Page 237 - Demo

Summaries23513implementationrevealsthatitispossibletoprojectthe virtualplanningdirectlyintheworkfieldofthesurgeon Themostimportantadvantageisthatitsolvestheswitching focusproblem allowing the surgeon tolook continuously at the surgicalsiteinsteadofswitchingtoamonitorwhenconsultingthevirtualplanningIfaHMDwithastereoscopicviewisusedtoachieveARrelevantvirtualinformationcanbevisualizedin3DattheiranatomicalpositionresultinginamoreintuitivevisualizationInChapter7anARapplicationwasdevelopedtotransferaVSPforopencranialvault surgery Since AR can display theplanning directly on thepatientit canbe analternativeforsurgicalguideswhicharetime-consumingtoproduceandratherexpensiveInthisstudywefoundthatconsiderablylongertimewasrequiredtotransferaplanning when theAR workflow wasused Therefore weconcluded thatsurgicalguidesarepresentlythemostfittingmethodtotransfera VSP.InadditiontherelativelylargeoutliersintheARworkflowmeantthatthemeanaccuracywasjustoutsidetheclinicallyacceptablemarginHowever,thelowcostandsimplicitymaketheARworkflowstillapromisingalternativetosurgicalguidesInChapter8anAR-guidedworkflowispresentedtotransferpre-surgicalinformationtopatientsduringabreastreconstructionwithadeepinferiorepigastricarteryperforator(DIEP)flapThe3DvisualizationintheHoloLensprovidesanintuitiveandstrongperceptionofthecomplexanatomysegmentedfromaCTAscan ThisenablestheusertoviewtherelationoftheperforatorwiththerectusabdominismuscleReal-timetrackingandanovelregistrationmethodusingthepatient’sabdominalbirthmarksensuresthattheanatomystayedcorrectlyfusedwiththepatientregardlessofpositionchangesofthepatientorthesurgeonSincetheAR-DIEPapplicationwillbeusedforglobalorientationtheworkflowdoesnotdemandmillimeteraccuracyTheusabilityintuitivenessandset-uparethemostimportantfactorsthatwilldecideifARwillbeintegratedinclinicalworkflowinthefutureThereforeifnewdevelopmentsandresearchcanrealizethistheDIEPapplicationwillbeofgreatvalueandcanbeusedforother(free)flapsChapter9showsthatARguidancewasaneffectivemethodtoassistthesurgeonduringacondylectomySince thesmallsurgicalopeningmakes theuseofsurgicalguidesimpracticalARisprobablythebestmethodtoindicatetothesurgeon