Augmented reality (AR) in operation theaters allows surgeons to find blood
vessels under the skin accurately and quickly by overlaying scan images onto
- Using a
computer-aided technology called augmented reality in operation theaters
may aid and improve the outcome of similar surgeries.
- HoloLens, a
wearable headset system allows surgeons to visualize the internal
structure of the limb by overlaying a 3D model onto the limb.
- The approach
helps surgeons locate and reconnect key blood vessels during
reconstructive surgery with more precision.
, shows new study carried out by a team at Imperial College
London published in European Radiology Experimental. AR allows the surgeon to see through the patient's skin to study the
underlying anatomy without making a single incision, thus bringing preoperative computed tomography (CT) angiography (CTA)
information imaging to life.
Wikipedia states that "The primary value of Augmented reality is that
it brings components of the digital world into a person's perception of the
real world, and does so not as a simple display of data, but through the
integration of immersive sensations that are perceived as natural parts of an
‘Augmented reality, a novel technology can help in “seeing through” a patient’s limb during operation and thus help surgeons improve outcome of similar surgeries.’
Using Microsoft's HoloLens headsets while operating on
patients undergoing reconstructive lower limb surgery helps surgeons locate and
reconnect key blood vessels during surgery, which could improve outcomes for
surgery is mostly carried out on
faces after trauma and to reconstruct the head and neck after cancer
. It is performed by plastic
surgeons and surgeons who operate on the head, neck, and face aiming to improve their
form and function.
"We are one of the first groups in the world to use the
HoloLens successfully in the operating theatre," said Dr Philip Pratt, a
Research Fellow in the Department of Surgery Cancer and lead author of
the study, "Through this initial series of patient cases we have shown
that the technology is practical, and that it can provide a benefit to the
surgical team. With the HoloLens, you look at the leg and essentially see
inside of it. You see the bones, the course of the blood vessels, and can
identify exactly where the targets are located."
Building the model
surgery are first scanned. The CT
of their limbs maps the structure of the limb
including the position of the bones and blood vessels. The scanned images are
then segmented into bone, muscle, fatty tissue and blood
vessels by a radiologist. These are then loaded onto a software to generate a 3-dimensional model. Once a
model is generated, the data was fed into a
specially designed software that provides images for the HoloLens headset. When
the surgeon looks at the patient's limb through the HoloLens, the generated
model overlays the actual limb giving the surgeon the precise location of the
internal complexity. If needed, the models may be manipulated through hand
gestures to make any fine adjustments and correctly line up the model with
surgical landmarks on the patient's limbs, such as the knee joint or ankle
Dimitri Amiras, a consultant radiologist at Imperial College Healthcare NHS
Trust, said, "Now,
using the HoloLens, we can identify where the blood vessels are in 3D space and
use virtual 3D arrows to guide the surgeon
. Currently, data preparation is
process, but in the future,
much of this could be automated, with the consultant radiologist checking the
accuracy of the model against the original scan. I think this is a great
example of what can be achieved in an Academic Health Science Centre."
errors in the modeling stage
model may be misaligned with the actual limb
the trial was only conducted on limbs that have surgical landmarks like
ankles and knees, this does not apply to body parts like the abdomen
- Pratt, P. et al. Through the HoloLens™ looking glass: augmented reality for extremity reconstruction surgery using 3D vascular models with perforating vessels. European Radiology Experimental2, (2018).