Augmented Reality-Assisted versus Freehand Ventriculostomy in a Head Model

Area of Science:

• Neurosurgery
• Medical Technology
• Augmented Reality

Background:

• Ventriculostomy (VST) is a common neurosurgical procedure.
• Freehand catheter placement is standard but often requires multiple attempts.
• Augmented reality (AR) headset guidance for VST is explored using custom head models.

Purpose of the Study:

• To evaluate the feasibility of AR headset-guided VST.
• To compare AR-guided VST with freehand VST.
• To investigate the learning curve associated with AR-guided VST.

Main Methods:

• A proof-of-concept study using 3D-printed head models with distinct ventricular systems.
• Eleven surgeons performed both AR-guided and freehand VST.
• A subgroup of four surgeons underwent repeated AR-guided VST sessions to assess learning.
• Microsoft HoloLens was used as the AR hardware platform.

Main Results:

• Marker tracking, image segmentation, and holographic display functioned well.
• Freehand VST achieved a 72.7% success rate; AR-guided VST achieved 68.2% (not statistically significant).
• Repeated AR-guided punctures improved success rates from 65% to 95%, indicating a learning curve.
• User experience feedback was positive.

Conclusions:

• AR headset-based navigation shows potential for VST.
• Further technical development is required before human application.
• AR holograms could offer compact navigational assistance in and out of the operating room.