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Dynamic Mixed-Reality Patient-Specific Aneurysm Clipping Simulation for Two Cases-A Feasibility Study.
Fredrick J Joseph1, Miguel Cuba1, Michael Murek2
1Image Guided Therapy, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
Operative Neurosurgery (Hagerstown, Md.)
|December 6, 2023
Summary
This study shows a mixed-reality simulator effectively trains neurosurgeons on intracranial aneurysm clipping strategies. Surgeons could test and discard multiple approaches, regardless of aneurysm complexity, improving surgical planning.
Area of Science:
- Neurosurgery
- Medical Simulation
- Medical Imaging
Background:
- Intracranial aneurysm (IA) clipping is a complex neurosurgical procedure.
- Minimizing risks and maximizing patient outcomes requires advanced technology.
Purpose of the Study:
- Evaluate the feasibility of training patient-specific microsurgical clipping procedures.
- Assess a mixed-reality physical neurosurgical simulator for unruptured IA.
Main Methods:
- Two neurosurgeons simulated clipping on two patient-specific IA models.
- Collected data on time, procedures, and outcomes.
- Analyzed indocyanine green fluorescence angiography (ICG-FA) for clipping strategy evaluation.
Main Results:
- 4-8 clipping strategies were tested per model, with more complex aneurysms requiring more strategies.
- Surgeons discarded up to 53.8% of attempted strategies.
- ICG-FA showed specific but poor sensitivity for aneurysm occlusion.
Conclusions:
- The mixed-reality simulator enables testing and discarding of IA clipping strategies irrespective of complexity.
- Limitations exist for ICG-FA in post-clipping aneurysm inspection.
