Ibrahim Naser, Shiino Shuhei, Nguyen Kenneth, Shapiro Stephen, Janssen Andrew, Dumont Aaron
Tulane Medical Center, Department of Neurosurgery, 131 S. Robertson St, Ste 1300, New Orleans, LA, 70112, USA.
Department of Neurosurgery, Ochsner Health System, 131 S. Robertson St, Ste 1300, New Orleans, LA, 70112, USA.
Acta Neurochir (Wien). 2025 Sep 12;167(1):243. doi: 10.1007/s00701-025-06659-5.
Augmented Reality (AR) is an emerging technology in the field of neurosurgery. It allows surgeons to view three-dimensional (3D) patient anatomy overlaid onto the surgical field in real time. In this technical report, we describe the preoperative and intraoperative use of the Hoth AR system for resection of a thoracic meningioma.
Prior to surgery, the 3D model of the patient's tumor and surrounding anatomy is rendered from the patient's preoperative imaging, and it is uploaded into the AR headset. Once the patient is positioned in the operating room, registration is performed by tracing reference points on the skin while wearing the headset. The surgeon wears the headset while operating, and they can toggle on-off and transparency of each component of the model using voice commands to best visualize the 3D rendering overlaid on the patient's anatomy.
We provide a video case demonstrating the use of the Hoth AR system for resection of a thoracic meningioma. The system was able to register the model to the patient accurately in under 30 s. It was used to accurately plan the incision preoperatively, determine levels for laminectomy intraoperatively, and for precise localization of the tumor prior to opening the dura.
This case describes the clinical integration of a novel AR system for preoperative localization and intraoperative visualization during a resection of a thoracic meningioma. As AR systems continue to evolve and become more accessible, they are poised to become a standard tool in the surgical arsenal.
增强现实（AR）是神经外科领域的一项新兴技术。它使外科医生能够实时在手术视野上看到叠加的三维（3D）患者解剖结构。在本技术报告中，我们描述了Hoth AR系统在胸椎脑膜瘤切除术中的术前和术中应用。
手术前，根据患者的术前影像生成患者肿瘤及周围解剖结构的3D模型，并上传到AR头显中。患者在手术室就位后，佩戴头显时通过在皮肤上追踪参考点进行配准。外科医生在手术时佩戴头显，他们可以使用语音命令切换模型各组件的开关和透明度，以便最佳地可视化叠加在患者解剖结构上的3D渲染图像。
我们提供了一个视频案例，展示了Hoth AR系统在胸椎脑膜瘤切除术中的应用。该系统能够在30秒内将模型准确地与患者配准。它被用于术前精确规划切口、术中确定椎板切除的节段以及在打开硬脑膜之前精确确定肿瘤的位置。
本案例描述了一种新型AR系统在胸椎脑膜瘤切除术中术前定位和术中可视化的临床整合。随着AR系统不断发展并变得更易于使用，它们有望成为手术工具库中的标准工具。
