Department of Digestive Surgery, Kawaguchi Municipal Medical Center, Kawaguchi, Japan
Department of Digestive Surgery, Kawaguchi Municipal Medical Center, Kawaguchi, Japan.
Anticancer Res. 2022 Oct;42(10):4849-4856. doi: 10.21873/anticanres.15990.
BACKGROUND/AIM: This study aimed to investigate the feasibility of a mixed reality (MR)-based hologram for intraoperative navigation in colorectal surgery. Virtual reality (VR) and MR technologies can visualize overlapping three-dimensional (3D) hologram images and real space using the wearable HoloLens2 glasses. PATIENTS AND METHODS: This study comprised 13 patients with colorectal cancer. Twelve participants had hologram images created from computed tomography (CT) between August and September 2021. One patient who underwent lateral lymph node dissection (LLND) after this period was included. A 3D hologram of the arteries, veins, and tumor was downloaded to HoloLens2 with the Holoeyes MD system and used during surgery. Hologram visibility, surgical outcome, and the NASA Task Load Index (TLX) were examined. RESULTS: A total of 2 ileocecal resections, 6 right hemicolectomies, 1 partial colectomy, 4 LLNDs, and 1 para-aortic lymph node dissection were performed safely while viewing the holograms. The mean operative duration was 421 [290-555] min, blood loss was 5 [5-15] ml, and the postoperative hospital stay was 10 [9-14] days. Regarding the TLX, the mental demand score was 30 [20-40], the physical demand score was 60 [50-67.5], the temporal demand score was 50 [40-62.5], the performance score was 15 [2.5-35], the effort score was 45 [35-62.5], the frustration score was 60 [50-65], and the weighted workload score was 34 [30.17-45.835]. CONCLUSION: Viewing a hologram in VR/MR can improve the understanding of the anatomy, which cannot be ascertained on a conventional two-dimensional monitor. Holographic guidance is a highly novel surgical concept that can potentially reduce the mental demand on surgeons.
背景/目的:本研究旨在探讨基于混合现实(MR)的全息图在结直肠手术中用于术中导航的可行性。虚拟现实(VR)和 MR 技术可以使用可穿戴式 HoloLens2 眼镜可视化重叠的三维(3D)全息图像和真实空间。
患者和方法:本研究纳入了 13 例结直肠癌患者。12 名患者的 CT 图像于 2021 年 8 月至 9 月期间创建了全息图。在此期间之后接受侧方淋巴结清扫术(LLND)的 1 名患者也被纳入研究。使用 Holoeyes MD 系统将动脉、静脉和肿瘤的 3D 全息图下载到 HoloLens2 上,并在手术中使用。检查了全息图的可视性、手术结果和 NASA 任务负荷指数(TLX)。
结果:共安全完成 2 例回盲部切除术、6 例右半结肠切除术、1 例部分结肠切除术、4 例 LLND 和 1 例腹主动脉旁淋巴结清扫术,同时观察了全息图。平均手术时间为 421[290-555]分钟,术中出血量为 5[5-15]毫升,术后住院时间为 10[9-14]天。TLX 评分方面,脑力需求评分为 30[20-40]分,体力需求评分为 60[50-67.5]分,时间需求评分为 50[40-62.5]分,绩效评分为 15[2.5-35]分,努力程度评分为 45[35-62.5]分,挫折感评分为 60[50-65]分,加权工作量评分为 34[30.17-45.835]分。
结论:在 VR/MR 中观看全息图可以提高对解剖结构的理解,而这在传统的二维显示器上是无法确定的。全息引导是一种极具创新性的手术概念,有可能降低外科医生的脑力需求。
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