Georg Enislidis

Virtual image guided navigation in tumor surgery — technical innovation

We present a new visualization system for image-guided stereotactic navigation in tumor surgery. The combination of frameless stereotactic localization technology with real-time video processing permits the visualization of medical imaging data as a video overlay during the actual surgical procedure. Virtual computer-generated anatomical structures are displayed intraoperatively in a semi-immersive head-up display. This results in surgical navigation assistance without limiting the judgement of the physician based on the continuous observation of the operating field. The case presented documents the potential of augmented reality visualization concepts in tumor surgery of the head.

Computed intraoperative navigation guidance-a preliminary report on a new technique

OBJECTIVE To assess the value of a computer-assisted three-dimensional guidance system (Virtual Patient System) in maxillofacial operations. DESIGN Laboratory and open clinical study. SETTING Teaching Hospital, Austria. SUBJECTS 6 patients undergoing various procedures including removal of foreign body (n=3) and biopsy, maxillary advancement, and insertion of implants (n=1 each). INTERVENTIONS Storage of computed tomographic (CT) pictures on an optical disc, and imposition of intraoperative video images on to these. The resulting display is shown to the surgeon on a micromonitor in his head-up display for guidance during the operations. MAIN OUTCOME MEASURES To improve orientation during complex or minimally invasive maxillofacial procedures and to make such operations easier and less traumatic. RESULTS Successful transferral of computed navigation technology into an operation room environment and positive evaluation of the method by the surgeons involved. CONCLUSIONS Computer-assisted three-dimensional guidance systems have the potential for making complex or minimally invasive procedures easier to do, thereby reducing postoperative morbidity.

Prinzipien der „virtuellen Realität” und deren Anwendung in intraoperativen navigationshilfesystemen

ZusammenfassungGrundlagenDie Technik der „virtuellen Realität” ermöglicht die intraoperative schematische Darstellung von anatomischen und pathologischen Strukturen, von chirurgischen Instrumenten und Implantaten in der Datenbrille des Operateurs.MethodikEin computergestütztes Operationssystem dient der Analyse von digitalisierten radiologischen Daten, der Generierung von Graphiken, die mit diesen Bildern in Überlagerung gebracht werden, und der Visualisierung des gewonnenen Informationskomplexes.ErgebnisseDurch die Navigationshilfestellung kann der Chirurg die Dauer des Eingriffes verkürzen, dessen Präzision erhöhen und die Invasivität minimieren.SchlußlgerungenDer intraoperative Einsatz von computerisierten, bildgestützten Navigationshilfen ist seit langem in der Neurochirurgie bewährt. Die Eingliederung der „Virtual reality”-Technologie eröffnet neue Dimensionen für die minimal invasive Chirurgie im Kopf-Halsbereich.SummaryBackgroundThe “virtual reality” technology allows intraoperative schematic visualization of anatomic and pathologic structures, surgical instruments and implants in the surgeons head-up display.MethodsA computer-based operation system analyzes digitalized radiologic data, generates graphics, which are superimposed on the images, and visualizes the generated information.ResultsWith navigation assistance, the surgeon can shorten the time, improve the precision and minimize the invasivity of the procedure.ConclusionsThe intraoperative use of computerized imageguided navigation systems has proved successful in neurosurgery. The introduction of the “virtual reality” technology opens new dimensions for minimally invasive procedures in the head and neck area