Department of Surgery, Tokushima University, Tokushima, Japan.
Research Center for Advanced Science and Technology, Tokyo University, Meguro-ku, Tokyo, Japan.
Ann Surg. 2020 Jan;271(1):e4-e7. doi: 10.1097/SLA.0000000000003552.
The aim of this study was to investigate the potential of an intraoperative 3D hologram, which was a computer graphics model liver, with mixed reality techniques in liver surgery.
The merits for the application of a hologram for surgical support are: 1) no sterilized display monitor; 2) better spatial awareness; and 3) 3D images shared by all the surgeons.
3D polygon data using preoperative computed tomography data was installed into head mount displays, HoloLens (Microsoft Corporation, Redmond, WA).
In a Wi-Fi-enabled operative room, several surgeons wearing HoloLens succeeded in sharing the same hologram and moving that hologram from respective operators' angles by means of easy gesture-handling without any monitors. The intraoperative hologram contributed to better imagination of tumor locations, and for determining the parenchymal dissection line in the hepatectomy for the patients with more than 20 multiple colo-rectal liver metastases. In another case, the hologram enabled a safe Gliisonean pedicle approach for hepato-cellular carcinoma with a hilar anatomical anomaly. Surgeons could easily compare the real patient's anatomy and that of the hologram just before the hepatic hilar procedure.
This initial experience suggested that an intraoperative hologram with mixed reality techniques contributed to "last-minute simulation," not for "navigation." The intraoperative hologram might be a new next-generation operation-supportive tool in terms of spatial awareness, sharing, and simplicity.
本研究旨在探讨术中 3D 全息图（一种基于计算机图形学的肝脏模型）与混合现实技术在肝脏手术中的应用潜力。
全息图应用于手术支持的优点包括：1）无需消毒的显示器；2）更好的空间感知能力；3）所有外科医生共享的 3D 图像。
使用术前计算机断层扫描数据的 3D 多边形数据安装到头戴式显示器、HoloLens（微软公司，雷德蒙德，华盛顿州）中。
在启用 Wi-Fi 的手术室中，几名佩戴 HoloLens 的外科医生成功地共享了相同的全息图，并通过简单的手势处理从各自操作员的角度移动该全息图，而无需任何监视器。术中全息图有助于更好地想象肿瘤位置，并有助于确定 20 多个结直肠多发肝转移患者的肝切除术的实质解剖线。在另一个病例中，全息图使得对于具有肝门解剖异常的肝细胞癌的 Glisson 蒂入路变得安全。外科医生可以在进行肝门操作之前轻松比较真实患者的解剖结构和全息图。
这项初步经验表明，混合现实技术的术中全息图有助于“最后一刻模拟”，而不是“导航”。术中全息图可能是一种具有空间感知、共享和简单性的下一代手术支持工具。
