Augmented Reality Implementation in Minimally Invasive Surgery for Future Application in Pulmonary Surgery: A...

Area of Science:

• Medical Technology
• Surgical Navigation
• Augmented Reality

Background:

• Minimally invasive surgery (MIS) for deformable organs presents navigation challenges.
• Augmented Reality (AR) systems offer potential solutions for intraoperative guidance.
• Current AR techniques require comprehensive understanding for specialized workflows like pulmonary surgery.

Purpose of the Study:

• To systematically review Augmented Reality (AR) systems for MIS of deformable organs.
• To analyze initial registration, dynamic tracking, and visualization methods in AR surgical applications.
• To inform the development of a dedicated AR workflow for pulmonary Video or Robotic Assisted Thoracic Surgery (VATS/RATS).

Main Methods:

• Systematic literature search conducted across Embase, Medline (Ovid), and Web of Science.
• Search focused on intraoperative AR applications and navigational purposes for deformable organs.
• Included studies were assessed for quality and categorized by registration and tracking methods.

Main Results:

• 33 articles were included; only one focused on pulmonary surgery.
• Registration methods included manual and semi-automatic techniques (landmark-based, fiducial-based, surface-based).
• Surface-based registration achieved accuracy below 5 mm in most studies.

Conclusions:

• AR can enhance real-time navigation and decision-making in complex MIS.
• Future pulmonary AR research should prioritize accurate, non-invasive surface-based registration.
• Vascular-labeling-based methods and clinical feasibility assessments are crucial for VATS/RATS.