Augmented reality-assisted systematic mapping of anterolateral thigh perforators

Area of Science:

• Reconstructive Surgery
• Medical Imaging
• Augmented Reality Applications

Background:

• Perforator localization and flap harvesting are critical challenges in soft tissue reconstructive surgery.
• Augmented reality (AR) offers a promising technological solution for mapping perforators.

Purpose of the Study:

• To evaluate the effectiveness of AR combined with computed tomography angiography (CTA) for mapping perforator emergence points.
• To assess the accuracy and reliability of AR-guided flap harvesting in anterolateral thigh perforator flaps.

Main Methods:

• Computed tomography angiography (CTA) was used to reconstruct the lateral circumflex femoral artery (LCFA) and its perforators in 14 patients.
• Perforator emergence points were marked and projected onto the skin surface using AR and a portable projector.
• The accuracy of AR-guided localization was compared to intraoperative findings and handheld Doppler ultrasound.

Main Results:

• CTA accurately determined perforator sources, locations, and numbers.
• The AR-CTA method achieved 90.2% accuracy and 97.4% sensitivity in mapping perforator emergence points.
• AR guidance resulted in significantly smaller differences between marked points and intraoperative findings compared to Doppler ultrasound (P < 0.001).
• All flaps were successfully harvested and survived, with only one complication.

Conclusions:

• AR, specifically CTA combined with projection, is a vital and reliable tool for locating perforator emergence points.
• This technique enhances intraoperative guidance for flap harvesting, leading to improved outcomes and reduced risks.