van Lindert E J, Grotenhuis J A, Beems T
Neurosurgical Department, University Medical Center, Nijmegen, The Netherlands.
Comput Aided Surg. 2004;9(6):251-6. doi: 10.3109/10929080500165476.
To evaluate the clinical use of a head-mounted display (HMD) for visualization in all neuroendoscopic procedures.
We retrospectively evaluated all endoscopic and endoscope-controlled procedures in which the HMD was used in our department between July 1999 and June 2002.
A total of 269 endoscopic procedures were performed. In 147 cases intraventricular endoscopic procedures were carried out, mostly third ventriculocisternostomies, for which a fiberscope was used exclusively. Thirty intracranial cysts were fenestrated or removed (colloid cysts) with the help of various endoscopes. A total of 87 endoscopic transsphenoidal surgeries were performed with a lensscope. In only one case was it necessary to abandon use of the HMD due to inferior visualization; in all other cases visualization by the HMD was thought to be sufficient. Fatigue of the surgeon due to wearing the helmet did not occur. All surgeons had the impression that visual strain was decreased in comparison to looking at a monitor from a distance. The working position was considered to be more comfortable when wearing the HMD, and eye-hand coordination was improved. No technical problems occurred with the system.
The HMD is a new visualization tool in neurosurgery that may improve the ergonomics of neuroendoscopic and endoscope-controlled procedures.
评估头戴式显示器（HMD）在所有神经内镜手术中的临床应用价值。
我们回顾性评估了1999年7月至2002年6月间在我科使用HMD的所有内镜及内镜辅助手术。
共进行了269例内镜手术。其中147例为脑室内内镜手术，主要是第三脑室造瘘术，仅使用了纤维内镜。借助各种内镜对30个颅内囊肿进行了开窗或切除（胶样囊肿）。使用透镜内镜共进行了87例经蝶窦内镜手术。仅1例因视野不佳而不得不放弃使用HMD；在所有其他病例中，HMD的视野被认为是足够的。未出现因佩戴头盔导致外科医生疲劳的情况。所有外科医生都感觉与远距离看显示器相比，视觉疲劳减轻了。佩戴HMD时工作姿势更舒适，眼手协调性也有所提高。该系统未出现技术问题。
HMD是神经外科一种新的可视化工具，可能会改善神经内镜及内镜辅助手术的人体工程学。
