Application effect of head-mounted mixed reality device combined with 3D printing model in neurosurgery ventricular and hematoma puncture training

Abstract

Background The purpose of this study was to explore the applicability of application effect of head-mounted mixed reality (MR) equipment combined with a three-dimensional (3D) printed model in neurosurgical ventricular and haematoma puncture training. Methods Digital Imaging and Communications in Medicine (DICOM) format image data of two patients with common neurosurgical diseases (hydrocephalus and basal ganglia haemorrhage) were imported into 3D Slicer software for 3D reconstruction, saved, and printed using 3D printing to produce a 1:1-sized head model with real person characteristics. The required model (brain ventricle, haematoma, puncture path, etc.) was constructed and imported into the head-mounted MR device, HoloLens, and a risk-free, visual, and repeatable system was designed for the training of junior physicians. A total of 16 junior physicians who studied under this specialty from September 2020 to March 2022 were selected as the research participants, and the applicability of the equipment and model during training was evaluated with assessment score sheets and questionnaires after training. Results According to results of the assessment and questionnaire, the doctors trained by this system are more familiar with the localization of the lateral anterior ventricle horn puncture and the common endoscopic surgery for basal ganglia haemorrhage, as well as more confident in the mastery of these two operations than the traditional training methods. Conclusions The use of head-mounted MR equipment combined with 3D printing models can provide an ideal platform for the operation training of young doctors. Through holographic images created from the combination of virtual and real images, operators can be better immersed in the operation process and deepen their understanding of the operation and related anatomical structures. The 3D printed model can be repeatedly reproduced so that doctors can master the technology, learn from mistakes, better achieve the purpose of teaching and training, and improve the effect of training.

The Integration of 3D Virtual Reality and 3D Printing Technology as Innovative Approaches to Preoperative Planning in Neuro-Oncology

“…Due to the advancing technology and its increasing availability, the use of 3D printing technology has emerged in various fields of neurosurgery [8][9][10][11]. As 3D technology goes further, the costs of printers and materials lower while printed materials become more realistic, making the application of 3D printing in the medical field more appealing [11].…”

“…Peng et al explored the combined use of a 3D-printed model and mixed-reality (MR) glasses to train in the ventricular puncture technique as well as to complete endoscopic trajectory training for basal ganglia intracerebral hematomas (ICHs). The authors compared results between two groups, one without MR and the other with MR, showing that the second group achieved better results in terms of positioning, depth of puncture, accuracy, and self-confidence, among other criteria [10].…”

“…Some of the limitations of 3D printing are the duration of the printing process, registration and segmentation inaccuracies, as well as drift possibility, making a 3D model less accurate [10]. Indeed, even though all our cases were segmented and implemented into the VR system to be analyzed and facilitate surgical planning, only a few of them were fully 3D printed.…”

“…Therefore, by printing 3D models, surgical interventions can be practiced [9]. With this, surgeons and trainees can gain manual skills, start their learning curve, face potential intraoperative gaps, and practice different approaches before carrying out a procedure on the patients themselves [10,11].…”