, this study provides an encouraging insight into the high levels of engagement AR has with a clinical audience as well as its ability to enhance future generations of medical robotics.


10.29007/9sb7 ◽  
2020 ◽  
Author(s):  
Yuan Gao ◽  
Le Xie ◽  
Guoyan Zheng

This paper presents a projector-based augmented reality (AR) system for Computer- Assisted Orthopaedic Surgery (CAOS). After calibration, our AR system allows for projection of not only the virtual model directly on the surface of the target organ to create an augmented reality but also important clinical information such as distance and angular deviations from a surgical plan, which are important for various computer-assisted surgical procedures such as trajectory drilling and fracture reduction. The feasibility and accuracy of the system is experimentally validated on a 3D printed phantom model with pyramid shape, a dry goat bone and an in vitro pig leg. An average projection distance error of 1.03±0.58mm and an average drill alignment error of 1.17±0.43°were found. The results demonstrate the efficacy of the proposed AR system.


2020 ◽  
Author(s):  
Philipp Fürnstahl ◽  
Fabio A. Casari ◽  
Joëlle Ackermann ◽  
Magda Marcon ◽  
Michael Leunig ◽  
...  

Abstract Background: Legg–Calvé–Perthes (LCP) is a common orthopedic childhood disease leading to a deformity of the femoral head and to an adaptive deformity of the acetabulum. The altered joint biomechanics can result in early joint degeneration requiring total hip arthroplasty. In 2002 Ganz et al. introduced the femoral head reduction osteotomy (FHRO) as a direct joint-preserving treatment. The procedure remains one of the most challenging in hip surgery. Computer-based 3D preoperative planning and patient-specific navigation instruments have been successfully used to reduce technical complexity in other anatomies. The goal of this study was to evaluate the feasibility and anatomic reconstruction of such an approach for FHRO. Methods: In this pilot study 6 LCP patients were treated by FHRO in multiple centers between May 2017 and June 2019. Based on patient-specific 3D models of the hips, the surgeries were simulated in a step-wise fashion. Patient-specific intstruments tailored to FHRO were designed 3D-printed and used in the surgeries for navigating the osteotomies. The results were assessed radiographically and time and costs recorded. Results and Interpretation: The clinical feasibility of our approach for FHRO surgery has been demonstrated. The results showed significant improvement compared to the preoperative situation. The sphericity index improved postoperatively by 20% (p=0.028), the postoperative head diameter differed by only 1.8% (p = 0.043) from the contralateral side and Stulberg classification improved from 4.33 poor coxathrosis outcome to 1.5 good outcome (p = 0.026). The average time (minutes) for preliminary analysis, computer simulation, and patient-specific instrument design was 63 (±48), 156 (±64), and 105 (±68.5), respectively. All operations were performed by experienced surgeons, still three complications occurred, showing that FHRO remains one of the most complex hip surgeries, even with computer assistance; however none was directly related to simulation or navigation technique.


Materials ◽  
2021 ◽  
Vol 14 (4) ◽  
pp. 1021
Author(s):  
Bernhard Dorweiler ◽  
Pia Elisabeth Baqué ◽  
Rayan Chaban ◽  
Ahmed Ghazy ◽  
Oroa Salem

As comparative data on the precision of 3D-printed anatomical models are sparse, the aim of this study was to evaluate the accuracy of 3D-printed models of vascular anatomy generated by two commonly used printing technologies. Thirty-five 3D models of large (aortic, wall thickness of 2 mm, n = 30) and small (coronary, wall thickness of 1.25 mm, n = 5) vessels printed with fused deposition modeling (FDM) (rigid, n = 20) and PolyJet (flexible, n = 15) technology were subjected to high-resolution CT scans. From the resulting DICOM (Digital Imaging and Communications in Medicine) dataset, an STL file was generated and wall thickness as well as surface congruency were compared with the original STL file using dedicated 3D engineering software. The mean wall thickness for the large-scale aortic models was 2.11 µm (+5%), and 1.26 µm (+0.8%) for the coronary models, resulting in an overall mean wall thickness of +5% for all 35 3D models when compared to the original STL file. The mean surface deviation was found to be +120 µm for all models, with +100 µm for the aortic and +180 µm for the coronary 3D models, respectively. Both printing technologies were found to conform with the currently set standards of accuracy (<1 mm), demonstrating that accurate 3D models of large and small vessel anatomy can be generated by both FDM and PolyJet printing technology using rigid and flexible polymers.


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