Three-dimensional Head-mounted Display Research Articles

Introducing next-generation transcranial surgery with the head-mounted 3D View Vision display in extracorporeal microsurgery: illustrative cases.

Exoscopy in neurosurgery offers various advantages, including increased freedom of the viewing axis while the surgeon maintains a comfortable upright position. However, the optimal monitor positioning to avoid interference with surgical manipulation remains unresolved. Herein, the authors describe two cases in which a three-dimensional head-mounted display (3D-HMD) was introduced into a transcranial neurosurgical procedure using an exoscope. Case 1 was a 50-year-old man who presented with recurrent epistaxis and was diagnosed with an olfactory neuroblastoma that extended from the nasal cavity to the anterior cranial base and infiltrated the right anterior cranial fossa. Case 2 was a 65-year-old man who presented with epistaxis and was diagnosed with a left-sided olfactory neuroblastoma. In both cases, en bloc tumor resection was successfully performed via a simultaneous exoscopic transcranial approach using a 3D-HMD and an endoscopic endonasal approach, eliminating the need to watch a large monitor beside the patient. This is the first report of using a 3D-HMD in transcranial surgery. The 3D-HMD effectively addressed issues with the field of vision and concentration while preserving the effectiveness of traditional microscopic and exoscopic procedures when observed on a 3D monitor. Combining the 3D-HMD with an exoscope holds the potential to become a next-generation surgical approach.

Novel anatomical apical dissection utilizing puboprostatic "open-collar" technique: Impact on apical surgical margin and early continence recovery.

PurposeTo evaluate the impact of modifications to anatomical apical dissection including a puboprostatic open-collar technique, which visualizes the lateral aspect of the apex and dorsal vein complex (DVC) covering the rhabdosphincter while preserving the puboprostatic collar, on positive surgical margin (PSM) and continence recovery.MethodsOne-hundred-and-sixty-seven patients underwent gasless single-port retroperitoneoscopic radical prostatectomy using a three-dimensional head-mounted display system. Sequentially modified surgical techniques comprised puboprostatic open-collar technique, sutureless transection of the DVC, retrograde urethral dissection, and anterior reconstruction. The associations of these modifications with PSM and continence recovery were assessed.ResultsThe puboprostatic open-collar technique, sutureless DVC transection, and retrograde urethral dissection were significantly associated with lower apical PSM (P = 0.003, 0.003, and 0.010, respectively). The former two also showed similar associations in 84 patients with anterior apical tumor (P = 0.021 and 0.030, respectively). Among 92 patients undergoing all of these three procedures, overall and apical PSM rates were 13.0% and 3.3%, respectively. Retrograde urethral dissection (odds ratio [OR] 2.73, P = 0.004) together with nerve sparing (OR 2.77, P = 0.003) and anterior apical tumor (OR 0.45, P = 0.017) were independently associated with immediate continence recovery. A multivariable model for 3-month continence recovery included anterior apical tumor (OR 0.28, P = 0.003) and puboprostatic open-collar technique (OR 3.42, P = 0.062). Immediate and 3-month continence recovery rates were 56.3% and 85.4%, respectively, in 103 patients undergoing both the puboprostatic open-collar technique and retrograde urethral dissection.ConclusionNovel anatomical apical dissection utilizing a puboprostatic open-collar technique may favorably impact on both apical surgical margin and continence recovery.

Clinically node-positive micropapillary bladder cancer in a young female desiring to spare functional bladder and fertility.

A 38-year-old female developing pelvic lymph node recurrence (cN2) of bladder cancer was referred to our hospital. Eighteen months earlier, she had received complete transurethral resection of bladder tumor and pathological diagnosis of muscle-invasive urothelial carcinoma with micropapillary variant had been made. She had declined radical cystectomy or chemoradiation because of a strong desire to spare the bladder and fertility. She received induction gemcitabine/cisplatin therapy. After three cycles, she achieved a clinically complete response. Then, she underwent transumbilical gasless retroperitoneoscopic super-extended pelvic lymph node dissection up to the inferior mesenteric artery trunk using the three-dimensional head-mounted display system. Pathologically, one of 42 resected lymph nodes was positive for metastasis. She is alive with no evidence of disease 5years after lymph node dissection, retaining functional bladder and normal ovarian functions.

PD07-05 THE OUTCOME OF GASLESS LAPAROSCOPIC SINGLE-PORT CLAMPLESS SUTURELESS PARTIAL NEPHRECTOMY USING THREE-DIMENSIONAL HEAD-MOUNTED DISPLAY

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy I1 Apr 2018PD07-05 THE OUTCOME OF GASLESS LAPAROSCOPIC SINGLE-PORT CLAMPLESS SUTURELESS PARTIAL NEPHRECTOMY USING THREE-DIMENSIONAL HEAD-MOUNTED DISPLAY Yosuke Yasuda, Kazutaka Saito, Takahiko Soma, Toshiki Kijima, Soichiro Yoshida, Minato Yokoyama, Junichiro Ishioka, Yoh Matsuoka, Kazunori Kihara, and Yasuhisa Fujii Yosuke YasudaYosuke Yasuda More articles by this author , Kazutaka SaitoKazutaka Saito More articles by this author , Takahiko SomaTakahiko Soma More articles by this author , Toshiki KijimaToshiki Kijima More articles by this author , Soichiro YoshidaSoichiro Yoshida More articles by this author , Minato YokoyamaMinato Yokoyama More articles by this author , Junichiro IshiokaJunichiro Ishioka More articles by this author , Yoh MatsuokaYoh Matsuoka More articles by this author , Kazunori KiharaKazunori Kihara More articles by this author , and Yasuhisa FujiiYasuhisa Fujii More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.438AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Partial nephrectomy (PN) is now the standard treatment for clinically localized renal cancers. Vascular clamping during the tumor resection might induce renal ischemia and reperfusion injury. Renal renorrhaphy could be associated with postoperative pseudoaneurysm. We have performed gasless laparoscopic single-port clampless sutureless PN using a three-dimensional head-mounted display (3D-HMD) system which combines a high-definition 3-D organic electroluminescent HMD with a high-definition 3D endoscope (Kihara K, Int. J. Urol 2015). The tumor is resected in a three-step procedure called the mushroom technique; the three steps are as follows 1) coagulating the resection margin and creating a groove around the tumor, 2) tapering the bottom of the groove to create a “mushroom stalk” shape in the tumor base, and 3) transecting the mushroom stalk. The surgical, oncological and functional outcomes of this surgery are presented. METHODS Between November 2011 and April 2017, consecutive 328 patients with suspected renal cell carcinoma (RCC) underwent gasless laparoscopic single-port PN using 3D-HMD by 21 surgeons. Six patients with metastatic RCC and 11 patients with bilateral RCC were excluded. RESULTS Of the 311 patients, 301 patients (97%) were treated by PN without vascular clamping and parenchymal suture. Median tumor size was 2.5 cm (range 0.9-9.8 cm). The median PADUA score was 8 (range 6-12), and 89 patients (29%) were complex cases (PADUA score = 10). Ninety-three patients (30%) had central tumors and 32 patients (10%) had hilar tumors. Median operative time and blood loss were 225 min and 300ml, respectively. Eight patients (3%) received allogeneic blood transfusions. Twenty-two major complications (7%, all grade 3 urinary leakage) were observed. No patients developed postoperative pseudoaneurysms. Of the 282 RCC patients, eight patients (3%) had positive surgical margins. During the follow-up period (median, 31 months), one patient (0.4%) and four patients (1%) developed bone metastasis and local recurrences, respectively. No patients died of RCC. The median percent decrease in estimated glomerular filtration rate three months after PN was 5.3%. CONCLUSIONS Gasless laparoscopic single-port clampless sutureless PN can be accomplished in almost all cases. This surgery is technically feasible and safe, yielding favorable oncological and functional outcomes. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e158 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Yosuke Yasuda More articles by this author Kazutaka Saito More articles by this author Takahiko Soma More articles by this author Toshiki Kijima More articles by this author Soichiro Yoshida More articles by this author Minato Yokoyama More articles by this author Junichiro Ishioka More articles by this author Yoh Matsuoka More articles by this author Kazunori Kihara More articles by this author Yasuhisa Fujii More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Three-Dimensional Head-Mounted Display System for Ophthalmic Surgical Procedures.

Three-Dimensional Head-Mounted Display System for Ophthalmic Surgical Procedures.

Compact see-through 3D head-mounted display based on wavefront modulation with holographic grating filter.

A compact see-through three-dimensional head-mounted display (3D-HMD) is proposed and investigated in this paper. Two phase holograms are analytically extracted from the object wavefront and uploaded on different zones of the spatial light modulator (SLM). A holographic grating is further used as the frequency filter to couple the separated holograms together for wavefront modulation. The developed preliminary prototype has a simple optical facility and a compact structure (133.8mm × 40.4mm × 35.4mm with a 47.7mm length viewing accessory). Optical experiments demonstrated that the proposed system can present 3D images to the human eye with full depth cues. Therefore, it is free of the accommodation-vergence conflict and visual fatigue problem. The dynamic display ability is also tested in the experiments, which provides a promising potential for the true 3D interactive display.

Compact three-dimensional head-mounted display system with Savart plate.

We propose three-dimensional (3D) head-mounted display (HMD) providing multi-focal and wearable functions by using polarization-dependent optical path switching in Savart plate. The multi-focal function is implemented as micro display with high pixel density of 1666 pixels per inches is optically duplicated in longitudinal direction according to the polarization state. The combination of micro display, fast switching polarization rotator and Savart plate retains small form factor suitable for wearable function. The optical aberrations of duplicated panels are investigated by ray tracing according to both wavelength and polarization state. Astigmatism and lateral chromatic aberration of extraordinary wave are compensated by modification of the Savart plate and sub-pixel shifting method, respectively. To verify the feasibility of the proposed system, a prototype of the HMD module for monocular eye is implemented. The module has the compact size of 40 mm by 90 mm by 40 mm and the weight of 131 g with wearable function. The micro display and polarization rotator are synchronized in real-time as 30 Hz and two focal planes are formed at 640 and 900 mm away from eye box, respectively. In experiments, the prototype also provides augmented reality function by combining the optically duplicated panels with a beam splitter. The multi-focal function of the optically duplicated panels without astigmatism and color dispersion compensation is verified. When light field optimization for two additive layers is performed, perspective images are observed, and the integration of real world scene and high quality 3D images is confirmed.

V41 Gasless single-port RoboSurgeon partial cystectomy: A hybrid technique combining an intravesical and extravesical approach

Gasless single-port RoboSurgeon partial cystectomy using a novel hybrid technique is performed with the assistance of a system (RoboSurgeon) that involves the robotization of the surgeon. This hybrid technique combines an intravesical approach through a natural orifice, the external urethral orifice, and an extravesical approach through a coin-sized single port. The RoboSurgeon system consists of three components: a three-dimensional head-mounted display (3D-HMD), handheld robot-like devices, and an endoscope manipulation robot. Depending on the situation, part or all of this system is used. The 3D-HMD, which provides six fields of vision in front of the eyes regardless of head position, is always used by surgeons. Using the direct view obtained by moving the angle of sight downward, surgeons can receive instruments from the scrub nurse and can also observe the operative field to ensure safety. In partial cystectomy, by making use of the multivision function, each participant can simultaneously see both intravesical and extravesical views. This surgery achieves four key “no’s”: no high costs, no CO2, no multiple ports, and no intraperitoneal injury. The adjustable port size provides safety and ease of learning. The aforementioned direct vision and adjustable port size facilitate the transition from open surgery. Without the RoboSurgeon system, single-port-like surgery, in which the port size is somewhat larger, can be performed using the procedures described herein.

Technology of Operations on Devices in a Virtual Aircraft Cabin

This paper focuses on the manual operations on the virtual cabin devices of a flight simulator developed by virtual reality technology. The system consists of the space positioning system, the data glove, the three-dimensional head-mounted display, the left and right eye stereoscopic imaging computers, the space positioning computer, and the main simulation computer. The hand position, attitude, and shape data are measured through the space positioning system and the data glove while the aircraft position and attitude are calculated through the aircraft simulation system. The hand model is represented by the hand position, attitude, rotation angles of fingers, the key points in the hand and the movement directions of these points .The virtual devices are modeled with object-oriented method encapsulating device shapes, operation status, the hand key points and their movement directions that are affective on the device shapes and operation status. The aircraft attitude is overlaid with the hand attitude in order to regard the moving cabin as static. Thus the coordinate transformations are confined to only the hand model and the device models that operation status changed to avoid the large amount of coordinate transformations and reduce the system time consumption. The application result shows that the virtual operation algorithm has a high efficiency, and the operation precision meets the need of system performance.

950 Novel three-dimensional head-mounted display system (RoboSurgeon System) – application to the initial 60 cases of gasless single-port access urologic surgeries

950 Novel three-dimensional head-mounted display system (RoboSurgeon System) – application to the initial 60 cases of gasless single-port access urologic surgeries

New three‐dimensional head‐mounted display system, TMDU‐S‐3D system, for minimally invasive surgery application: Procedures for gasless single‐port radical nephrectomy

We present an application of a new three-dimensional head-mounted display system that combines a high-definition three-dimensional organic electroluminescent head-mounted display with a high-definition three-dimensional endoscope to minimally invasive surgery, using gasless single-port radical nephrectomy procedures as a model. This system presents the surgeon with a higher quality of magnified three-dimensional imagery in front of the eyes regardless of head position, and simultaneously allows direct vision by moving the angle of sight downward. It is also significantly less expensive than the current robotic surgery system. While carrying out gasless single-port radical nephrectomy, the system provided the surgeon with excellent three-dimensional imagery of the operative field, direct vision of the outside and inside of the patient, and depth perception and tactile feedback through the devices. All four nephrectomies were safely completed within the operative time, blood loss was within usual limits and there were no complications. The display was light enough to comfortably be worn for a long operative time. Our experiences show that the three-dimensional head-mounted display system might facilitate maneuverability and safety in minimally invasive procedures, without prohibitive cost, and thus might mitigate the drawbacks of other three-dimensional vision systems. Because of the potential benefits that this system offers, it deserves further refinements of its role in various minimally invasive surgeries.

A Study on the Possibility of Applying Subliminal Visual Cue for Guiding Subject’s Attention

This paper presents a new warning method for increasing drivers’ sensitivity for recognizing hazardous factors in the driving environment. The method is based on a subliminal effect. In this study, the presentation of a visual cue at a lower contrast ratio than that of the background scenery was investigated as subliminal visual information instead of flashing information quickly. This method was chosen in consideration of its use in real-world driving situations where changes in ambient brightness are among the biggest visual disturbances experienced by drivers. Accordingly, it is necessary to have amethod that is applicable in the context of dynamic changes in brightness. The results of many experiments performed with a threedimensional head-mounted display show that the response time for detecting a flashing mark tended to decrease when a subliminal mark was shown in advance. A priming effect is observed for subliminal visual information. This paper also proposes a scenario for implementing this method in real vehicles.