Augmented reality neurosurgery

BACKGROUND: Our study presents a single center experience in resection of intradural spinal tumors either with or without using intraoperative CT (iCT)-based registration and microscope-based augmented reality (AR). Microscope-based AR was recently described for improved orientation in the operative field in spine surgery, using superimposed images of segmented structures of interest in a two- (2D) or three-dimensional (3D) mode. MATERIALS AND METHODS: All patients who underwent surgery for resection of intradural spinal tumors at our department were retrospectively included in the study...

INTRODUCTION: Augmented Reality (AR) and Virtual Reality (VR) technologies have been introduced to Neurosurgery with the goal of improving the experience of human visualization. In recent years, the application of remote AR and VR has opened new horizons for neurosurgical collaboration across diverse domains of education and patient treatment. Herein, we aimed to systematically review the literature about the feasibility of this technology and discuss the technical aspects, current limitations, and future perspectives...

External ventricular drain (EVD) is a common, yet challenging neurosurgical procedure of placing a catheter into the brain ventricular system that requires prolonged training for surgeons to improve the catheter placement accuracy. In this paper, we introduce NeuroLens, an Augmented Reality (AR) system that provides neurosurgeons with guidance that aides them in completing an EVD catheter placement. NeuroLens builds on prior work in AR-assisted EVD to present a registered hologram of a patient's ventricles to the surgeons, and uniquely incorporates guidance on the EVD catheter's trajectory, angle of insertion, and distance to the target...

Neurosurgeons receive extensive technical training, which equips them with the knowledge and skills to specialise in various fields and manage the massive amounts of information and decision-making required throughout the various stages of neurosurgery, including preoperative, intraoperative, and postoperative care and recovery. Over the past few years, artificial intelligence (AI) has become more useful in neurosurgery. AI has the potential to improve patient outcomes by augmenting the capabilities of neurosurgeons and ultimately improving diagnostic and prognostic outcomes as well as decision-making during surgical procedures...

BACKGROUND AND OBJECTIVES: Several factors contribute to the anatomical complexity of the trochlear nerve including small diameter, complex and longest intracranial course, deep location, and numerous neurovascular relationships. 3-D photorealistic model of cranial nerves provides detailed and immersive representation of the anatomy, enabling to improve surgical planning, advanced surgical research and training. The purpose of this paper is to present a 3-dimentional photogrammetric study for a more intuitive and interactive way to explore and describe the entire course of trochlear nerve...

Giant supratentorial brain tumors (GSBTs) in children are uncommon and extremely challenging entities unique to pediatric neurosurgery. Factors such as young patient age, need for urgent intervention, intraoperative blood loss, and ongoing raised intracranial pressure symptoms are examples of difficulties faced. Recently, there has been a growing body of literature on augmented reality (AR) in adult neurosurgery. In contrast, the use of AR in pediatric neurosurgery is comparatively less. Nonetheless, we postulate that AR systems will be helpful for understanding spatial relationships of complex GSBT anatomy for preoperative planning in a timely fashion...

Three dimensional (3D) virtual models for neurosurgery have demonstrated substantial clinical utility, especially for neuro-oncological cases. Computer-aided design (CAD) modelling of radiological images can provide realistic and high-quality 3D models which neurosurgeons may use pre-operatively for surgical planning. 3D virtual models are useful as they are the basis for other models that build off this design. 3D virtual models are quick to segment but can also be easily added to normal neurosurgical and radiological workflow without disruption...

Recently, three-dimensional(3D)holograms from mixed-reality(MR)devices have become available in the medical field. 3D holographic images can provide immersive and intuitive information that has been reported to be very useful for preoperative simulations. Compared with conventional 3D images on a two-dimensional(2D)monitor, 3D holograms offer a higher level of realism, allowing observation of the images anytime and anywhere if the MR device is operational. Even during surgery, surgeons can check realistic 3D holograms in front of them, above the surgical field, without having to turn their heads toward a 2D monitor on the wall...

With its recent release, the Apple Vision Pro (Apple Inc., Cupertino, CA) represents a promising technological advancement of mixed reality in the field of neurosurgery and medicine more broadly. With all new technologies, it is critical to facilitate early use and assessment of the technology to facilitate adoption by the larger medical community. A 44-year-old female with a history of ruptured intracranial aneurysm status post anterior communicating artery aneurysm clipping presented with worsened confusion and intermittent headache...

OBJECTIVES: The prospect of extended reality (XR) being integrated with surgical training curriculum has attracted scholars. However, there is a lack of bibliometric analysis to help them better understand this field. Our aim is to analyze relevant literature focusing on development trajectory and research directions since the 21st century to provide valuable insights. METHODS: Papers were retrieved from the Web of Science Core Collection. Microsoft Excel, VOSviewer, and CiteSpace were used for bibliometric analysis...

Background Operating room (OR) nurses' training for surgical fields such as neurosurgery is often inconsistent and overly lengthy due to the lack of consistently scheduled procedures and the nature of procedures being for the most part emergencies. Virtual reality (VR) simulation has been explored for nurses training in various contexts with positive results. Objectives To develop a VR simulation that could replicate a pediatric neurosurgery craniotomy procedure reflecting a real OR scenario and the surgical procedural sequence of a craniotomy; and to assess OR nurses' confidence in assisting craniotomy procedures as scrub nurses before and after the VR simulation...

Augmented reality (AR) is an exciting technology that has garnered considerable attention in the field of neurosurgery. Despite this, clinical use of this technology is still in its infancy. An area of great potential for this technology is the ability to display 3D anatomy overlaid with the patient to assist with presurgical and intraoperative decision-making. A 39-year-old woman presented with headaches and was experiencing what was described as a whooshing sound. MRI revealed the presence of a large left frontal mass involving the genu of the corpus callosum, with heterogeneous enhancement and central hemorrhagic necrosis, confirmed to be a glioma...

Augmented reality (AR) and virtual reality (VR) are powerful technologies with proven utility and tremendous potential. Spine surgery, in particular, may benefit from these developing technologies for resident training, preoperative education for patients, surgical planning and execution, and patient rehabilitation. In this review, the history, current applications, challenges, and future of AR/VR in spine surgery are examined.

A historical overview of the evolution of anterolateral approaches to the lumber spine and associated patient outcomes is presented. In addition, the modern incorporation of new technologies is discussed, including interbody cages, intraoperative image guidance, robotics, augmented reality, and machine learning, which have significantly improved the spine surgery safety and efficacy profile. Current challenges and future directions are also covered, emphasizing the need for further research and development, particularly in robotic assistance and machine learning algorithms...

The realm of spine surgery is undergoing a transformative shift, thanks to the integration of image-guided navigation technology. This innovative system seamlessly blends real-time imaging data with precise location tracking. While the indispensable expertise of experienced spine surgeons remains irreplaceable, navigation systems bring a host of valuable advantages to the operating room. By offering a comprehensive view of the surgical anatomy, these systems empower surgeons to conduct procedures with accuracy, while minimizing radiation exposure for both patients and medical professionals...

Background and Objectives: To investigate the role of augmented reality (AR) in skull base (SB) neurosurgery. Materials and Methods: Utilizing PRISMA methodology, PubMed and Scopus databases were explored to extract data related to AR integration in SB surgery. Results: The majority of 19 included studies (42.1%) were conducted in the United States, with a focus on the last five years (77.8%). Categorization included phantom skull models (31.2%, n = 6), human cadavers (15.8%, n = 3), or human patients (52.6%, n = 10)...

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PURPOSE: This study evaluates the nnU-Net for segmenting brain, skin, tumors, and ventricles in contrast-enhanced T1 (T1CE) images, benchmarking it against an established mesh growing algorithm (MGA). METHODS: We used 67 retrospectively collected annotated single-center T1CE brain scans for training models for brain, skin, tumor, and ventricle segmentation. An additional 32 scans from two centers were used test performance compared to that of the MGA. The performance was measured using the Dice-Sørensen coefficient (DSC), intersection over union (IoU), 95th percentile Hausdorff distance (HD95), and average symmetric surface distance (ASSD) metrics, with time to segment also compared...

We present a novel method for intraoperative patient-to-image registration by learning Expected Appearances. Our method uses preoperative imaging to synthesize patient-specific expected views through a surgical microscope for a predicted range of transformations. Our method estimates the camera pose by minimizing the dissimilarity between the intraoperative 2D view through the optical microscope and the synthesized expected texture. In contrast to conventional methods, our approach transfers the processing tasks to the preoperative stage, reducing thereby the impact of low-resolution, distorted, and noisy intraoperative images, that often degrade the registration accuracy...

Image guidance technologies can significantly improve the accuracy and safety of intracranial catheter insertions. Augmented reality (AR) allows surgeons to visualize 3D information overlaid onto a patient's head. As such, AR has emerged as a novel image guidance technology that offers unique advantages when navigating intracranial targets. A 71-year-old woman with a history of brain metastasis from breast cancer and prior resection surgery and chemotherapy presented with altered mental status and generalized weakness worse on her left side...