Abstract
Objective The aim of this work was the development of an augmented reality system including
the functionality of conventional surgical navigation systems.
Methods An application software for the Augmented Reality System HoloLens 2 from Microsoft
was developed. It detects the position of the patient as well as position of surgical
instruments in real time and displays it within the two-dimensional (2D) magnetic
resonance imaging or computed tomography (CT) images. The surgical pointer instrument,
including a pattern that is recognized by the HoloLens 2 sensors, was created with
three-dimensional (3D) printing. The technical concept was demonstrated at a cadaver
skull to identify anatomical landmarks.
Results With the help of the HoloLens 2 and its sensors, the real-time position of the surgical
pointer instrument could be shown. The position of the 3D-printed pointer with colored
pattern could be recognized within 2D-CT images when stationary and in motion at a
cadaver skull. Feasibility could be demonstrated for the clinical application of transsphenoidal
pituitary surgery.
Conclusion The HoloLens 2 has a high potential for use as a surgical navigation system. With
subsequent studies, a further accuracy evaluation will be performed receiving valid
data for comparison with conventional surgical navigation systems. In addition to
transsphenoidal pituitary surgery, it could be also applied for other surgical disciplines.
Keywords
augmented reality - surgical navigation - transsphenoidal pituitary surgery - computer-assisted
surgery
