scholarly journals Virtual Reality (VR) Simulation and Augmented Reality (AR) Navigation in Orthognathic Surgery: A Case Report

2021 ◽  
Vol 11 (12) ◽  
pp. 5673
Author(s):  
Ye-Joon Jo ◽  
Jun-Seok Choi ◽  
Jin Kim ◽  
Hyo-Joon Kim ◽  
Seong-Yong Moon
Keyword(s):  
Virtual Reality ◽  
Orthognathic Surgery ◽  
Preoperative Planning ◽  
Medical Application ◽  
3D Models ◽  
Average Difference ◽  
Operative Results ◽  
Surgical Guides ◽  
3D Printed ◽  
Surgical Field

VR and AR technology have gradually developed to the extent that they could help operators in the surgical field. In this study, we present a case of VR simulation for preoperative planning and AR navigation applied to orthognathic surgery. The average difference between the preplanned data and the post-operative results was 3.00 mm, on average, and the standard deviation was 1.44 mm. VR simulation could provide great advantages for 3D medical simulations, with accurate manipulation and immersiveness. AR navigation has great potential in medical application; its advantages include displaying real time augmented 3D models of patients. Moreover, it is easily applied in the surgical field, without complicated 3D simulations or 3D-printed surgical guides.

Virtual Reality Angiogram vs 3-Dimensional Printed Angiogram as an Educational tool—A Comparative Study

Neurosurgery ◽  
2019 ◽  
Vol 85 (2) ◽  
pp. E343-E349 ◽  
Author(s):  
David Bairamian ◽  
Shinuo Liu ◽  
Behzad Eftekhar
Keyword(s):  
Virtual Reality ◽  
Depth Perception ◽  
3D Visualization ◽  
Three Dimensional ◽  
3D Models ◽  
Stereoscopic Depth ◽  
Educational Tool ◽  
Immersive Virtual Environment ◽  
3D Printed ◽  
Educational Potential

Abstract BACKGROUND Three-dimensional (3D) visualization of the neurovascular structures has helped preoperative surgical planning. 3D printed models and virtual reality (VR) devices are 2 options to improve 3D stereovision and stereoscopic depth perception of cerebrovascular anatomy for aneurysm surgery. OBJECTIVE To investigate and compare the practicality and potential of 3D printed and VR models in a neurosurgical education context. METHODS The VR angiogram was introduced through the development and testing of a VR smartphone app. Ten neurosurgical trainees from Australia and New Zealand participated in a 2-part interactive exercise using 3 3D printed and VR angiogram models followed by a questionnaire about their experience. In a separate exercise to investigate the learning curve effect on VR angiogram application, a qualified neurosurgeon was subjected to 15 exercises involving manipulating VR angiograms models. RESULTS VR angiogram outperformed 3D printed model in terms of resolution. It had statistically significant advantage in ability to zoom, resolution, ease of manipulation, model durability, and educational potential. VR angiogram had a higher questionnaire total score than 3D models. The 3D printed models had a statistically significant advantage in depth perception and ease of manipulation. The results were independent of trainee year level, sequence of the tests, or anatomy. CONCLUSION In selected cases with challenging cerebrovascular anatomy where stereoscopic depth perception is helpful, VR angiogram should be considered as a viable alternative to the 3D printed models for neurosurgical training and preoperative planning. An immersive virtual environment offers excellent resolution and ability to zoom, potentiating it as an untapped educational tool.

scholarly journals IMHOTEP: cross-professional evaluation of a three-dimensional virtual reality system for interactive surgical operation planning, tumor board discussion and immersive training for complex liver surgery in a head-mounted display

2021 ◽  
Author(s):  
Hannes Götz Kenngott ◽  
Micha Pfeiffer ◽  
Anas Amin Preukschas ◽  
Lisa Bettscheider ◽  
Philipp Anthony Wise ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Patient Care ◽  
Liver Surgery ◽  
Preoperative Planning ◽  
Medical Training ◽  
3D Models ◽  
Patient Data ◽  
Tumor Board ◽  
Operation Planning ◽  
And Training

Abstract Background Virtual reality (VR) with head-mounted displays (HMD) may improve medical training and patient care by improving display and integration of different types of information. The aim of this study was to evaluate among different healthcare professions the potential of an interactive and immersive VR environment for liver surgery that integrates all relevant patient data from different sources needed for planning and training of procedures. Methods 3D-models of the liver, other abdominal organs, vessels, and tumors of a sample patient with multiple hepatic masses were created. 3D-models, clinical patient data, and other imaging data were visualized in a dedicated VR environment with an HMD (IMHOTEP). Users could interact with the data using head movements and a computer mouse. Structures of interest could be selected and viewed individually or grouped. IMHOTEP was evaluated in the context of preoperative planning and training of liver surgery and for the potential of broader surgical application. A standardized questionnaire was voluntarily answered by four groups (students, nurses, resident and attending surgeons). Results In the evaluation by 158 participants (57 medical students, 35 resident surgeons, 13 attending surgeons and 53 nurses), 89.9% found the VR system agreeable to work with. Participants generally agreed that complex cases in particular could be assessed better (94.3%) and faster (84.8%) with VR than with traditional 2D display methods. The highest potential was seen in student training (87.3%), resident training (84.6%), and clinical routine use (80.3%). Least potential was seen in nursing training (54.8%). Conclusions The present study demonstrates that using VR with HMD to integrate all available patient data for the preoperative planning of hepatic resections is a viable concept. VR with HMD promises great potential to improve medical training and operation planning and thereby to achieve improvement in patient care.

scholarly journals Accuracy of Patient-Specific Drilling Guides in Acetabular Fracture Surgery: A Human Cadaver Study

2021 ◽  
Vol 11 (8) ◽  
pp. 763
Author(s):  
Anne M. L. Meesters ◽  
Nick Assink ◽  
Kaj ten Duis ◽  
Eelco M. Fennema ◽  
Joep Kraeima ◽  
...  
Keyword(s):  
Acetabular Fracture ◽  
Preoperative Planning ◽  
Soft Tissue Injuries ◽  
Ct Scans ◽  
Screw Placement ◽  
Patient Specific ◽  
Surgical Guides ◽  
Entry Points ◽  
3D Printed ◽  
Fracture Surgery

Due to the complex anatomical shape of the pelvis, screw placement can be challenging in acetabular fracture surgery. This study aims to assess the accuracy of screw placement using patient-specific surgical drilling guides applied to pre-contoured conventional implants in acetabular fracture surgery. CT scans were made of four human cadavers to create 3D models of each (unfractured) pelvis. Implants were pre-contoured on 3D printed pelvic models and optically scanned. Following virtual preoperative planning, surgical drilling guides were designed to fit on top of the implant and were 3D printed. The differences between the pre-planned and actual screw directions (degrees) and screw entry points (mm) were assessed from the pre- and postoperative CT-scans. The median difference between the planned and actual screw direction was 5.9° (IQR: 4–8°) for the in-plate screws and 7.6° (IQR: 6–10°) for the infra-acetabular and column screws. The median entry point differences were 3.6 (IQR: 2–5) mm for the in-plate screws and 2.6 (IQR: 2–3) mm for the infra-acetabular and column screws. No screws penetrated into the hip joint or caused soft tissue injuries. Three-dimensional preoperative planning in combination with surgical guides that envelope pre-contoured conventional implants result in accurate screw placement during acetabular fracture surgery.

Is Preoperative Planning for Hip Surgery Using Three-Dimensional Printed Models Associated with Improved Intra- and Postoperative Outcomes? A Systematic Review

2019 ◽  
Vol 03 (03) ◽  
pp. 151-160
Author(s):  
Michael J. Mosca ◽  
Pablo Castañeda
Keyword(s):  
3D Printing ◽  
Clinical Outcomes ◽  
Preoperative Planning ◽  
Three Dimensional ◽  
Postoperative Outcomes ◽  
Hip Surgery ◽  
Patient Specific ◽  
Original Research ◽  
Surgical Guides ◽  
3D Printed

AbstractUse of three-dimensional (3D) printed models for preoperative planning, patient-specific surgical guides, and implants in orthopaedic surgery is a burgeoning technology. It has not been established if 3D-printed models for preoperative planning are associated with improved clinical outcomes or if they are cost-effective for hip surgeries including total hip arthroplasty (THA), periacetabular osteotomy (PAO), proximal femoral osteotomy (PFO), and/or hip fractures. The purpose of this study was to conduct a systematic search and literature review to determine if preoperative planning for hip surgery using 3D-printed models was associated with improved intra- and postoperative outcomes. Specific aims were to determine the (1) types of applications and studies conducted, (2) types of 3D printing/materials used, (3) specific outcomes evaluated, (4) efficacy of 3D printing in planning for hip surgery, and (5) limitations of current research. The authors searched Medline, Embase, Cochrane Database of Systematic Reviews, CINAHL, and PubMed from inception through July 2017. Original research publications were included if the primary purpose was to evaluate 3D-printed models' ability to assist with the planning of hip surgeries. Papers were excluded if they were reviews, abstracts, and not available in English, their models were not patient-specific, or their research did not evaluate surgery of the acetabulofemoral joint or pelvis. Of the 3,369 unique papers identified, 21 met inclusion criteria after full-text review. Among the included studies, six evaluated 3D printing in THA, seven in PAO/PFO, and eight in fracture repairs/reconstruction. The research included nine case reports, three case series, one retrospective uncontrolled study, six prospective uncontrolled studies, and two prospective controlled studies. 3D printed models resulted in: reduced intraoperative improvisation, operating room time, blood loss/transfusions, improved positioning of plates/screws/implants, clinical scores, measures of realignment, and functional status. Recent innovations in 3D printing are promising but unproven to improve clinical outcomes in hip surgeries due to limitations of published research. This may impact utilization and reimbursement of 3D-printed models in hip surgery. Studies of resource utilization, cost-effectiveness, and controlled trials with standardized methods and clinical outcomes of relevance are needed.

scholarly journals Development of a Patient-Specific 3D-Printed Liver Model for Preoperative Planning

2017 ◽  
Vol 24 (2) ◽  
pp. 145-150 ◽  
Author(s):  
Marta J. Madurska ◽  
Matthieu Poyade ◽  
David Eason ◽  
Paul Rea ◽  
Angus J. M. Watson
Keyword(s):  
Liver Tumor ◽  
Liver Surgery ◽  
Preoperative Planning ◽  
Clinical Care ◽  
Biliary Tree ◽  
3D Models ◽  
Digital Data ◽  
Patient Specific ◽  
Operative Strategies ◽  
3D Printed

Introduction. Liver surgery is widely used as a treatment modality for various liver pathologies. Despite significant improvement in clinical care, operative strategies, and technology over the past few decades, liver surgery is still risky, and optimal preoperative planning and anatomical assessment are necessary to minimize risks of serious complications. 3D printing technology is rapidly expanding, and whilst appliactions in medicine are growing, but its applications in liver surgery are still limited. This article describes the development of models of hepatic structures specific to a patient diagnosed with an operable hepatic malignancy. Methods. Anatomy data were segmented and extracted from computed tomography and magnetic resonance imaging of the liver of a single patient with a resectable liver tumor. The digital data of the extracted anatomical surfaces was then edited and smoothed, resulting in a set of digital 3D models of the hepatic vein, portal vein with tumor, biliary tree with gallbladder, and hepatic artery. These were then 3D printed. Results. The final models of the liver structures and tumor provided good anatomical detail and representation of the spatial relationships between the liver tumor and adjacent hepatic structures and could be easily manipulated and explored from different angles. Conclusions. A graspable, patient-specific, 3D printed model of liver structures could provide an improved understanding of the complex liver anatomy and better navigation in difficult areas and allow surgeons to anticipate anatomical issues that might arise during the operation. Further research into adequate imaging, liver-specific volumetric software, and segmentation algorithms are worth considering to optimize this application.

scholarly journals Clinical Value of Virtual Reality Versus 3D Printing in Congenital Heart Disease

Biomolecules ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 884
Author(s):  
Ivan Lau ◽  
Ashu Gupta ◽  
Zhonghua Sun
Keyword(s):  
Medical Education ◽  
Congenital Heart Disease ◽  
Virtual Reality ◽  
Heart Disease ◽  
3D Printing ◽  
Congenital Heart ◽  
Preoperative Planning ◽  
Clinical Value ◽  
Significant Difference ◽  
3D Printed

Both three-dimensional (3D) printing and virtual reality (VR) are reported as being superior to the current visualization techniques in conveying more comprehensive visualization of congenital heart disease (CHD). However, little is known in terms of their clinical value in diagnostic assessment, medical education, and preoperative planning of CHD. This cross-sectional study aims to address these by involving 35 medical practitioners to subjectively evaluate VR visualization of four selected CHD cases in comparison with the corresponding 3D printed heart models (3DPHM). Six questionnaires were excluded due to incomplete sections, hence a total of 29 records were included for the analysis. The results showed both VR and 3D printed heart models were comparable in terms of the degree of realism. VR was perceived as more useful in medical education and preoperative planning compared to 3D printed heart models, although there was no significant difference in the ratings (p = 0.54 and 0.35, respectively). Twenty-one participants (72%) indicated both the VR and 3DPHM provided additional benefits compared to the conventional medical imaging visualizations. This study concludes the similar clinical value of both VR and 3DPHM in CHD, although further research is needed to involve more cardiac specialists for their views on the usefulness of these tools.

DICOM 3D viewers, virtual reality or 3D printing – a pilot usability study for assessing the preference of orthopedic surgeons

2021 ◽  
pp. 095441192110201
Author(s):  
Diana Popescu ◽  
Rodica Marinescu ◽  
Dan Laptoiu ◽  
Gicu Calin Deac ◽  
Costel Emil Cotet
Keyword(s):  
Virtual Reality ◽  
3D Printing ◽  
Medical Training ◽  
3D Models ◽  
Usability Study ◽  
Dicom Viewer ◽  
Orthopedic Surgeons ◽  
Patient Diagnosis ◽  
Lack Of Information ◽  
3D Printed

As standard practice in orthopedic surgery, the information gathered by analyzing Computer Tomography (CT) 2D images is used for patient diagnosis and planning surgery. Lately, these virtual slices are the input for generating 3D virtual models using DICOM viewers, facilitating spatial orientation, and diagnosis. Virtual Reality (VR) and 3D printing (3DP) technologies are also reported for use in anatomy visualization, medical training, and diagnosis. However, it has not been yet investigated whether the surgeons consider that the advantages offered by 3DP and VR outweigh their development efforts. Moreover, no comparative evaluation for understanding surgeon’s preference in using these investigation tools has been performed so far. Therefore, in this paper, a pilot usability test was conducted for collecting surgeons’ opinions. 3D models of knee, hip and foot were displayed using DICOM 3D viewer, two VR environments and as 3D-printed replicas. These tools adequacy for diagnosis was comparatively assessed in three cases scenarios, the time for completing the diagnosis tasks was recorded and questionnaires filled in. The time for preparing the models for VR and 3DP, the resources needed and the associated costs were presented in order to provide surgeons with the whole context. Results showed a preference in using desktop DICOM viewer with 3D capabilities along with the information provided by Unity-based VR solution for visualizing the virtual model from various angles challenging to analyze on the computer screen. 3D-printed replicas were considered more useful for physically simulating the surgery than for diagnosis. For the VR and 3DP models, the lack of information on bone quality was considered an important drawback. The following order of using the tools was preferred: DICOM viewer, followed by Unity VR and 3DP.

Development of a patients-specific 3D-printed preoperative planning and training tool, with functionalized internal surfaces, for complex oncologic cases

2019 ◽  
Vol 25 (2) ◽  
pp. 363-377 ◽  
Author(s):  
Asier Muguruza Blanco ◽  
Lucas Krauel ◽  
Felip Fenollosa Artés
Keyword(s):  
3D Printing ◽  
Preoperative Planning ◽  
Low Cost ◽  
Hepatic Metastases ◽  
Value Added ◽  
3D Models ◽  
Anatomical Models ◽  
Anatomical Model ◽  
Content Type ◽  
3D Printed

Purpose The use of physical 3D models has been used in the industry for a while, fulfilling the function of prototypes in the majority of cases where the designers, engineers and manufacturers optimize their designs before taking them into production. In recent years, there has been an increasing number of reports on the use of 3D models in medicine for preoperative planning. In some highly complex surgeries, the possibility of using printed models to previously perform operations can be determining in the success of the surgery. With the aim of providing new functionalities to an anatomical 3D-printed models, in this paper, a cost-effective manufacturing process has been developed. A set of tradition of traditional techniques have been combined with 3D printing to provide a maximum geometrical freedom to the process. By the use of an electroluminescent set of functional paints, the tumours and vessels of the anatomical printed model have been highlighted, providing to this models the possibility to increase its interaction with the surgeon. These set of techniques has been used to increase the value added to the reproduced element and reducing the costs of the printed model, thus making it more accessible. Design/methodology/approach Successfully case in where the use of a low-cost 3D-printed anatomical model was used as a tool for preoperative planning for a complex oncological surgery. The said model of a 70-year-old female patient with hepatic metastases was functionalized with the aim of increasing the interaction with the surgeons. The analysis of the construction process of the anatomical model based on the 3D printing as a tool for their use in the medical field has been made, as well as its cost. Findings The use of 3D printing in the construction of anatomical models as preoperative tools is relatively new; however, the functionalization of these tools by using conductive and electroluminescent materials with the aim of increasing the interaction with it by the surgeons is a novelty. And, based on the DIY principles, it offers a geographical limitlessness, reducing its cost without losing the added value. Originality/value The process based on 3D printing presented in this paper allows to reproduce low-cost anatomical models by following a simple sequence of steps. It can be done by people with low qualification anywhere with only access to the internet and with the local costs. The interaction of these models with the surgeon based on touch and sight is much higher, adding a very significant value it, without increasing its cost.

scholarly journals Quality Control in 3D Printing: Accuracy Analysis of 3D-Printed Models of Patient-Specific Anatomy

Materials ◽  
2021 ◽  
Vol 14 (4) ◽  
pp. 1021
Author(s):  
Bernhard Dorweiler ◽  
Pia Elisabeth Baqué ◽  
Rayan Chaban ◽  
Ahmed Ghazy ◽  
Oroa Salem
Keyword(s):  
Wall Thickness ◽  
Large Scale ◽  
Fused Deposition Modeling ◽  
Vascular Anatomy ◽  
3D Models ◽  
Patient Specific ◽  
Stl File ◽  
Fused Deposition ◽  
3D Printed ◽  
The Mean

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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