Koo Kyoyeong, Park Taeyong, Jeong Heeryeol, Khang Seungwoo, Koh Chin Su, Park Minkyung, Kim Myung Ji, Jung Hyun Ho, Shin Juneseuk, Kim Kyung Won, Lee Jeongjin
School of Computer Science and Engineering, Soongsil University, Seoul, Korea.
Department of Biomedical Informatics, Hallym University Medical Center, Anyang, Korea.
Healthc Inform Res. 2023 Jul;29(3):218-227. doi: 10.4258/hir.2023.29.3.218. Epub 2023 Jul 31.
Intraoperative navigation reduces the risk of major complications and increases the likelihood of optimal surgical outcomes. This paper presents an augmented reality (AR)-based simulation technique for ventriculostomy that visualizes brain deformations caused by the movements of a surgical instrument in a three-dimensional brain model. This is achieved by utilizing a position-based dynamics (PBD) physical deformation method on a preoperative brain image.
An infrared camera-based AR surgical environment aligns the real-world space with a virtual space and tracks the surgical instruments. For a realistic representation and reduced simulation computation load, a hybrid geometric model is employed, which combines a high-resolution mesh model and a multiresolution tetrahedron model. Collision handling is executed when a collision between the brain and surgical instrument is detected. Constraints are used to preserve the properties of the soft body and ensure stable deformation.
The experiment was conducted once in a phantom environment and once in an actual surgical environment. The tasks of inserting the surgical instrument into the ventricle using only the navigation information presented through the smart glasses and verifying the drainage of cerebrospinal fluid were evaluated. These tasks were successfully completed, as indicated by the drainage, and the deformation simulation speed averaged 18.78 fps.
This experiment confirmed that the AR-based method for external ventricular drain surgery was beneficial to clinicians.
术中导航可降低重大并发症的风险，并增加实现最佳手术效果的可能性。本文提出了一种基于增强现实（AR）的脑室造瘘术模拟技术，该技术可在三维脑模型中可视化由手术器械移动引起的脑变形。这是通过在术前脑图像上使用基于位置的动力学（PBD）物理变形方法来实现的。
基于红外摄像头的AR手术环境将现实世界空间与虚拟空间对齐，并跟踪手术器械。为了实现逼真的呈现并降低模拟计算负荷，采用了一种混合几何模型，该模型结合了高分辨率网格模型和多分辨率四面体模型。当检测到脑与手术器械之间发生碰撞时，执行碰撞处理。使用约束来保持软体的属性并确保稳定变形。
该实验在模拟环境中进行了一次，在实际手术环境中进行了一次。评估了仅使用通过智能眼镜呈现的导航信息将手术器械插入脑室并验证脑脊液引流的任务。如引流所示，这些任务均成功完成，变形模拟速度平均为18.78帧/秒。
该实验证实基于AR的脑室外引流手术方法对临床医生有益。
