Maki Sugimoto, MD, PhD. International University of Health Welfare
Objectives: Endoscopic minimally invasive surgery provides a limited field of view, thus requiring a high degree of spatial awareness and orientation. Because of a 2D field of endoscopic view, a surgeon’s spatial awareness is diminished. This study aims to evaluate the efficacy of our novel surgical navigation system of immersive holographic mixed reality (MR) using a head-mounted smart glass display HoloLens to enhance spatial awareness of the operating field in laparoscopic surgery. The authors describe a method of registering and overlaying the preoperative MDCT imaging localization of tumors, vessels, and organs onto the real world in the operating theatre through holographic smartglasses in augmented reality (AR).
Methods: In this study we included 20 laparoscopic GI, HPB, urology, and gynecologic surgeries using this system. We developed a CT-based patient-specific holographic MR surgical navigating application using HoloLens, that is a pair of see-through monitors built-in head-mounted display.
By reconstructing the patient-specific 3D surface polygons of tumors, vessels, and organs out of the patient’s MDCT, MR anatomy was displayed on the see-through grasses three-dimensionally during actual surgery. The HoloLens features an inertial measurement unit which includes an accelerometer, gyroscope, and a magnetometer for environment understanding sensors, an energy-efficient depth camera, a photographic video camera, and an ambient light sensor.
Results: The accurate surgical anatomy of size, position, and depth of the tumors, surrounding organs, and vessels during surgeries could be measured using build-in dual infrared light sensors. The exact location between surgical devices and patient’s anatomy could be traced on the pair of MR smart-glasses by satellite tracking. The gesture controlled manipulation by surgeons’ hands with surgical groves was useful for intraoperative anatomical references of tumors and vascular position under sterilized environment. It allowed the user to manipulate the spatial attributes of the virtual and real anatomies. This system reduced the length of the operation and discussion time. This could support complex procedures with the help of pre- and intra-operative imaging with better visualization of the surgical anatomy and spatial awareness with visualization of surgical instruments in relation to anatomical landmarks.
Conclusions: The immersive holographic MR system provides a real-time 3D interactive perspective of the inside of the patient, accurately guiding the surgeon. This helps spatial awareness of the surgeons in the operating field and has illustrative benefits in surgical planning, simulation, education, and navigation. Enhancing scene visualization is a feasible strategy for augmenting spatial awareness in laparoscopic surgery.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87821
Program Number: P505
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster