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J Neurol Surg B Skull Base 2024; 85(04): 363-369
DOI: 10.1055/a-2083-7766
Original Article

NextLens—The Next Generation of Surgical Navigation: Proof of Concept of an Augmented Reality System for Surgical Navigation

Ronny Grunert
1   Department of Neurosurgery, University Leipzig, Leipzig, Germany
2   Fraunhofer Plastics Technology Center Oberlausitz, Fraunhofer Institute for Machine Tools and Forming Technology, Zittau, Germany
,
Carl-Henry Snyderman 
3   Center for Skull Base Surgery, University Pittsburgh, Medical Center, Pittsburgh, Pennsylvania, United States
,
Paul Gardner
3   Center for Skull Base Surgery, University Pittsburgh, Medical Center, Pittsburgh, Pennsylvania, United States
,
Michel Busse
1   Department of Neurosurgery, University Leipzig, Leipzig, Germany
,
Lukas Ahner
1   Department of Neurosurgery, University Leipzig, Leipzig, Germany
,
Fabian Kropla
1   Department of Neurosurgery, University Leipzig, Leipzig, Germany
,
Robert Möbius
1   Department of Neurosurgery, University Leipzig, Leipzig, Germany
,
Svenja Jung
1   Department of Neurosurgery, University Leipzig, Leipzig, Germany
,
Sebastian Scholz
2   Fraunhofer Plastics Technology Center Oberlausitz, Fraunhofer Institute for Machine Tools and Forming Technology, Zittau, Germany
,
Erdem Güresir
1   Department of Neurosurgery, University Leipzig, Leipzig, Germany
,
Dirk Winkler
1   Department of Neurosurgery, University Leipzig, Leipzig, Germany
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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

Authors' Contributions

R.G., D.W., C.S.: technical idea, writing of manuscript; M.B., L.A.: software instrument tracking; P.G.: design of surgical pointer, review of manuscript; F.K.: segmentation CT, construction of surgical pointer; E.G., R.M., S.S.: review of manuscript.


Ethics Approval

No ethical approval was required. The cadaver skull was applied according to the Declaration of Helsinki.


Consent to Participate

The cadaver skull was applied according to the declaration of Helsinki.


Data Availability Statement

The data that support the findings of this study are available from the corresponding author, upon request.




Publikationsverlauf

Eingereicht: 16. Februar 2023

Angenommen: 24. April 2023

Accepted Manuscript online:
28. April 2023

Artikel online veröffentlicht:
01. Juni 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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