Byunghyun Cho

Preliminary Study on the Clinical Application of Augmented Reality Neuronavigation

OBJECTIVE To develop an augmented reality (AR) neuronavigation system with Web cameras and examine its clinical utility. METHODS The utility of the system was evaluated in three patients with brain tumors. One patient had a glioblastoma and two patients had convexity meningiomas. Our navigation system comprised the open-source software 3D Slicer (Brigham and Womens Hospital, Boston, Massachusetts, USA), the infrared optical tracking sensor Polaris (Northern Digital Inc., Waterloo, Canada), and Web cameras. We prepared two different types of Web cameras: a handheld type and a headband type. Optical markers were attached to each Web camera. We used this system for skin incision planning before the operation, during craniotomy, and after dural incision. RESULTS We were able to overlay these images in all cases. In Case 1, accuracy could not be evaluated because the tumor was not on the surface, though it was generally suitable for the outline of the external ear and the skin. In Cases 2 and 3, the augmented reality error was ∼2 to 3 mm. CONCLUSION AR technology was examined with Web cameras in neurosurgical operations. Our results suggest that this technology is clinically useful in neurosurgical procedures, particularly for brain tumors close to the brain surface.

Warning navigation system using real-time safe region monitoring for otologic surgery

AbstractPurpose We developed a surgical navigation system that warns the surgeon with auditory and visual feedback to protect the facial nerve with real-time monitoring of the safe region during drilling. Methods Warning navigation modules were developed and integrated into a free open source software platform. To obtain high registration accuracy, we used a high-precision laser-sintered template of the patient’s bone surface to register the computed tomography (CT) images. We calculated the closest distance between the drill tip and the surface of the facial nerve during drilling. When the drill tip entered the safe regions, the navigation system provided an auditory and visual signal which differed in each safe region. To evaluate the effectiveness of the system, we performed phantom experiments for maintaining a given safe margin from the facial nerve when drilling bone models, with and without the navigation system. The error of the safe margin was measured on postoperative CT images. In real surgery, we evaluated the feasibility of the system in comparison with conventional facial nerve monitoring. Results The navigation accuracy was submillimeter for the target registration error. In the phantom study, the task with navigation (

An effective visualization technique for depth perception in augmented reality-based surgical navigation.

0.7 \pm 0.25

A clinical experience of ‘STAMP’ plate-guided Bonebridge implantation

mm) was more successful with smaller error, than the task without navigation (

A Surgical Navigation System for Guiding Exact Cochleostomy Using Auditory Feedback: A Clinical Feasibility Study

1.37 \pm 0.39

Augmented Reality Guidance with Electromagnetic Tracking for Transpyloric Tube Insertion

mm,