BACKGROUND: Augmented Reality (AR) in surgery consists in the fusion of synthetic computer-generated images (3D virtual model) obtained from medical imaging preoperative work-up and real-time patient images with the aim to visualize unapparent anatomical details. The potential of AR navigation as a tool to improve safety of the surgical dissection is presented in a case of pancreatico-duodenectomy (PD). METHODS: A 77-year-old male patient underwent an AR-assisted PD. The 3D virtual anatomical model was obtained from thoraco-abdominal CT scan using customary software (VR-RENDER®, IRCAD). The virtual model was superimposed to the operative field using an Exoscope (VITOM®, Karl Storz, Tüttlingen, Germany) as well as different visible landmarks (inferior vena cava, left renal vein, aorta, superior mesenteric vein, inferior margin of the pancreas). A computer scientist manually registered virtual and real images using a video mixer (MX 70; Panasonic, Secaucus, NJ) in real time. Dissection of the superior mesenteric artery and the hanging maneuver were performed under AR guidance along the hanging plane. RESULTS: AR allowed for precise and safe recognition of all the important vascular structures. Operative time was 360 min. AR display and fine registration was performed within 6 min. The postoperative course was uneventful. The pathology was positive for ampullary adenocarcinoma; the final stage was pT1N0 (0/43 retrieved lymph nodes) with clear surgical margins. CONCLUSIONS: AR is a valuable navigation tool that can enhance the ability to achieve a safe surgical resection during PD.
BACKGROUND: Augmented Reality (AR) in surgery consists in the fusion of synthetic computer-generated images (3D virtual model) obtained from medical imaging preoperative work-up and real-time patient images with the aim to visualize unapparent anatomical details. The potential of AR navigation as a tool to improve safety of the surgical dissection is presented in a case of pancreatico-duodenectomy (PD). METHODS: A 77-year-old male patient underwent an AR-assisted PD. The 3D virtual anatomical model was obtained from thoraco-abdominal CT scan using customary software (VR-RENDER®, IRCAD). The virtual model was superimposed to the operative field using an Exoscope (VITOM®, Karl Storz, Tüttlingen, Germany) as well as different visible landmarks (inferior vena cava, left renal vein, aorta, superior mesenteric vein, inferior margin of the pancreas). A computer scientist manually registered virtual and real images using a video mixer (MX 70; Panasonic, Secaucus, NJ) in real time. Dissection of the superior mesenteric artery and the hanging maneuver were performed under AR guidance along the hanging plane. RESULTS: AR allowed for precise and safe recognition of all the important vascular structures. Operative time was 360 min. AR display and fine registration was performed within 6 min. The postoperative course was uneventful. The pathology was positive for ampullary adenocarcinoma; the final stage was pT1N0 (0/43 retrieved lymph nodes) with clear surgical margins. CONCLUSIONS: AR is a valuable navigation tool that can enhance the ability to achieve a safe surgical resection during PD.
Authors: Jeannelyn S Estrella; Asif Rashid; Jason B Fleming; Matthew H Katz; Jeffrey E Lee; Robert A Wolf; Gauri R Varadhachary; Peter W T Pisters; Eddie K Abdalla; Jean-Nicolas Vauthey; Hua Wang; Henry F Gomez; Douglas B Evans; James L Abbruzzese; Huamin Wang Journal: Cancer Date: 2011-07-06 Impact factor: 6.860
Authors: P Pessaux; E Rosso; F Panaro; E Marzano; E Oussoultzoglou; P Bachellier; D Jaeck Journal: Eur J Surg Oncol Date: 2009-05-06 Impact factor: 4.424
Authors: Taylor S Riall; John L Cameron; Keith D Lillemoe; Kurtis A Campbell; Patricia K Sauter; JoAnn Coleman; Ross A Abrams; Daniel Laheru; Ralph H Hruban; Charles J Yeo Journal: J Gastrointest Surg Date: 2005-12 Impact factor: 3.267