Development of a surgical navigation system based on augmented reality using an optical see-through head-mounted display

Recently, virtual reality (VR) and augmented reality (AR) have received increasing attention, with the development of VR/AR devices such as head-mounted displays, haptic devices, and AR glasses Medicine is considered to be one of the most effective applications of VR/AR In this article, we describe a systematic literature review conducted to investigate the state-of-the-art VR/AR technology relevant to plastic surgery The 35 studies that were ultimately selected were categorized into 3 representative topics: VR/AR-based preoperative planning, navigation, and training In addition, future trends of VR/AR technology associated with plastic surgery and related fields are discussed

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Virtual Reality and Augmented Reality in Plastic Surgery: A Review.

Biomedical engineering seeks to enhance the quality of life by developing advanced materials and technologies. Chitosan-based biomaterials have attracted significant attention because of having unique chemical structures with desired biocompatibility and biodegradability, which play different roles in membranes, sponges and scaffolds, along with promising biological properties such as biocompatibility, biodegradability and non-toxicity. Therefore, chitosan derivatives have been widely used in a vast variety of uses, chiefly pharmaceuticals and biomedical engineering. It is attempted here to draw a comprehensive overview of chitosan emerging applications in medicine, tissue engineering, drug delivery, gene therapy, cancer therapy, ophthalmology, dentistry, bio-imaging, bio-sensing and diagnosis. The use of Stem Cells (SCs) has given an interesting feature to the use of chitosan so that regenerative medicine and therapeutic methods have benefited from chitosan-based platforms. Plenty of the most recent discussions with stimulating ideas in this field are covered that could hopefully serve as hints for more developed works in biomedical engineering.

Chitosan in Biomedical Engineering: A Critical Review

Medical procedures often involve the use of the tactile sense to manipulate organs or tissues by using special tools. Doctors require extensive preparation in order to perform them successfully; for example, research shows that a minimum of 750 operations are needed to acquire sufficient experience to perform medical procedures correctly. Haptic devices have become an important training alternative and they have been considered to improve medical training because they let users interact with virtual environments by adding the sense of touch to the simulation. Previous articles in the field state that haptic devices enhance the learning of surgeons compared to current training environments used in medical schools (corpses, animals, or synthetic skin and organs). Consequently, virtual environments use haptic devices to improve realism. The goal of this paper is to provide a state of the art review of recent medical simulators that use haptic devices. In particular we focus on stitching, palpation, dental procedures, endoscopy, laparoscopy, and orthopaedics. These simulators are reviewed and compared from the viewpoint of used technology, the number of degrees of freedom, degrees of force feedback, perceived realism, immersion, and feedback provided to the user. In the conclusion, several observations per area and suggestions for future work are provided.

A Review of Simulators with Haptic Devices for Medical Training

Volume rendering (VR) represents today’s standard three-dimensional (3-D) image post-processing technique, and often is used to visualize complex anatomical information. Recently, a novel 3-D technique for post-processing of computed tomography (CT) image data has been introduced, which is called cinematic rendering (CR). The objective of this review is to illustrate the image appearance and potential value of CR in comparison with conventional VR in a number of various applications and different anatomical regions. Similar to VR, CR best visualizes high density and high contrast structures such as bones and contrast-enhanced vessels, but at the same time provides a more natural and photo-realistic illumination of the rendered data. Further research will be necessary for determining possible advantages of CR over conventional VR and over two-dimensional (2-D) image post-processing for CT image data. • Cinematic rendering is a novel post-processing technique for 3D visualization of CT image data. • Compared to volume rendering, CR results in a more photo-realistic representation of anatomy. • Similar to volume rendering, CR provides best image quality of high density structures.

Cinematic rendering – an alternative to volume rendering for 3D computed tomography imaging

Development and validation of a surgical training simulator with haptic feedback for learning bone-sawing skill

Reverse engineering in CAD model reconstruction of customized artificial joint

Navigation-guided correction of midfacial post-traumatic deformities (Shanghai experience with 40 cases).

Background

VR-based surgery simulation provides a cost-effective and efficient method to train novices. In this study, a virtual training system for maxillofacial surgery (VR-MFS), which aims mainly at the simulation of operations on mandible and maxilla, was developed and demonstrated.



Methods

The virtual models of the anatomic structures were reconstructed from CT data, and the virtual instruments were built from laser scanning data using reverse engineering technology. For collision detection, axis aligned bounding boxes (AABBs) were constructed for the anatomic models. Then, the simulation algorithms were developed, and the haptic force feedback was consequently calculated based on regression equations. Finally, the vivid 3D stereo effect was implemented with the use of an immersive workbench.



Results

A virtual training system for maxillofacial surgery was developed; in particular, the application for Le-Fort I osteotomy was implemented. The tactile, visual and aural effects were highly integrated, making the virtual surgical environment vivid and realistic.



Conclusions

The VR-MFS provides an effective approach in terms of helping novices to become familiar with maxillofacial surgery procedures. The same method can also be applied to other bone simulations. Copyright © 2013 John Wiley & Sons, Ltd.

A virtual training system for maxillofacial surgery using advanced haptic feedback and immersive workbench

Background

Nowadays, there is a trend towards computer-aided oral and maxillofacial surgery. However, due to complicated preoperative planning, traditional neurosurgery-orientated navigation systems are not suitable and have to be adapted.



Methods

A surgical navigation system is presented for oral and maxillofacial surgery, named AccuNavi, which integrates 3D medical modelling, preoperative surgical planning and intraoperative tracking. Various algorithms were introduced, for each of which a set of dynamic link libraries (DLLs) were developed using C++, as well as the VTK and ITK, via object-orientated programming methodology, allowing for expandability, accessibility and maintainability in our system.



Results

The advantage of AccuNavi is validated through clinical applications, especially in a case report about the planning and subsequent precise treatment of old zygomatic fractures. The postoperative 3D-reconstructed CT image demonstrated that the fractured zygoma was fixed in the appropriate position and orientation.



Conclusions

The clinical application demonstrates tyhe feasibility and reliability of AccuNavi, and it can be extended to various areas in oral and maxillofacial surgery. Copyright © 2010 John Wiley & Sons, Ltd.

Yanping Lin

Papers

Development and validation of a surgical training simulator with haptic feedback for learning bone-sawing skill

Reverse engineering in CAD model reconstruction of customized artificial joint

Navigation-guided correction of midfacial post-traumatic deformities (Shanghai experience with 40 cases).

A virtual training system for maxillofacial surgery using advanced haptic feedback and immersive workbench

A surgical navigation system for oral and maxillofacial surgery and its application in the treatment of old zygomatic fractures