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Augmented Reality in Transsphenoidal Surgery.

Barbara Carl1, Miriam Bopp2, Benjamin Voellger1

  • 1Department of Neurosurgery, University of Marburg, Marburg, Germany.

World Neurosurgery
|February 15, 2019
PubMed
Summary
This summary is machine-generated.

Augmented reality (AR) enhances transsphenoidal surgery safety by improving visualization and surgeon comfort. Automatic registration significantly boosts AR accuracy, making it a reliable tool for complex procedures.

Keywords:
Augmented realityIntraoperative computed tomography imagingRegistrationTranssphenoidal surgery

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Area of Science:

  • Neurosurgery
  • Medical Imaging
  • Surgical Technology

Background:

  • Transsphenoidal surgery requires precise visualization of complex anatomical structures.
  • Traditional surgical navigation can be limited in accuracy and real-time feedback.
  • Augmented reality (AR) offers potential to enhance surgical guidance and improve patient outcomes.

Purpose of the Study:

  • To investigate the application and efficacy of microscope-based augmented reality (AR) in supporting transsphenoidal surgery.
  • To evaluate the accuracy and integration of AR systems using different navigation registration methods.
  • To assess the impact of AR on surgical workflow, accuracy, and patient safety.

Main Methods:

  • AR system integrated with operating microscopes via head-up displays.
  • Navigation registration performed using fiducial-based or automatic methods with intraoperative computed tomography (iCT).
  • Microscope calibration verified by geometric overlap assessment.

Main Results:

  • AR was successfully integrated into the surgical workflow for 47 patients.
  • Automatic iCT-based registration significantly improved AR accuracy (TRE: 0.83 ± 0.44 mm) compared to fiducial-based registration (TRE: 2.33 ± 1.30 mm).
  • AR facilitated orientation in reoperations and complex anatomies, increasing surgeon comfort and improving 3D perception.

Conclusions:

  • Microscope-based AR is a reliable tool for enhancing patient safety in complex transsphenoidal surgeries.
  • Intraoperative imaging-based automatic patient registration is recommended for optimal AR accuracy.
  • AR visualization improves surgical precision and surgeon confidence in challenging cases.