Digital endocasts of the cranial surface generated by the 3D vision system

The three-dimensional (3D) vision system was released to the medical market to improve laparoscopic outcomes. We analyzed the muscular pain and fatigue, and the performance outcomes after several laparoscopic urologic tasks were completed with the 3D vision system. A total of 49 participants with different surgical expertise levels were enrolled in the study. All the participants performed some laparoscopic urologic tasks using two-dimensional (2D) and 3D vision systems separately. A mini questionnaire survey was also completed by the participants. The duration and quality of the tasks and the muscular fatigue and pain were objectively determined. All the parameters were compared between the 2D and 3D systems. Although all the tasks were completed in significantly shorter times with the 3D vision system in each expertise level, maximal shortening was seen in the residents. The overall quality scores were significantly higher with the 3D vision system. However, a maximal increase was seen in the residents. The muscular pain of the participants was lower with 3D vision system. The overall handgrip strength significantly increased from 41.2 to 42.4 kg after the tasks with the 3D vision system, but the difference was significant in only the residents. Twenty-seven participants (56.2%) declared that the 3D system contributed to their performance, and most of the participants (83.3%) preferred the 3D system in the questionnaire survey. 3D technology may be effective for use in urologic laparoscopic training programs of novice surgeons. It may also contribute to the skills of specialists and experts, shortening the surgical time, which may decrease the surgical morbidity.

This paper proposes a three-dimensional (3D) vision system based on range image processing for mechanical assembly and disassembly. In the field of assembly and, moreover, because of the increasing importance of recycling of industrial products, in the field of disassembly, a more flexible vision system is required. Conventional intensity image processing is not sufficient and so a 3D vision system is required. A prototype of a vision system with a high-speed range image sensor is constructed, and its robustness for assembly and disassembly is verified by experiments to detect a target region (dial of an audio amplifier) with blemishes. Shape recognition algorithms which are applicable to sparse range images of the 3D vision system are introduced. They utilize primitive surface features such as planar or cylindrical surfaces as features for model matching. Fundamental experiments show the effectiveness of the general shape recognition algorithms.

In the field of artificial intelligence (AI), three-dimensional (3D) vision system is increasingly used to obtain 3D information of targets. In this paper, a method for measuring the azimuth of CCD camera’s apparent axis with high precision applied to 3D vision system is proposed. The azimuth angle of the apparent axis of CCD camera can be easily and accurately measured by using the laser projection transfer method through the horizontal two-dimensional turntable and the linear laser, which provides a method for 3D vision system calibration. This paper introduced the principle of measuring angles of the system, deduced the equation of coordinate transformation of the system, and made systematic error analysis. The results show that the measurement accuracy and reliability of this method meet the needs of 3D vision system calibration, which is much higher than the measurement accuracy and stability of geomagnetic sensors.

To report the outcomes, advantages and disadvantages of a heads-up three-dimensional (3D) visualization system compared to the conventional microscope in pediatric tractional retinal detachment (TRD) surgery secondary to advanced stage retinopathy of prematurity (ROP). Medical records of patients with ROP stage 4 or 5 who underwent surgery for tractional retinal detachment at King Khaled Eye Specialist Hospital between September 2017 and July 2019 were identified and reviewed. Eyes were divided into 2 groups, eyes that underwent surgery with a 3D heads-up platform (3D group) and eyes that underwent surgery with a conventional microscope (conventional group). Data were collected on neonatal history, visual acuity, intraoperative complications and success rates between groups.Eighteen eyes of 14 patients who underwent surgical repair of TRD related to ROP. Postoperative outcomes were compared between 10 eyes (7 patients) in the 3D group and 8 eyes (7 patients) in the conventional group There was no statistically significant difference in success rate between both groups (75% conventional group vs 70% 3D group). Partial or complete reattachment was achieved in 7 eyes in 3D group compared to 6 eyes in conventional group. Lower postmenstrual age at the time of the first surgery and presence of retinal breaks were associated with poorer surgical outcome. Heads up 3D visualization system is feasible in tractional retinal detachment related to ROP with similar success rate and no increased risk of complications when compared to conventional microscope. This system may be advantageous in advanced pediatric tractional retinal detachment surgeries.

Objectives: The objective of the study was to discuss the design method of medical image three-dimensional (3D) visualization system based on magnetic resonance angiography (MRA) data. Methods: Using 3D visualization of the carotid artery as an example, the three-position reconstruction algorithm on the basis of volume rendering was discussed. Moreover, if 3D carotid artery is extracted, based on this, we could combine Visualization Toolkit and Image Segmentation and Registration Toolkit with it to construct a 3D visualization system of medical images based on MRA data using C++. Results: The 3D visualization system of medical image data can be read on the MRA based on Digital Imaging and Communications in Medicine images and can be displayed completely. At the same time, a series of interactive operations can be carried out on the 3D image, and three-position blood vessel segmentation and enhancement on the basis of volume rendering can be realized. Conclusions: The medical image 3D visualization system based on MRA data can read and display 3D images and can realize a series of interactive operations, which can achieve better blood vessel enhancement effect and carotid artery extraction. It has important function and significance for a three-bit visualization of medical image.

Background: Laparoscopic cholecystectomy is a common procedure for the definitive treatment for cholecystitis and symptomatic cholelithiasis. One advancement in minimally invasive surgery has been the development of three-dimensional (3D) visualization systems to provide stereopsis. It is yet to be determined whether this innovation is beneficial to the surgeon or simply just a gimmick. This narrative review aims to answer the following research question, what is the impact of 3D visualization systems on surgical efficiency compared with two-dimensional visualization systems in laparoscopic cholecystectomy? Methods: Through a broad literature search it was determined that operative time and intraoperative errors have been used in published research to assess intraoperative efficiency. Results: Studies published to date have used operative time, intraoperative errors, and intraoperative bleeding as current measures for intraoperative efficiency. Previous meta-analysis have shown a slight improvement in operative time for 3D visualization systems; however, subsequent randomized control trials have not shown a significant difference in operative time. Reporting of intraoperative errors has been quite subjective and a difference between visualisation modality has not been shown. Conclusion: 3D visualization systems have shown a minor improvement in operative time compared with traditional laparoscopic systems and it is unlikely to be of any clinical significance. Studies that measure intraoperative error vary greatly in what they report, and which assessment tool is used. Across existing literature, studies do not control for surgeon's experience, elective/emergent cases, and grade of gallbladder/difficulty. Further research is required, using novel tools for assessment in laparoscopic cholecystectomy to determine intraoperative differences through objective and quantitative variables.

The purpose of this work was to create a 3D visualization system to aid physicians in observing abnormalities of the human lungs. A series of 20-30 helical CT lung slice images obtained from the lung cancer screening protocol as well as a series of 100-150 diagnostic helical CT lung slice images were used as an input. We designed a segmentation filter to enhance the lung boundaries and filter out small and medium bronchi from the original images. The pairs of original and filtered images were further processed with the contour extraction method to segment out only the lung field for further study. In the next step the segmented lung images containing the small bronchi and lung textures were used to generate the volumetric dataset input for the 3D visualization system. Additional processing for the extracted contour was used to smooth the 3D lung contour in the lung boundaries. The computer program developed allows, among others, viewing of the 3D lung object from various angles, zooming in and out as well as selecting the regions of interest for further viewing. The density and gradient opacity tables are defined and used to manipulate the displayed contents of 3D rendered images. Thus, an effective 'see-through' technique is applied to the 3D lung object for better visual access to the internal lung structures like bronchi and possible cancer masses. These and other features of the resulting 3D lung visualization system give the user a powerful tool to observe and investigate the patient's lungs. The filter designed for this study is a completely new solution that greatly facilitates the boundary detection. The developed 3D visualization system dedicated from chest CT provides the user a new way to explore effective diagnosis of potential lung abnormalities and cancer. In the authors' opinion, the developed system can be successfully used to view and analyze patient's lung CT images in a new powerful approach in both diagnosis and surgery-planning applications. Additionally, we see the possibility of using the system for teaching anatomy as well as pathology of the human lung.

To investigate the feasibility of teaching minimally invasive vitreoretinal surgery with a robot-assisted surgical system and a three-dimensional (3D) visualization system. Enucleated porcine eyes were established as an animal model for removing foreign bodies. Forty medical students were recruited to remove foreign bodies to compare the traditional microscope and the 3D system. One junior resident performed the surgical task with manual and robot-assisted operations on 20 porcine eyes for each group. One senior surgeon evaluated the retinal invasion by a graded injury degree. The learning curve for minimally invasive vitreoretinal surgery was described. Compared with the robot-assisted group, the injury degree was higher in the manual group. For the first ten surgeries, the manual and robot-assisted groups had injuries of 2.60±1.35 (4 to 0) and 1.80±1.62 (4 to 0), respectively. For the last ten surgeries, the injury degrees were 1.90±1.20 (3 to 0) and 0.80±0.42 (1 to 0). Considering the manual and robot-assisted groups together, 95%, 75% and 60% of the students considered surgical manipulation with the 3D visualization system to be more comfortable, easier and clearer, respectively. The robot-assisted surgical system and 3D visualization system may have value in teaching minimally invasive vitreoretinal surgery.

Background: Three-dimensional (3D) visualization systems, also known as heads-up systems, are now available for eye surgery and as with every new device there is need for a specific evaluation. Objectives: The aim of this study was to compare the efficiency, surgical comfort, and safety of a 3D visualization system to a standard binocular microscope (BM) in routine ophthalmologic procedures. Method: After a 4-week training period, a 3D visualization system (Ngenuity, Alcon®) available in one of the Robert Debré Hospital Ophthalmology Departments’ operating rooms was compared to a standard BM (OPMI LUMIRA 700, Zeiss®), in the process of a call for new device evaluation. From December 2017 to March 2018, 5 surgeons and their respective residents were asked to fill in a questionnaire for all procedures. Before the surgery, the surgeon recorded: (i) the type of surgery (cataract [PK], retinal detachment [RD], epiretinal membrane peeling [ERM], macular hole, vitreous haemorrhage [VH]), (ii) the type of visualization system chosen (3D or BM), and (iii) the estimated surgical risk (low, intermediate, or high grade). At the end of the procedure, the primary surgeon recorded the remaining parameters, including: (i) surgery duration, (ii) intraoperative complications, (iii) percentage of endoillumination for posterior segment surgeries, (iv) status of the operator (senior or resident) and operator switch if necessary (senior only, resident only, or resident with help of the senior), and rated: (i) the visual comfort (low, normal, excellent), (ii) the operative fluency (low, normal, excellent), (iii) backaches (none, low, moderate, important), and (iv) headaches (range from 0 to 10). Age and sex were collected retrospectively. The procedures performed with 3D and BM were subsequently compared using univariate (χ², Fisher, Wilcoxon) and multivariate analysis (generalized linear model), allowing us to identify parameters independently associated with PK surgery duration. Results: A total of 102 valid questionnaires, relative to 73 PK and 29 vitreoretinal procedures, respectively, were analysed. As regards PK (3D, n = 25 vs. BM, n = 48), the mean age, sex ratio, surgical risk, intraoperative complications (1/25 vs. 4/48), visual comfort, backaches, and headaches were similar between the two systems. The use of 3D allowed faster PK surgeries (16.44 ± 4.36 vs. 21.44 ± 7.50 min; p = 0.007) and slightly enhanced the operative fluency. In vitreoretinal surgeries (3D, n = 14 vs. BM, n = 15), no obvious differences between the two visualization systems were observed, although the use of the 3D system was found to slightly decrease the operative fluency. Parameters independently associated with PK surgery duration were 3D visualization (β = –4.4 ± 1.4; p = 0.002), high preoperative surgical risk (β = 6.2 ± 2.4; p = 0.012), intraoperative complications (β = 8.7 ± 2.6; p = 0.001), and surgeon status (β = –4.4 ± 1.3; p = 0.001) in univariate and multivariate analysis. Conclusions: 3D visualization can be safely used in routine practice. It slightly improves the operative fluency, allowing faster PK surgery.

Three-dimensional (3D) versus two-dimensional (2D) laparoscopic adrenalectomy: A case-control study

In view of the increasing multidimensional, detailed and dynamic nature of modern battlefield situation, the traditional two-dimensional (2D) battlefield situation visualization can no longer satisfy the needs of battlefield command and decision-making. Based on the in-depth study of OpenSceneGraph (OSG) and Qt. This paper designs and implements a three-dimensional (3D) visualization system of battlefield situation. This system combined with the radar system, uses User Datagram Protocol (UDP) protocol for real-time data communication. It is designed and implemented from four parts: resource management database, 3D visualization platform, radar system and interactive function realization. And the interactive function, such as radar beam dynamic scanning display, battlefield situation information display and playback, and real-time data communication, etc, are mainly designed in this system. The visualization results shows that the 3D visualization system has good real-time performance, comprehensive functions and strong sense of immersion. It has reference and guiding significance for the research and development of various application systems of 3D situation.

IntroductionPars plana vitrectomy (PPV) is a primary strategy to restore vision for patients who have rhegmatogenous retinal detachment (RRD). Perfluorocarbon liquid (PFCL) is frequently used during PPV surgery. However, the unintended intraocular retention of PFCL may cause retina toxicity and thus lead to possible postoperative complications. In this paper, the experiences and surgical outcomes of a NGENUITY 3D Visualization System-assisted PPV are shown to evaluate the possibility of excluding the application of PFCL.MethodsA consecutive series of 60 cases with RRD were presented, all of whom had undergone 23-gauge PPV with the assistance of a three-dimensional (3D) visualization system. Among them, 30 cases used PFCL to assist the drainage of subretinal fluid (SRF), while the other 30 cases did not. Parameters including retinal reattachment rate (RRR), best-corrected visual acuity (BCVA), operation time, and SRF residual were compared between the two groups.ResultsBaseline data showed no statistical significance between the two groups. At the last postoperative follow-up, the RRR of all the 60 cases reached 100% and best-corrected visual acuity (BCVA) gained significant improvement. The BCVA (logMAR) increased from 1.293 ± 0.881 to 0.479 ± 0.316 in the PFCL-excluded group, exhibiting better results than the PFCL included group, whose final BCVA was 0.650 ± 0.371. More importantly, excluding PFCL greatly reduced the operation time (decrease of 20%), therefore, avoiding possible complications caused by both the use of PFCL and the operation process.ConclusionWith the assistance of the 3D visualization system, it is feasible to treat RRD and perform PPV without using PFCL. The 3D visualization system is highly recommendable, as not only can it achieve the same surgical effect without the assistance of PFCL, but also simplify the operation procedure, shorten the operation time, save costs, and avoid complications related to PFCL.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40123-023-00692-2.

Objective: To assess the clinical efficacy and safety of a new technique for visualizing the anterior lens capsule (ALC) during the anterior capsulorhexis maneuver. This method utilizes a three-dimensional (3D) visualization system and does not require the use of the technically invasive trypan blue (TB) dye staining. Methods: The study population was divided into two groups: the main group (MG) and the control group (CG). The MG consisted of 250 patients who underwent cataract surgery using a 3D visualization system. This system employs black-and-white filters and reduced color saturation to improve visibility during capsulorhexis. In contrast, in the CG, which also consisted of 250 patients, conventional microscope imaging with TB dye (0.05%) staining for ALC visualization was utilized. Results: The patients in the MG and the CG exhibited a low rate of intraoperative and postoperative complications, with only 8 cases out of 500 eyes operated, resulting in a complication rate of 1.6%. There were no statistically significant differences between the MG and CG regarding best-corrected visual acuity (BCVA) and uncorrected visual acuity (UCVA) (p>0.05). The average surgical time was 10.2 minutes for the MG and 11.1 minutes for the CG (p>0.05). However, there was a statistically significant increase in the capsulorhexis time in the MG (p<0.05), as well as in the intraocular lens (IOL) implantation time in the CG (p<0.05). Additionally, significantly lower light intensity was used in the operating microscope for the MG, averaging 17.2%, compared to 47.9% for the CG (p<0.05). In the MG, there was a significantly lower incidence of the capsulorhexis radial tear at 0.8% of patients, compared to 4.0% in the CG (p<0.05). The peripheral runaway capsulorhexis was observed in 0.4% of patients in the MG, while it occurred in 1.6% of patients in the CG (p>0.05).Conclusion: The visualization of the ALC using a 3D system and black-and-white filters is currently of interest for cataract surgery, serving as an alternative to the standard visualization method that employs TB dye. Keywords: Ophthalmic surgery, three-dimensional visualization, cataract, capsulorhexis.

Purpose:The aim of this study was to evaluate the application and safety of three-dimensional (3D) visualization system in varied anterior segment procedures and Scleral Buckle.Methods:This was a prospective observational study of 313 eyes. Patients undergoing phacoemulsification (PE) with intraocular lens (IOL), trabeculectomies, glaucoma triple procedure (GTP), scleral fixated (SF) IOL, and scleral buckle (SB) were included in the study. Cases were randomly distributed in 3D visualization system (learning and post-learning phase) and conventional microscope group. Parameters studied were complications (intraoperative and early postoperative), surgical outcomes, and surgeon’s perspective on various parameters (through a validated questionnaire) like surgical time, time lag, learning curve, ease of doing various steps and its value as an educational tool, for both groups [Questionnaires 1 and 2].Results:Complications rates were not different in two groups. Surgical outcomes (anatomical and physiological) were similar in both the groups. Mean duration of surgery in PE+IOL, Trabeculectomy, GTP in learning stage by 3D was significantly higher than Microscope, which became insignificant in postlearning stage. For, SB and SFIOL, duration between two groups were insignificantly different. There was significant learning struggle in PE+IOL, SB, and Trabeculectomy. Image resolution, depth perception, illumination and postural comfort was graded higher for 3D surgery across the stages. Time lag, poor color contrast, and field of view were appreciated during the learning stage. Educational relevance of 3D was higher, as appreciated by resident and nurses.Conclusion:3D surgery is as safe, faster, and predictable after initial learning struggle. Even in anterior segment procedure, no apparent lag was appreciated after learning curve.

Does 3D imaging improve laparoscopic intracorporeal suturing skill acquisition in novices and trainee surgeons?