Own experience of using holographic neuronavigation using an augmented reality helmet in neurosurgery

Abstract

Objective: to optimize surgical access to intracranial lesions (tumors, arteriovenous malformations, cysts, etc.) by using a holographic neuronavigation system with augmented reality helmet. Materials and methods: The study included thirty-four patients who underwent cerebral neurosurgical interventions. Creation and clinical use of mixed reality neuronavigation (MRN) system holograms was possible in all cases, which allowed accurate localization of lesions. The additional time required for synchronizing the MRN system with the clinical environment was estimated, which decreased with the number of MRN system uses. Operators evaluated the effectiveness of the technology and in most cases provided positive evaluations after use. Results: A semi-automatic MRN recording system on HoloLens smart glasses has been developed and tested for accuracy and performance. 34 patients with intracranial lesions were prospectively included in the study. Three-dimensional holograms of lesions, markers, and surrounding anatomical landmarks based on multimodal imaging were generated for each patient and then imported into the MRN system in AR helmet. After point recording, holograms were projected onto the patient’s head and observed through the AR helmet during the planning and conducting of surgical interventions. Conclusions: In this small pilot study, the authors found that mixed reality neuronavigation system MRN can be applied in the workflow of a neurosurgical operating room and is a possible method of preoperative identification of lesion boundaries for surgical access planning. Future studies are needed to identify strategies to improve and optimize the accuracy of MRN system.