Abstract
BackgroundAugmented Reality (AR) is a rapidly emerging technology finding growing acceptance and application in different fields of surgery. Various studies have been performed evaluating the precision and accuracy of AR guided navigation. This study investigates the feasibility of a commercially available AR head mounted device during orthopedic surgery.MethodsThirteen orthopedic surgeons from a Swiss university clinic performed 25 orthopedic surgical procedures wearing a holographic AR headset (HoloLens, Microsoft, Redmond, WA, USA) providing complementary three-dimensional, patient specific anatomic information. The surgeon’s experience of using the device during surgery was recorded using a standardized 58-item questionnaire grading different aspects on a 100-point scale with anchor statements.ResultsSurgeons were generally satisfied with image quality (85 ± 17 points) and accuracy of the virtual objects (84 ± 19 point). Wearing the AR device was rated as fairly comfortable (79 ± 13 points). Functionality of voice commands (68 ± 20 points) and gestures (66 ± 20 points) provided less favorable results. The greatest potential in the use of the AR device was found for surgical correction of deformities (87 ± 15 points). Overall, surgeons were satisfied with the application of this novel technology (78 ± 20 points) and future access to it was demanded (75 ± 22 points).ConclusionAR is a rapidly evolving technology with large potential in different surgical settings, offering the opportunity to provide a compact, low cost alternative requiring a minimum of infrastructure compared to conventional navigation systems. While surgeons where generally satisfied with image quality of the here tested head mounted AR device, some technical and ergonomic shortcomings were pointed out. This study serves as a proof of concept for the use of an AR head mounted device in a real-world sterile setting in orthopedic surgery.
Highlights
Augmented Reality (AR) is a rapidly emerging technology finding growing acceptance and application in different fields of surgery
The greatest potential in the use of the AR device was found for surgical correction of deformities (87 ± 15 points), osteotomies (82 ± 17 points), revision surgery (77 ± 22 points), and tumor surgery (77 ± 21 points), whereas lowest potential was found for arthroscopic (32 ± 25 points) and reconstructive surgery (41 ± 22 points) (Fig. 9)
This prospective clinical study offers a proof of concept of the clinical feasibility of a wearable augmented reality device for using three-dimensional virtual object reconstructions of individual patients’ anatomy as an intraoperative aid during orthopedic surgical procedures
Summary
Augmented Reality (AR) is a rapidly emerging technology finding growing acceptance and application in different fields of surgery. Augmented Reality (AR) is a rapidly emerging technology providing the user with computer-generated information superimposed to real-world environment. The user’s field of view is transformed into a display where real-world objects can be complemented with virtual data. This way information including drilling axis or cutting planes can be projected directly onto the patients’ anatomy within the surgical field. We performed a prospective clinical feasibility study in a real world-environment where orthopedic surgeons used a commercially available holographic headset (HoloLens I, Microsoft, Redmond, WA, USA) during surgery (Fig. 1). The surgeon’s experience of using the device during surgery was recorded using a standardized questionnaire
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