Introduction:
Rapid advances in immersive technologies such as virtual reality (VR) and augmented reality (AR) have created new opportunities for entertainment, education, healthcare, and other applications. The field of surgery is continually evolving due to the need for better patient outcomes and lower costs. Virtual reality (VR) and augmented reality (AR) are increasingly essential to improving surgical operations. These immersive technologies can improve pre-operative planning, intra-operative support, and post-operative care.
How to Plan the Surgery Preoperatively Using Virtual Reality and Augmented Reality Technologies?
The conventional pre-operative planning methods usually depend on 2D imaging techniques such as axial, sagittal, and coronal views, which may need help mentally developing a 3D image of complex anatomical structures, limiting the surgeon's understanding and spatial awareness during the procedure. VR and AR technologies have developed into effective tools to overcome these limitations.
VR technologies, which vary from non-immersive to completely immersive experiences, enable surgeons to explore and interact with a virtual world using head movements or handheld devices with a sense of touch. AR technologies, such as AR and mixed reality (MR), on the other hand, offer virtual and real-world pictures simultaneously, allowing surgeons to connect with both environments.
These technologies provide improved visualization of complex anatomy, depth perception, and manipulation and analysis of virtual models of patients' anatomy. In AR/VR-aided pre-operative planning, segmentation is critical. Surgeons can analyze organs and tissues individually and predict alternative surgical paths by isolating organs and tissues.
This segmentation can be color-coded, compared, and evaluated to aid in simulation and surgical decision-making. Furthermore, augmented reality (AR) technologies can give real-time guidance during surgery by superimposing virtual pictures onto the patient's anatomy to aid in guidance and exact instrument positioning.
What Are the Surgical Techniques Used in Virtual Reality and Augmented Reality Technologies?
AR/VR technology is used in various surgical procedures, from robotic liver resections to complicated neurosurgery. These technologies are classified according to their display systems and incorporation into the operating room setting.
The different types and their specific applications in surgical operations include:
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Projection-Type AR-Enhanced Surgery: In projection-type AR-enhanced surgery, a picture, such as a CT scan, can be projected directly over the patient's skin, displaying both virtual and real-world pictures simultaneously. This technique enables exact instrument positioning and avoids severe movements during laparoscopic or robotic treatments by accurately aligning the projected image with the patient's anatomy. Surgeons can manipulate the virtual image to show different anatomical aspects such as bones, blood vessels, or internal organs, allowing for better vision and control during surgery.
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Heads-Up Display (HUD) Type AR-Enhanced Surgery: In HUD-type AR-enhanced surgery, the surgeon views real and virtual images with a mounted HUD. The HUD screen can be semi-transparent, allowing some of the natural light from the real image to be considered alongside the virtual image presented as a hologram. A digital display may show both the real-world image taken by a video camera and the virtual image simultaneously. This device augments the surgeon's field of view, allowing the surgeon to acquire important information without changing their concentration away from the surgical site. HUD AR has been utilized successfully in various surgical operations, including nerve plexus injections and tumor resections.
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Operating Microscope Type AR-Enhanced Surgery: AR-display systems are integrated into existing operating microscopes used in neurosurgery, ophthalmology, otolaryngology, and plastic surgery in the operating microscope type AR-enhanced surgery. Surgeons can improve their visualization and understanding of the surgical field by superimposing the virtual image over the real image seen through the microscope. Because the operating microscope is already a typical instrument in the operating room, incorporating AR technology into the microscope provides surgeons with a smooth transition.
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HMD Type AR-Enhanced Surgery: HMD Type AR Enhanced Surgery employs lightweight and compact HMDs that give surgeons both the real and the overlay virtual images. These HMDs, worn as goggles by surgeons, provide depth awareness, head tracking, and enhanced human-machine interfaces. Surgeons can concentrate on the operating field without shifting their focus from the surgical site to external monitors providing radiological images. On the other hand, accepting HMDs in the operating room is difficult, as doctors are used to wearing glasses or surgical loupes for greater eyesight and protection. Smaller and lighter HMDs are critical for their widespread use in surgical procedures.
What Are the Advantages of AR/VR-Enhanced Surgery?
In terms of surgical precision, patient safety, and overall healthcare efficiency, AR-enhanced surgery has various benefits.
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These technologies improve surgeons' visualization, depth perception, and spatial awareness, allowing them to explore complex anatomical structures more precisely.
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VR/AR immersive experiences strengthen surgical training, minimize errors, and shorten surgery time, resulting in better patient outcomes and cost savings.
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In pre-operative planning, AR technology can help surgeons identify key structures and tasks, improving their focus and decision-making during surgery.
What Are the Limitations Associated With AR/VR-Enhanced Surgery?
It is critical to understand the limitations of AR-enhanced surgery. The virtual image utilized in AR shows the patient's anatomy before surgery and may not reflect the change in the patient's anatomy during the procedure. Intra-operative imaging, such as CT or fluoroscopy, can assist in tracking changes in the patient's anatomy and providing updated virtual pictures for increased accuracy. Furthermore, registering virtual and real-world images might be difficult, especially with non-rigid soft tissues. Deformable registration techniques can assist in eliminating errors and enhancing alignment during surgery.
Conclusion:
Virtual and augmented reality are changing the field of surgery by providing surgeons with improved visualization, navigation, and decision-making capabilities. These technologies can potentially enhance patient outcomes, decrease surgical errors, and boost healthcare efficiency. Combining AR/VR with robotic-assisted surgery will advance the medical field by enabling more accurate and minimally invasive procedures. As AR/VR technology advances, its incorporation into surgical practice will pave the way for novel possibilities in precise medicine and customized surgical care. The unlimited possibilities of AR/VR technologies will enhance the future of surgery.
