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Augmented reality in preoperative anterolateral thigh flap perforators positioning: A pilot diagnostic study
Bin Wei1, Guoxiong Lu2, Zhiqiang Bai2
1Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Guangzhou, China; Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Augmented reality with the AR-Finder device significantly improves the accuracy of locating anterolateral thigh (ALT) flap perforators compared to traditional ultrasound. This novel approach enhances surgical planning and reduces complications in ALT flap reconstructions.
Area of Science:
- Microsurgery
- Plastic Surgery
- Surgical Navigation
Background:
- The anterolateral thigh (ALT) flap is crucial for soft-tissue reconstruction, particularly in head and neck cases.
- Anatomic variations in ALT perforators pose challenges to flap integrity and survival.
- Accurate perforator localization is key to improving surgical success and minimizing revision surgeries.
Purpose of the Study:
- To investigate a novel method for locating ALT flap perforators using augmented reality (AR).
- To compare the accuracy of the AR-Finder system against traditional ultrasound localization.
Main Methods:
- Utilized augmented reality (AR) technology combined with a self-designed device, AR-Finder.
- Compared AR-Finder's perforator localization accuracy to traditional ultrasound color Doppler (UCD).
- Evaluated 24 patients undergoing ALT flap reconstruction.
Main Results:
- AR-Finder demonstrated superior sensitivity (97.5%) and AUC (0.90) compared to UCD (81.1% sensitivity, 0.70 AUC).
- The average distance difference to the actual perforator was significantly smaller with AR-Finder (3.54 mm) versus UCD (9.57 mm).
- All but one flap survived, indicating high overall success with the tested methods.
Conclusions:
- AR-Finder offers a more accurate and reliable method for locating ALT flap perforators than UCD.
- This technology presents a promising new tool for enhancing the design and elevation of ALT flaps.
- Improved perforator localization via AR-Finder can lead to better surgical outcomes and reduced patient morbidity.
