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Related Experiment Video

Updated: Sep 9, 2025

Technical Approach for Infrared Tracking for Soft Tissue Navigation with a Holographic Head-Mounted Display and Preclinical Validation
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Holographic Deep Inferior Epigastric Perforator Exploration in Mixed Reality using Real-Time Cinematic Rendering.

Fabian N Necker1,2,3, David J Cholok3, Mohammed S Shaheen3

  • 1Department of Radiology, Stanford IMMERS (Incubator for Medical Mixed and Extended Reality at Stanford), Stanford University School of Medicine, Palo Alto, CA, USA.

Aesthetic Plastic Surgery
|August 28, 2025
PubMed
Summary
This summary is machine-generated.

This study introduces a new photorealistic 3D Mixed Reality workflow for planning Deep Inferior Epigastric Artery perforator (DIEP) flap surgery. This innovative approach enhances surgeon understanding of complex perforator anatomy for improved breast reconstruction outcomes.

Keywords:
Cinematic anatomyDIEP-flapsIndividualized surgeryMixed realityPatient-specific anatomyPhotorealistic rendering

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Area of Science:

  • Plastic Surgery
  • Medical Imaging
  • Virtual and Mixed Reality

Background:

  • Deep Inferior Epigastric Artery perforator (DIEP) flaps are standard for autologous breast reconstruction but pose challenges due to individual perforator anatomy.
  • Current preoperative planning using computed tomography (CT) angiography is limited by 2D visualization, lacking photorealism and detailed vascular depiction.

Purpose of the Study:

  • To introduce a novel holographic, photorealistic rendering workflow for Mixed Reality (MR) headsets to improve DIEP flap planning.
  • To enhance surgeons' understanding of complex perforator anatomy and spatial relationships for more precise surgical execution.

Main Methods:

  • Developed a photorealistic rendering workflow using Cinematic Anatomy on MR headsets (Microsoft HoloLens).
  • Utilized CT angiography data, allowing surgeons to interact with 3D holograms via hand gestures for real-time modification and dissection.
  • Employed interactive visualization settings to intuitively understand the spatial relationship of perforators to surrounding tissues.

Main Results:

  • The new workflow provides superior depth perception and photorealism compared to conventional segmentation and volume rendering.
  • Surgeons can interactively explore the sub- and intramuscular course of the vascular tree and surrounding anatomy.
  • The technique is surgeon-independent, requiring only a laptop and MR headset, increasing accessibility of CT angiography data.

Conclusions:

  • This study presents the first use of photorealistic rendering in MR for exploring perforator anatomy in DIEP flap planning.
  • The holographic approach offers a more intuitive and accurate understanding of complex vascular structures, potentially improving surgical planning and outcomes in breast reconstruction.