scholarly journals Hybrid Spine Simulator Prototype for X-ray Free Pedicle Screws Fixation Training

2021 ◽  
Vol 11 (3) ◽  
pp. 1038
Author(s):  
Sara Condino ◽  
Giuseppe Turini ◽  
Virginia Mamone ◽  
Paolo Domenico Parchi ◽  
Vincenzo Ferrari
Keyword(s):  
Augmented Reality ◽  
Low Cost ◽  
Lumbar Vertebrae ◽  
Pedicle Screws ◽  
Simulation Software ◽  
Patient Specific ◽  
Innovative Strategy ◽  
X Ray ◽  
3D Printed ◽  
Harmful Radiation

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.

scholarly journals Three-dimensional–printed marker–based augmented reality neuronavigation: a new neuronavigation technique

2021 ◽  
Vol 51 (2) ◽  
pp. E20
Author(s):  
Gorkem Yavas ◽  
Kadri Emre Caliskan ◽  
Mehmet Sedat Cagli
Keyword(s):  
Augmented Reality ◽  
Mobile Device ◽  
Low Cost ◽  
Three Dimensional ◽  
Skin Incision ◽  
Optical Tracking ◽  
Patient Specific ◽  
Navigation Systems ◽  
Intracranial Tumors ◽  
3D Printed

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.

scholarly journals Accessing 3D Printed Vascular Phantoms for Procedural Simulation

2021 ◽  
Vol 7 ◽  
Author(s):  
Jasamine Coles-Black ◽  
Damien Bolton ◽  
Jason Chuen
Keyword(s):  
3D Printing ◽  
Endovascular Procedures ◽  
Low Cost ◽  
3D Models ◽  
Routine Care ◽  
Aortic Aneurysms ◽  
Patient Specific ◽  
Ct Angiogram ◽  
Abdominal Aortic ◽  
3D Printed

Introduction: 3D printed patient-specific vascular phantoms provide superior anatomical insights for simulating complex endovascular procedures. Currently, lack of exposure to the technology poses a barrier for adoption. We offer an accessible, low-cost guide to producing vascular anatomical models using routine CT angiography, open source software packages and a variety of 3D printing technologies.Methods: Although applicable to all vascular territories, we illustrate our methodology using Abdominal Aortic Aneurysms (AAAs) due to the strong interest in this area. CT aortograms acquired as part of routine care were converted to representative patient-specific 3D models, and then printed using a variety of 3D printing technologies to assess their material suitability as aortic phantoms. Depending on the technology, phantoms cost $20–$1,000 and were produced in 12–48 h. This technique was used to generate hollow 3D printed thoracoabdominal aortas visible under fluoroscopy.Results: 3D printed AAA phantoms were a valuable addition to standard CT angiogram reconstructions in the simulation of complex cases, such as short or very angulated necks, or for positioning fenestrations in juxtarenal aneurysms. Hollow flexible models were particularly useful for device selection and in planning of fenestrated EVAR. In addition, these models have demonstrated utility other settings, such as patient education and engagement, and trainee and anatomical education. Further study is required to establish a material with optimal cost, haptic and fluoroscopic fidelity.Conclusion: We share our experiences and methodology for developing inexpensive 3D printed vascular phantoms which despite material limitations, successfully mimic the procedural challenges encountered during live endovascular surgery. As the technology continues to improve, 3D printed vascular phantoms have the potential to disrupt how endovascular procedures are planned and taught.

scholarly journals Patients Specific Spine Simulators for Surgical Training and Rehearsal in Pedicle Screws Placement: A New Way for Surgical Education

10.29007/38mg ◽  
2020 ◽  
Author(s):  
Paolo Domenico Parchi ◽  
Sara Condino ◽  
Marina Carbone ◽  
Sara Stagnari ◽  
David Rocchi ◽  
...  
Keyword(s):  
Surgical Training ◽  
Pedicle Screws ◽  
Senior Resident ◽  
Patient Specific ◽  
Training Tool ◽  
Surgical Simulators ◽  
Timeline Analysis ◽  
Significant Difference ◽  
Ct Evaluation ◽  
3D Printed

In pedicle screws placement using a free-hand technique or a fluoroscopic guided technique the main difficulties are facing to the bone morphology (i.e in deformity cases) and it could be easily reproduced in a patient’s specific spine simulator (we can choose the case). The aim of this work is to evaluate the use of 3D printed patient- specific models (3D printing) not only as a surgical planning tool but also as a surgical training tool in spine surgery and in particular in pedicle screws placement. The manufacturing of patient-specific physical replica involves the elaboration of CT dataset and rapid prototyping techniques. . Five resident surgeons were involved in different training sessions on simulators. To evaluate the exact screws position weperformed a CT evaluation of each instrumented simulators. Statistical analysis was conducted using SPSS software. A total of 120 pedicle screws were positioned, 90 screws were well-positioned and 30 screws were bad-positioned. There were a significant difference (p = 0.000008) between the bad-positioning screw rate of the “senior” resident (13/72) and those of “young” participants (17/48). Timeline analysis of pedicle instrumentation training showed the presence of a learning effect, with a lower error rate in the latest session (p=000001). We believe that the use of patient- specific surgical simulators, especially for those surgical tasks in which the complexity is mainly linked to the spine morphology (i.e. deformity), may represent a valid alternative to the use of cadavers that generally present a standard or otherwise poorly predictable anatomy.

Computer-assisted extra-articular distal radius osteotomies using patient-specific surgical guides

10.29007/svbd ◽  
2018 ◽  
Author(s):  
Vasilii Shishkin ◽  
Valeriy Golubev
Keyword(s):  
Distal Radius ◽  
Patient Specific ◽  
Control Group ◽  
Computer Assisted ◽  
X Ray ◽  
Surgical Guides ◽  
Planning Approach ◽  
3D Printed ◽  
Planning Group

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.

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 ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Patient Specific ◽  
Computer Assisted ◽  
3D Printed

scholarly journals Augmented Reality, Surgical Navigation, and 3D Printing for Transcanal Endoscopic Approach to the Petrous Apex

OTO Open ◽  
2018 ◽  
Vol 2 (4) ◽  
pp. 2473974X1880449 ◽  
Author(s):  
Samuel R. Barber ◽  
Kevin Wong ◽  
Vivek Kanumuri ◽  
Ruwan Kiringoda ◽  
Judith Kempfle ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Skull Base ◽  
Surgical Planning ◽  
Preoperative Planning ◽  
Endoscopic Approach ◽  
Physical Models ◽  
Petrous Apex ◽  
Patient Specific ◽  
Lateral Skull Base ◽  
3D Printed

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.

scholarly journals 3D Printing of Rapid, Low-Cost and Patient-Specific Models of Brain Vasculature for Use in Preoperative Planning in Clipping of Intracranial Aneurysms

2021 ◽  
Vol 10 (6) ◽  
pp. 1201
Author(s):  
Maciej Błaszczyk ◽  
Redwan Jabbar ◽  
Bartosz Szmyd ◽  
Maciej Radek
Keyword(s):  
3D Visualization ◽  
Low Cost ◽  
Cost Benefit ◽  
Image Data ◽  
Cost Effective ◽  
3D Models ◽  
Urgent Care ◽  
Patient Specific ◽  
Stl File ◽  
3D Printed

We developed a practical and cost-effective method of production of a 3D-printed model of the arterial Circle of Willis of patients treated because of an intracranial aneurysm. We present and explain the steps necessary to produce a 3D model from medical image data, and express the significant value such models have in patient-specific pre-operative planning as well as education. A Digital Imaging and Communications in Medicine (DICOM) viewer is used to create 3D visualization from a patient’s Computed Tomography Angiography (CTA) images. After generating the reconstruction, we manually remove the anatomical components that we wish to exclude from the print by utilizing tools provided with the imaging software. We then export this 3D reconstructions file into a Standard Triangulation Language (STL) file which is then run through a “Slicer” software to generate a G-code file for the printer. After the print is complete, the supports created during the printing process are removed manually. The 3D-printed models we created were of good accuracy and scale. The median production time used for the models described in this manuscript was 4.4 h (range: 3.9–4.5 h). Models were evaluated by neurosurgical teams at local hospital for quality and practicality for use in urgent and non-urgent care. We hope we have provided readers adequate insight into the equipment and software they would require to quickly produce their own accurate and cost-effective 3D models from CT angiography images. It has become quite clear to us that the cost-benefit ratio in the production of such a simplified model is worthwhile.

scholarly journals Patient-specific 3D printed and augmented reality kidney and prostate cancer models: impact on patient education

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Nicole Wake ◽  
Andrew B. Rosenkrantz ◽  
Richard Huang ◽  
Katalina U. Park ◽  
James S. Wysock ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Patient Education ◽  
Augmented Reality ◽  
Patient Specific ◽  
Cancer Models ◽  
3D Printed
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