Augmented-reality template guided transorbital approach for intradural tumors

Area of Science:

• Neurosurgery
• Surgical Technology
• Medical Imaging

Background:

• Minimally invasive surgery for deep-lying skull base lesions requires precise bone openings.
• Achieving adequate bone access is critical for surgical success.
• Traditional methods may lack the precision needed for complex approaches.

Purpose of the Study:

• To demonstrate the use of augmented reality (AR) templates for precise surgical openings in skull base surgery.
• To evaluate the utility of virtual reality (VR) for surgical rehearsal and planning.
• To showcase the transpalpebral, transorbital approach for intradural tumors using AR guidance.

Main Methods:

• Virtual reality (VR) renderings of patient-specific anatomy were used for surgical rehearsal.
• Navigation-integrated AR templates were generated from VR models.
• AR templates were projected into the microscope eyepiece during surgery.
• The AR template guided incision planning, soft-tissue exposure, and drilling.

Main Results:

• AR templates enhanced the planning of surgical incisions and soft-tissue exposure.
• The AR template effectively guided the surgical drill toward the target lesion.
• This approach facilitated precise bone opening for a transpalpebral, transorbital approach.

Conclusions:

• AR templates, developed through VR surgical rehearsal, enable precise bone openings for minimally invasive skull base surgery.
• This technology improves surgical planning and guidance, particularly for complex approaches like the transpalpebral, transorbital route.
• VR and AR integration offers a promising tool for enhancing surgical accuracy and outcomes.