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AugmentedrealityforDIEPflapharvest1438DISCUSSIONWedevelopedaworkflowtovisualizerelevantanatomysegmentedfromacomputedtomographicangiographforaDIEPflapharvestdirectlyintheabdomenofthepatientwithHoloLensaugmentedrealityglassesReal-timetracking ensures that the anatomy stays correctly fused with thepatientregardlessofpositionchangesofthepatientortheHoloLensuserThe3Dholographicvisualizationprovidesanintuitiveandstrongperceptionofcomplexanatomyinthis case thelocation ofperforators and theirrelation with epigastric arteriesin therectusabdominismuscleTheworkflowisthemostadvanceddescribedtodatebecauseofthecombinationofreal-timepatienttrackingandanovelregistrationmethod thatusesabdominalneviasnaturallandmarks TheworkflowcanbeusedpreoperativelytomarkanatomicalstructuressuchasvesselsonthepatientorintraoperativelytonavigateAlimitationoftheworkflowisthatthedepthofthehologramissometimesdifficulttoestimatebecausearealworldhandortooldoesnotinteractwiththehologramHowever,wetrytosolvethisbyusingatoolthatisalsodisplayedasahologramandthereforecaninteractwiththeanatomyhologram Thisworkflowcouldbeused forother flapsother typesofsurgeryorincombinationwithotherinnovativetechnologies15–17Figure4WhiletheHoloLenstracksthepatientpositionbythequickresponsemarkerabovethenaveltheanatomyhologramisvisualized Thegreencylindersindicateperforatorlocationsontheskin Theusercanswitchbetweenvisualizationsofdifferentanatomicalstructures
