Immersive 3-Dimensional Virtual Reality Modeling for Case-Specific Presurgical Discussions in Cerebrovascular Neurosurgery

2020 ◽  
Author(s):  
Taku Sugiyama ◽  
Tod Clapp ◽  
Jordan Nelson ◽  
Chad Eitel ◽  
Hiroaki Motegi ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Surgical Planning ◽  
Objective Assessment ◽  
Surgical Techniques ◽  
Patient Specific ◽  
Decision Making Process ◽  
3 Dimensional ◽  
Head Mounted Display ◽  
Precise Understanding ◽  
Cerebrovascular Surgery

Abstract BACKGROUND Adequate surgical planning includes a precise understanding of patient-specific anatomy and is a necessity for neurosurgeons. Although the use of virtual reality (VR) technology is emerging in surgical planning and education, few studies have examined the effectiveness of immersive VR during surgical planning using a modern head-mounted display. OBJECTIVE To investigate if and how immersive VR aids presurgical discussions of cerebrovascular surgery. METHODS A multiuser immersive VR system, BananaVisionTM, was developed and used during presurgical discussions in a prospective patient cohort undergoing cerebrovascular surgery. A questionnaire/interview was administered to multiple surgeons after the surgeries to evaluate the effectiveness of the VR system compared to conventional imaging modalities. An objective assessment of the surgeon's knowledge of patient-specific anatomy was also conducted by rating surgeons’ hand-drawn presurgical illustrations. RESULTS The VR session effectively enhanced surgeons’ understanding of patient-specific anatomy in the majority of cases (83.3%). An objective assessment of surgeons’ presurgical illustrations was consistent with this result. The VR session also effectively improved the decision-making process regarding minor surgical techniques in 61.1% of cases and even aided surgeons in making critical surgical decisions about cases involving complex and challenging anatomy. The utility of the VR system was rated significantly higher by trainees than by experts. CONCLUSION Although rated as more useful by trainees than by experts, immersive 3D VR modeling increased surgeons’ understanding of patient-specific anatomy and improved surgical strategy in certain cases involving challenging anatomy.

scholarly journals Minimally Invasive Mini-orbitozygomatic Approach for Clipping an Anterior Communicating Artery Aneurysm: Virtual Reality Surgical Planning

2020 ◽  
Author(s):  
Nicolás González Romo ◽  
Franco Ravera Zunino
Keyword(s):  
Virtual Reality ◽  
Minimally Invasive ◽  
Surgical Planning ◽  
Artery Aneurysm ◽  
Patient Specific ◽  
Anterior Communicating Artery ◽  
Imaging Data ◽  
Advantages And Disadvantages ◽  
Orbitozygomatic Approach ◽  
Skull Base Anatomy

AbstractVirtual reality (VR) has increasingly been implemented in neurosurgical practice. A patient with an unruptured anterior communicating artery (AcoA) aneurysm was referred to our institution. Imaging data from computed tomography angiography (CTA) was used to create a patient specific 3D model of vascular and skull base anatomy, and then processed to a VR compatible environment. Minimally invasive approaches (mini-pterional, supraorbital and mini-orbitozygomatic) were simulated and assessed for adequate vascular exposure in VR. Using an eyebrow approach, a mini-orbitozygomatic approach was performed, with clip exclusion of the aneurysm from the circulation. The step-by-step process of VR planning is outlined, and the advantages and disadvantages for the neurosurgeon of this technology are reviewed.

scholarly journals Effect of 3-Dimensional Virtual Reality Models for Surgical Planning of Robotic-Assisted Partial Nephrectomy on Surgical Outcomes

2019 ◽  
Vol 2 (9) ◽  
pp. e1911598 ◽  
Author(s):  
Joseph D. Shirk ◽  
David D. Thiel ◽  
Eric M. Wallen ◽  
Jennifer M. Linehan ◽  
Wesley M. White ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Partial Nephrectomy ◽  
Surgical Outcomes ◽  
Surgical Planning ◽  
Robotic Assisted ◽  
3 Dimensional ◽  
Robotic Assisted Partial Nephrectomy

A Method to Develop Virtual Reality Platforms for the Medical Rehabilitation of Severe Memory Loss After Brain Stroke

2021 ◽  
Author(s):  
Daniel Lanzoni ◽  
Andrea Vitali ◽  
Daniele Regazzoni ◽  
Caterina Rizzi
Keyword(s):  
Virtual Reality ◽  
Data Management ◽  
Serious Games ◽  
Memory Loss ◽  
Medical Rehabilitation ◽  
Patient Specific ◽  
Medical Monitoring ◽  
Game Logic ◽  
Head Mounted Display ◽  
Brain Stroke

Abstract The paper presents a method to develop Virtual Reality (VR) platforms based on serious games for the rehabilitation of severe memory loss. In particular, it is related to retrograde amnesia, a condition affecting patient’s quality of life usually caused by brain stroke. Nowadays, the standard rehabilitation process consists in showing pictures of patient’s familiar environments in order to recover the memory. Past research works have investigated the use of 3D scanners for the virtualization of real environment and virtual reality for the generation of more immersive interaction to design serious games for neurocognitive rehabilitation. Reached results highlighted a time-consuming development process to interface each new environment with the game logic specifically developed for the serious games. Furthermore, a complete VR platform must also consider the medical monitoring and the data management oriented to a more objective medical assessment. The proposed method allows the design of VR platforms based on patient-specific serious games for memory loss starting from the 3D scanning acquisition of familiar environments. The 3D acquisition is performed using the Occipital Structure Sensor and the Skanect application. A modular procedure has been designed to interface the virtual objects of each acquired environment with the modules of the game-logic developed with Unity. The immersive Virtual Reality is based on the use of the HTC Vive Pro head mounted display. Furthermore, the method permits to associate the patient-specific serious game to a set of software modules for the medical monitoring and the data management for the generation of reports useful for the evaluation. The solution has been evaluated by measuring the time needed to develop a whole VR platform for two different familiar environments. Less than 5 hours are required to complete the design process.

3D modeling: a future of cardiovascular medicine

2019 ◽  
Vol 97 (4) ◽  
pp. 277-286 ◽  
Author(s):  
Kaley H. Garner ◽  
Dinender K. Singla
Keyword(s):  
3D Modeling ◽  
Surgical Planning ◽  
Surgical Techniques ◽  
3D Models ◽  
Health Concern ◽  
Patient Specific ◽  
Future Directions ◽  
Medical Device Design ◽  
Significant Interest ◽  
Operative Planning

Cardiovascular disease resulting from atypical cardiac structures continues to be a leading health concern despite advancements in diagnostic imaging and surgical techniques. However, the ability to visualize spatial relationships using current technologies remains a challenge. Therefore, 3D modeling has gained significant interest to understand complex and atypical cardiovascular disorders. Moreover, 3D modeling can be personalized and patient-specific. 3D models have been demonstrated to aid surgical planning and simulation, enhance communication among surgeons and patients, optimize medical device design, and can be used as a potential teaching tool in medical schools. In this review, we discuss the key components needed to generate cardiac 3D models. We highlight prevalent structural conditions that have utilized 3D modeling in pre-operative planning. Furthermore, we discuss the current limitations of routine use of 3D models in the clinic as well as future directions for utilization of this technology in the cardiovascular field.

scholarly journals O74: ASSESSING THE USEFULNESS OF THREE-DIMENSIONAL IMAGING AND VIRTUAL REALITY IN SURGICAL PLANNING: A MEDICAL STUDENT LED PILOT STUDY

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
C Ryan ◽  
E O'Malley ◽  
D Sheppard
Keyword(s):  
Virtual Reality ◽  
Medical Student ◽  
Pilot Study ◽  
Surgical Planning ◽  
Three Dimensional ◽  
Surgical Techniques ◽  
3D Models ◽  
Bleeding Complications ◽  
Three Dimensional Imaging ◽  
Patient Counselling

Abstract Introduction Nephron-sparing surgery is becoming more common as surgical techniques advance. VR and 3D visualisation appear to provide better anatomical understanding in presurgical planning than two-dimensional alone. 3D models may enable greater tissue salvation and fewer complications. 3D model preparation and advancing research is expensive and time consuming. We aim to pilot study led by medical student, create reliable anatomical kidney models and assess usefulness in surgical planning. Method Routine CT urograms were performed on 128 slice scanner using split bolus technique. Medical student segmented and displayed models in VR using 3DSlicer. Radiology registrar and consultant validated models. Two urology surgeons completed qualitative questionnaires. Result We included two patients. Only minor segmentation tweaks by radiologist ensured accurately demonstrated tumors. Tissue contrast quality varied between CT scans complicating segmentation. Both surgeons deemed models helpful in visualising hilar anatomy, predicting bleeding complications, determining laparoscopic/open and partial/full nephrectomy approach. Surgeons prioritised vasculature visualisation over collecting system. Surgeons suggested gauging tumor depth would be useful. Considering 3D printing cost, surgeons agreed VR alone may suffice. Conclusion Surgeons found 3D and VR enabled accurate surgical planning and patient counselling regarding nephrectomy risk. Minor CT protocol recommendations enable easier and more accurate segmentation, without increasing patient's radiation exposure. Annual leave during 8-week summer project reflects case numbers. Since, we've identified more cases to assess surgical parameters against matched cohort. We've begun work for adrenal surgery. It's feasible for medical students with minimal surgical/radiological knowledge to advance this research, gaining valuable experience. Abbrev Virtual Reality(VR), Three-dimensional(3D), Computerised Tomography(CT) Take-home message Three-dimensional imaging and virtual reality may improve surgical planning and patient counselling. Regarding nephrectomy, this could give surgeons the confidence to convert from full nephrectomy to partial nephrectomy approach, improving patient outcome.

scholarly journals Study of comparative surgical exposure to the petroclival region using patient-specific, petroclival meningioma virtual reality models

2021 ◽  
Vol 51 (2) ◽  
pp. E13
Author(s):  
Walter C. Jean ◽  
Yang Yang ◽  
Aneil Srivastava ◽  
Alexander X. Tai ◽  
Aalap Herur-Raman ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Tumor Volume ◽  
Surgical Techniques ◽  
Patient Specific ◽  
Surgical Approaches ◽  
Imaging Data ◽  
Petroclival Region ◽  
Petroclival Meningiomas ◽  
Retrolabyrinthine Approach ◽  
Ct And Mri

OBJECTIVE Despite advancement of surgical techniques, the attachments of petroclival meningiomas near the central clival depression (CCD) remain difficult to visualize. With existing methods, the amount of tumor near the CCD that is inaccessible through various approaches cannot be compared. Tumors distort the brainstem, changing the size of the operative corridor for some but not all approaches; therefore, using cadavers with normal posterior fossae makes it impossible to compare different approaches to the tumor. The authors used virtual reality (VR) models created from the imaging data of patients to compare various surgical approaches that have otherwise been incomparable in previous studies. METHODS CT and MRI data obtained in 15 patients with petroclival meningiomas were used to create anatomically accurate 3D VR models. For each model, various surgical approaches were performed, and the surgical freedom to 6 targets of the regions were measured. Furthermore, portions of the tumor that were visually blocked by the brainstem or bony structures were segmented and recorded as blinded volumes for comparison. RESULTS The extended retrosigmoid approach generated excellent exposure of the petroclival region, but for most specimens, there was inaccessible tumor volume adjacent to the brainstem (mean 641.3 mm3, SE 161.8). In contrast, the brainstem sides of the tumors were well-visualized by all the transpetrosal approaches. The blinded volume of the tumor was largest for the retrolabyrinthine approach, and this was statistically significant compared with all other approaches (mean 2381.3 mm3, SE 185.4). CONCLUSIONS The authors performed a novel laboratory study by using patient CT and MRI data to generate 3D virtual models to compare surgical approaches. Since it is impossible to perform various approaches in separate surgeries in patients for comparison, VR represents a viable alternative for such comparative investigations.

scholarly journals Developing Virtual Reality Head Mounted Display (HMD) Set-Up for Thoracoscopic Surgery of Complex Congenital Lung MalFormations in Children

Children ◽  
2022 ◽  
Vol 9 (1) ◽  
pp. 50
Author(s):  
Gloria Pelizzo ◽  
Sara Costanzo ◽  
Margherita Roveri ◽  
Giulia Lanfranchi ◽  
Maurizio Vertemati ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Pediatric Patients ◽  
Vascular System ◽  
Thoracoscopic Surgery ◽  
Lung Parenchyma ◽  
3 Dimensional ◽  
Head Mounted Display ◽  
Congenital Lung Malformations ◽  
Set Up ◽  
Organ Models

Video assisted thoracoscopic surgery (VATS) has been adopted in pediatric age for the treatment of congenital lung malformations (CLM). The success of VATS in pediatrics largely depends on the surgeon’s skill ability to understand the airways, vascular system and lung parenchyma anatomy in CLM. In the last years, virtual reality (VR) and 3-dimensional (3D) printing of organ models and VR head mounted display (HMD) technologies have been introduced for completion of preoperative planning in adult patients. To date no reports about the use of VR HMD technologies in a pediatric setting are available. The aim of this report is to introduce a VR HMD model in VATS procedure to improve the quality of care in children with CLM. VR HMD set-up for planning thoracoscopic surgery was performed in a series of pediatric patients with diagnosis of CLM. The preoperative VR HMD evaluation allowed a navigation into the malformation with the aim to explore, interact, and make the surgeon more confident and skilled to answer to the traps. A development of surgical simulations models and teaching program dedicated to education and training in pediatric VATS is suitable among the pediatric surgery community. Further studies should demonstrate all the benefits of such technology in pediatric patients submitted to VATS procedure.

scholarly journals Current applications of 3d printing in neurosurgery

2019 ◽  
pp. 417-423
Author(s):  
A. Chiriac ◽  
A. Iencean ◽  
Georgiana Ion ◽  
G. Stan ◽  
S. Munteanu ◽  
...  
Keyword(s):  
Medical Education ◽  
3D Printing ◽  
Surgical Planning ◽  
Patient Specific ◽  
Printing Technology ◽  
3 Dimensional ◽  
3D Printing Technology ◽  
Assessment And Treatment ◽  
Printing Techniques

Medical implications of 3-dimensional (3D) printing technology have progressed with increasingly used especially in surgical fields. 3D printing techniques are practical and anatomically accurate methods of producing patient specific models for medical education, surgical planning, training and simulation, and implants production for the assessment and treatment of neurosurgical diseases. This article presents the main directions of 3D printing models application in neurosurgery.

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