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Augmented reality system for endoscopic pituitary surgery with automatic registration.

Aure Enkaoua1, João Ramalhinho2, Mobarakol Islam2

  • 1UCL Hawkes Institute, Department of Medical Physics and Biomedical Engineering, University College London, London, UK. zcemaen@ucl.ac.uk.

International Journal of Computer Assisted Radiology and Surgery
|May 11, 2025
PubMed
Summary

This study introduces an Augmented Reality (AR) system for endoscopic pituitary surgery, offering improved accuracy and workflow efficiency over traditional methods. The AR system enhances surgical navigation and reduces procedure time.

Keywords:
Augmented realityEndoscopic surgeryMinimally invasive surgeryTranssphenoidal pituitary surgery

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Area of Science:

  • Neurosurgery
  • Medical Imaging
  • Surgical Technology

Background:

  • Endoscopic pituitary surgery is a minimally invasive technique for tumor removal.
  • Current image guidance uses a tracked pointer, which is mentally demanding and disrupts workflow.
  • The pointer method requires frequent tool removal and has significant setup time.

Purpose of the Study:

  • To develop and evaluate an Augmented Reality (AR) system for enhanced navigation in endoscopic pituitary surgery.
  • To improve upon existing image guidance systems by integrating pre-operative scan data directly into the endoscopic video feed.
  • To automate the registration process for increased efficiency and accuracy.

Main Methods:

  • An Augmented Reality (AR) system was developed, overlaying pre-operative scan information onto endoscopic video.
  • The system incorporates an on-board tracking mechanism for automatic registration.
  • System accuracy was evaluated and compared against an infrared (IR) camera-based tracking system.

Main Results:

  • The proposed AR system achieved an accuracy of 1.1 (± 0.4) mm.
  • The IR-tracked endoscope approach yielded an accuracy of 2.4 (± 0.9) mm.
  • The AR system demonstrated superior accuracy compared to the IR-tracked method.

Conclusions:

  • The developed AR system is more compact, transportable, and accurate than IR-tracked endoscopes.
  • Automatic registration significantly saves operating room time and enhances AR overlay precision.
  • This technology advancement improves the translation of AR into clinical practice for pituitary surgery.