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HAPPY: Hip Arthroscopy Portal Placement Using Augmented Reality

Correct positioning of the endoscope is crucial for successful hip arthroscopy. Only with adequate alignment can the anatomical target area be visualized and the procedure be successfully performed. Conventionally, surgeons rely on anatomical landmarks such as bone structure, and on intraoperative X...

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Detalles Bibliográficos
Autores principales: Song, Tianyu, Sommersperger, Michael, Baran, The Anh, Seibold, Matthias, Navab, Nassir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9695387/
https://www.ncbi.nlm.nih.gov/pubmed/36354875
http://dx.doi.org/10.3390/jimaging8110302
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author Song, Tianyu
Sommersperger, Michael
Baran, The Anh
Seibold, Matthias
Navab, Nassir
author_facet Song, Tianyu
Sommersperger, Michael
Baran, The Anh
Seibold, Matthias
Navab, Nassir
author_sort Song, Tianyu
collection PubMed
description Correct positioning of the endoscope is crucial for successful hip arthroscopy. Only with adequate alignment can the anatomical target area be visualized and the procedure be successfully performed. Conventionally, surgeons rely on anatomical landmarks such as bone structure, and on intraoperative X-ray imaging, to correctly place the surgical trocar and insert the endoscope to gain access to the surgical site. One factor complicating the placement is deformable soft tissue, as it can obscure important anatomical landmarks. In addition, the commonly used endoscopes with an angled camera complicate hand–eye coordination and, thus, navigation to the target area. Adjusting for an incorrectly positioned endoscope prolongs surgery time, requires a further incision and increases the radiation exposure as well as the risk of infection. In this work, we propose an augmented reality system to support endoscope placement during arthroscopy. Our method comprises the augmentation of a tracked endoscope with a virtual augmented frustum to indicate the reachable working volume. This is further combined with an in situ visualization of the patient anatomy to improve perception of the target area. For this purpose, we highlight the anatomy that is visible in the endoscopic camera frustum and use an automatic colorization method to improve spatial perception. Our system was implemented and visualized on a head-mounted display. The results of our user study indicate the benefit of the proposed system compared to baseline positioning without additional support, such as an increased alignment speed, improved positioning error and reduced mental effort. The proposed approach might aid in the positioning of an angled endoscope, and may result in better access to the surgical area, reduced surgery time, less patient trauma, and less X-ray exposure during surgery.
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spelling pubmed-96953872022-11-26 HAPPY: Hip Arthroscopy Portal Placement Using Augmented Reality Song, Tianyu Sommersperger, Michael Baran, The Anh Seibold, Matthias Navab, Nassir J Imaging Article Correct positioning of the endoscope is crucial for successful hip arthroscopy. Only with adequate alignment can the anatomical target area be visualized and the procedure be successfully performed. Conventionally, surgeons rely on anatomical landmarks such as bone structure, and on intraoperative X-ray imaging, to correctly place the surgical trocar and insert the endoscope to gain access to the surgical site. One factor complicating the placement is deformable soft tissue, as it can obscure important anatomical landmarks. In addition, the commonly used endoscopes with an angled camera complicate hand–eye coordination and, thus, navigation to the target area. Adjusting for an incorrectly positioned endoscope prolongs surgery time, requires a further incision and increases the radiation exposure as well as the risk of infection. In this work, we propose an augmented reality system to support endoscope placement during arthroscopy. Our method comprises the augmentation of a tracked endoscope with a virtual augmented frustum to indicate the reachable working volume. This is further combined with an in situ visualization of the patient anatomy to improve perception of the target area. For this purpose, we highlight the anatomy that is visible in the endoscopic camera frustum and use an automatic colorization method to improve spatial perception. Our system was implemented and visualized on a head-mounted display. The results of our user study indicate the benefit of the proposed system compared to baseline positioning without additional support, such as an increased alignment speed, improved positioning error and reduced mental effort. The proposed approach might aid in the positioning of an angled endoscope, and may result in better access to the surgical area, reduced surgery time, less patient trauma, and less X-ray exposure during surgery. MDPI 2022-11-06 /pmc/articles/PMC9695387/ /pubmed/36354875 http://dx.doi.org/10.3390/jimaging8110302 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Song, Tianyu
Sommersperger, Michael
Baran, The Anh
Seibold, Matthias
Navab, Nassir
HAPPY: Hip Arthroscopy Portal Placement Using Augmented Reality
title HAPPY: Hip Arthroscopy Portal Placement Using Augmented Reality
title_full HAPPY: Hip Arthroscopy Portal Placement Using Augmented Reality
title_fullStr HAPPY: Hip Arthroscopy Portal Placement Using Augmented Reality
title_full_unstemmed HAPPY: Hip Arthroscopy Portal Placement Using Augmented Reality
title_short HAPPY: Hip Arthroscopy Portal Placement Using Augmented Reality
title_sort happy: hip arthroscopy portal placement using augmented reality
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9695387/
https://www.ncbi.nlm.nih.gov/pubmed/36354875
http://dx.doi.org/10.3390/jimaging8110302
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