Preoperative Evaluation of Pulmonary Vascular Anatomy by Augmented Reality (Holograms) in Patients Undergoing Lung Resection

An augmented reality (AR) system provides the surgeon with computer processed imaging data in real-time via dedicated hardware and software. The projection of AR is made possible by using displays, projectors, cameras, trackers, or other specialized equipment.

At present, the applications of AR are limited by the essential requisite of preoperative 3D reconstructions of medical images. It is possible to create these reconstructions by using commercial or self-made software from the Digital Imaging and Communications in Medicine (DICOM) format . The quality of a reconstruction depends on the quality of input data and the accuracy of the reconstruction system. Such reconstructions can be used for virtual exploration of target areas, planning an elective surgical approach in advance, and for better orientation and navigation in the operative field. AR is especially useful in visualizing critical structures such as major vessels, nerves, or other vital tissues. By projecting these structures directly onto the patient, AR increases safety and reduces the time required to complete the procedure. Moreover Augmented reality proved to be an effective tool for training and skill assessment of surgery residents, other medical staff, or students. Augmented reality can be used effectively for preoperative planning and completion of the actual surgery in timely fashion. The preoperative 3D reconstructed images can be modified and prepared for display in AR systems. Commonly, AR is used for tailoring individually preferred incisions and cutting planes, optimal placement of trocars, or to generally improve safety by displaying positions of major organ components. Another benefit of AR is the ability to aid surgeons in difficult terrain after a neoadjuvant chemotherapy or radiotherapy.

Studies suggest that AR systems are becoming comparable to traditional navigation techniques, with precision and safety sufficient for routine clinical practice. Most problems faced presently will be solved by further medical and technological research. Augmented reality appears to be a powerful tool possibly capable of changing the field of surgery through a rational use. In the future, AR will likely serve as an advanced human-computer interface, working in symbiosis with surgeons, allowing them to achieve even better results. Nevertheless, further advancement is much needed to achieve maximum potential and cost-effectiveness of augmented reality.