HoloLens-Based Vascular Localization System: Precision Evaluation Study With a Three-Dimensional Printed Model.

Area of Science:

• Medical Technology
• Surgical Navigation
• Augmented Reality

Background:

• Vascular localization is critical for successful perforator flap transfer.
• Augmented reality (AR) systems, like the HoloLens headset, can integrate computed tomographic angiography data with the surgical field.
• This AR integration allows surgeons to visualize subsurface vasculature, enhancing perforator identification.

Purpose of the Study:

• To evaluate the precision of the HoloLens-based augmented reality system for vascular localization.
• To determine the system's accuracy as a key performance indicator for surgical navigation.

Main Methods:

• A HoloLens AR system was used to localize vessels on a 3D printed model in a simulated operating room.
• Navigation error was calculated by measuring the distance between corresponding points on virtual and physical vascular maps.
• Testing occurred under various conditions, including different visual angles, light intensities, and motion states.

Main Results:

• The HoloLens system demonstrated a mean navigation error between 1.35 mm and 3.18 mm, falling within clinically acceptable limits.
• No significant differences in error were observed across varying visual angles, light intensities, or static/motion states.
• A notable finding was that the system performed with greater accuracy in the absence of light.

Conclusions:

• The HoloLens-based system exhibits high precision for perforator localization, supporting its use in surgical navigation.
• The system has the potential to improve the safety and convenience of perforator flap transfer procedures.
• The study recommends utilizing the HoloLens surgical navigation system without light for optimal performance.