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增强现实辅助手术：基于3D打印的个性化手术导板精确植入患者特定的髋关节假体。

AR-assisted surgery: Precision placement of patient specific hip implants based on 3D printed PSIs.

作者信息

Iribar-Zabala Amaia, Fernández-Fernández Tanya, Orozco-Martínez Javier, Calvo-Haro José, Pérez-Mañanes Rubén, Aguilera-Jiménez Elena, de Gregorio-Bermejo Carla, Benito Rafael, Pose-Díez-de-la-Lastra Alicia, Beristain-Iraola Andoni, Pascau Javier, García-Sevilla Mónica

机构信息

Digital Health and Biomedical Technologies, Vicomtech Foundation Basque Research and Technology Alliance (BRTA) Donostia-San Sebastian Spain.

Departamento de Bioingeniería Universidad Carlos III de Madrid Leganés Spain.

出版信息

Healthc Technol Lett. 2024 Dec 10;11(6):402-410. doi: 10.1049/htl2.12112. eCollection 2024 Dec.

DOI:10.1049/htl2.12112
PMID:39720754
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11665800/
Abstract

Patient-specific implant placement in the case of pelvic tumour resection is usually a complex procedure, where the planned optimal position of the prosthesis may differ from the final location. This discrepancy arises from incorrect or differently executed bone resection and improper final positioning of the prosthesis. In order to overcome such mismatch, a navigation solution is presented based on an augmented reality application for HoloLens 2 to assist the entire procedure. This involves placing patient-specific instruments for tumour resection guidance in the supraacetabular, ischial and symphysial regions, performing the osteotomy and assisting within the adequate positioning of the implant. The supraacetabular patient-specific instrument and the prosthesis included optical markers attached to them to be used as reference for surgical guidance. The proposed application and workflow were validated by two clinicians on six phantoms, designed and fabricated from different cadaver specimens. The accuracy of the solution was evaluated by comparing the final position after navigation with the position defined in the surgical plan. Preliminary assessment shows promising results for the guidance system, with positive clinician feedback.

摘要

在骨盆肿瘤切除病例中，针对患者的植入物放置通常是一个复杂的过程，其中假体的计划最佳位置可能与最终位置不同。这种差异源于不正确或执行方式不同的骨切除以及假体最终定位不当。为了克服这种不匹配，提出了一种基于HoloLens 2增强现实应用的导航解决方案，以辅助整个手术过程。这包括在髋臼上、坐骨和耻骨联合区域放置针对患者的肿瘤切除引导器械，进行截骨术并协助植入物的适当定位。髋臼上针对患者的器械和假体都附有光学标记，用作手术引导的参考。两名临床医生在由不同尸体标本设计和制造的六个模型上对所提出的应用和工作流程进行了验证。通过将导航后的最终位置与手术计划中定义的位置进行比较，评估了该解决方案的准确性。初步评估显示该引导系统有良好的结果，并得到了临床医生的积极反馈。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ffe/11665800/096edf8afd6d/HTL2-11-402-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ffe/11665800/f1063b2eef68/HTL2-11-402-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ffe/11665800/ab9fcb603d58/HTL2-11-402-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ffe/11665800/1f82ae8e3f39/HTL2-11-402-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ffe/11665800/6edfd68fb3a7/HTL2-11-402-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ffe/11665800/d9822a4922b2/HTL2-11-402-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ffe/11665800/096edf8afd6d/HTL2-11-402-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ffe/11665800/f1063b2eef68/HTL2-11-402-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ffe/11665800/ab9fcb603d58/HTL2-11-402-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ffe/11665800/1f82ae8e3f39/HTL2-11-402-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ffe/11665800/6edfd68fb3a7/HTL2-11-402-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ffe/11665800/d9822a4922b2/HTL2-11-402-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ffe/11665800/096edf8afd6d/HTL2-11-402-g003.jpg

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Diagnostics (Basel). 2023 Jul 28;13(15):2516. doi: 10.3390/diagnostics13152516.
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Augmented Reality as a Tool to Guide Patient-Specific Templates Placement in Pelvic Resections.增强现实技术作为一种引导个体化模板在骨盆切除术中应用的工具。
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