Puladi Behrus, Ooms Mark, Bellgardt Martin, Cesov Mark, Lipprandt Myriam, Raith Stefan, Peters Florian, Möhlhenrich Stephan Christian, Prescher Andreas, Hölzle Frank, Kuhlen Torsten Wolfgang, Modabber Ali
Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany.
Institute of Medical Informatics, University Hospital RWTH Aachen, Aachen, Germany.
JMIR Serious Games. 2022 Apr 25;10(2):e34781. doi: 10.2196/34781.
Although nearly one-third of the world's disease burden requires surgical care, only a small proportion of digital health applications are directly used in the surgical field. In the coming decades, the application of augmented reality (AR) with a new generation of optical-see-through head-mounted displays (OST-HMDs) like the HoloLens (Microsoft Corp) has the potential to bring digital health into the surgical field. However, for the application to be performed on a living person, proof of performance must first be provided due to regulatory requirements. In this regard, cadaver studies could provide initial evidence.
The goal of the research was to develop an open-source system for AR-based surgery on human cadavers using freely available technologies.
We tested our system using an easy-to-understand scenario in which fractured zygomatic arches of the face had to be repositioned with visual and auditory feedback to the investigators using a HoloLens. Results were verified with postoperative imaging and assessed in a blinded fashion by 2 investigators. The developed system and scenario were qualitatively evaluated by consensus interview and individual questionnaires.
The development and implementation of our system was feasible and could be realized in the course of a cadaver study. The AR system was found helpful by the investigators for spatial perception in addition to the combination of visual as well as auditory feedback. The surgical end point could be determined metrically as well as by assessment.
The development and application of an AR-based surgical system using freely available technologies to perform OST-HMD-guided surgical procedures in cadavers is feasible. Cadaver studies are suitable for OST-HMD-guided interventions to measure a surgical end point and provide an initial data foundation for future clinical trials. The availability of free systems for researchers could be helpful for a possible translation process from digital health to AR-based surgery using OST-HMDs in the operating theater via cadaver studies.
尽管全球近三分之一的疾病负担需要手术治疗，但仅有一小部分数字健康应用直接用于手术领域。在未来几十年里，像HoloLens（微软公司）这样的新一代光学透视头戴式显示器（OST-HMD）与增强现实（AR）技术的应用，有可能将数字健康引入手术领域。然而，由于监管要求，要在活人身上进行此类应用，必须首先提供性能证明。在这方面，尸体研究可以提供初步证据。
本研究的目标是利用免费可得的技术，开发一个用于在人体尸体上进行基于AR手术的开源系统。
我们使用一个易于理解的场景来测试我们的系统，即通过HoloLens为研究人员提供视觉和听觉反馈，对面部骨折的颧弓进行复位。术后成像对结果进行验证，并由两名研究人员以盲法进行评估。通过共识访谈和个人问卷对所开发的系统和场景进行定性评估。
我们系统的开发和实施是可行的，并且可以在尸体研究过程中实现。研究人员发现，AR系统除了视觉和听觉反馈相结合外，对空间感知也有帮助。手术终点可以通过测量以及评估来确定。
利用免费可得的技术开发和应用基于AR手术系统，在尸体上进行OST-HMD引导的手术操作是可行的。尸体研究适用于OST-HMD引导的干预措施，以测量手术终点，并为未来的临床试验提供初步数据基础。为研究人员提供免费系统，可能有助于通过尸体研究，实现从数字健康到手术室中使用OST-HMD进行基于AR手术的可能转化过程。
