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HoloLens in Breast Reconstruction: What Is the Future?

Gary Masterton¹, Robert Miller¹, Jaymin Patel²

¹From the Departments of Plastic Surgery.

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Summary

Augmented reality with HoloLens technology aids surgeons in identifying critical abdominal vasculature for deep inferior epigastric perforator flap breast reconstruction, enhancing surgical planning and accuracy.

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Area of Science:

Surgical Innovation
Medical Imaging
Reconstructive Surgery

Background:

Deep inferior epigastric perforator (DIEP) flap is standard for autologous breast reconstruction.
Accurate identification of abdominal vasculature is crucial for DIEP flap dissection, surgical outcomes, and minimizing morbidity.

Purpose of the Study:

To describe a novel technique using augmented reality (AR) with HoloLens technology for surgical planning in DIEP flap breast reconstruction.
To assess the accuracy and usability of AR for identifying epigastric arteries and perforators.

Main Methods:

Preoperative computed tomography angiography (CTA) was used to visualize abdominal vasculature.
HoloLens AR technology was employed to superimpose CTA images onto the patient, creating a real-time, in vivo anatomical map.
The accuracy of AR visualization was evaluated against actual anatomy.

Main Results:

The HoloLens technology accurately identified epigastric arteries and perforators.
The AR system provided an intuitive, in vivo appreciation of the underlying anatomy.
The technology demonstrated ease of use and potential for real-time surgical planning.

Conclusions:

Augmented reality with HoloLens offers a valuable tool for preoperative planning in DIEP flap breast reconstruction.
This technology has the potential to enhance the accuracy and efficiency of free-flap surgery.
Further application of AR in reconstructive surgery is encouraged.