Mixed reality navigation system for ultrasound-guided percutaneous punctures: a pre-clinical evaluation

Davrieux, Carlos Federico; Giménez, Mariano Eduardo; González, Cristians; Ancel, Alexandre; Guinin, Maxime; Fahrer, Bénédicte; Serra, Edgardo; Kwak, Jungwon; Marescaux, Jacques; Hostettler, Alexandre

doi:10.1007/s00464-019-06755-5

Cited by 17 publications

(5 citation statements)

References 14 publications

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“…The difficulty in the application of 3D visualization models in puncture surgery lies in the accuracy of registration. [20][21][22] Due to the change in intraoperative body position and the influence of respiratory motility, the actual position of the kidney in the body will deviate from the registered 3D model, which brings challenges to the accuracy of puncture. Our considerations in surgical registration and position calibration were as follows: (i) Consideration of posture and breathing: given that prone position and intraoperative mechanical ventilation may lead to obvious renal displacement, we require patients to adopt prone position during CT examination and put the posture pad on the abdomen to simulate the scene of puncture during operation.…”

Section: Discussionmentioning

confidence: 99%

“…The difficulty in the application of 3D visualization models in puncture surgery lies in the accuracy of registration 20–22 . Due to the change in intraoperative body position and the influence of respiratory motility, the actual position of the kidney in the body will deviate from the registered 3D model, which brings challenges to the accuracy of puncture.…”

Section: Discussionmentioning

confidence: 99%

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Application of a three‐dimensional visualization model in intraoperative guidance of percutaneous nephrolithotomy

et al. 2022

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Objectives: To establish a three-dimensional visualization model of percutaneous nephrolithotomy, apply it to guiding intraoperative puncture in a mixed reality environment, and evaluate its accuracy and clinical value. Methods: Patients with percutaneous nephrolithotomy indications were prospectively divided into three-dimensional group and control group with a ratio of 1:2. For patients in three-dimensional group, positioning markers were pasted on the skin and enhanced computed tomography scanning was performed in the prone position. Holographic three-dimensional models were made and puncture routes were planned before operation. During the operation, the three-dimensional model was displayed through HoloLens glass and visually registered with the patient's body. Puncture of the target renal calyx was performed under three-dimensional-image guiding and ultrasonic monitoring. Patients in the control group underwent routine percutaneous nephrolithotomy in the prone position under the monitoring of B-ultrasound. Deviation distance of the kidney, puncture time, puncture attempts, channel coincidence rate, stone clearance rate, and postoperative complications were assessed.Results: Twenty-one and 40 patients were enrolled in three-dimensional and control group, respectively. For three-dimensional group, the average deviation between virtual and real kidney was 3.1 AE 2.9 mm. All punctures were performed according to preoperative planning. Compared with the control group, the three-dimensional group had shorter puncture time (8.9 AE 3.3 vs 14.5 AE 6.1 min, P < 0.001), fewer puncture attempts (1.4 AE 0.6 vs 2.2 AE 1.5, P = 0.009), and might also have a better performance in stone clearance rate (90.5% vs 72.5%, P = 0.19) and postoperative complications (P = 0.074). Conclusions: The percutaneous nephrolithotomy three-dimensional model manifested acceptable accuracy and good value for guiding puncture in a mixed reality environment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Application of a three‐dimensional visualization model in intraoperative guidance of percutaneous nephrolithotomy

et al. 2022

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“…However, both US imaging and insertion of needle-shaped instruments are known to be expert tasks and require training 3 not always available to physicians who only occasionally perform such procedures. Existing assistance solutions aim to augment the live US image with information on the needle location by means of optical 4 – 7 , (electro-) magnetic 8 – 10 , or image-based 11 tracking. Regardless of the clinical application, localization (tracking) of the needle in the coordinate frame of the US image is essential to such guidance solutions.…”

Section: Introductionmentioning

confidence: 99%

“…perform such procedures. Existing assistance solutions aim to augment the live US image with information on the needle location by means of optical [4][5][6][7] , (electro-) magnetic [8][9][10] , or image-based 11 tracking. Regardless of the clinical application, localization (tracking) of the needle in the coordinate frame of the US image is essential to such guidance solutions.…”

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confidence: 99%

Miniaturized electromagnetic tracking enables efficient ultrasound-navigated needle insertions

Seitel,

Groener,

Eisenmann

et al. 2024

Sci Rep

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Ultrasound (US) has gained popularity as a guidance modality for percutaneous needle insertions because it is widely available and non-ionizing. However, coordinating scanning and needle insertion still requires significant experience. Current assistance solutions utilize optical or electromagnetic tracking (EMT) technology directly integrated into the US device or probe. This results in specialized devices or introduces additional hardware, limiting the ergonomics of both the scanning and insertion process. We developed the first ultrasound (US) navigation solution designed to be used as a non-permanent accessory for existing US devices while maintaining the ergonomics during the scanning process. A miniaturized EMT source is reversibly attached to the US probe, temporarily creating a combined modality that provides real-time anatomical imaging and instrument tracking at the same time. Studies performed with 11 clinical operators show that the proposed navigation solution can guide needle insertions with a targeting accuracy of about 5 mm, which is comparable to existing approaches and unaffected by repeated attachment and detachment of the miniaturized tracking solution. The assistance proved particularly helpful for non-expert users and needle insertions performed outside of the US plane. The small size and reversible attachability of the proposed navigation solution promises streamlined integration into the clinical workflow and widespread access to US navigated punctures.

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“…Recently, various research institutes, including ourselves, have shown the superiority and feasibility of MR for the guidance of surgery, including in I 125 seed brachytherapy, laparoscopic procedures, ultrasound-guided percutaneous punctures, complicated hepatectomy and so on. [14][15][16][17] In this study, we developed a new surgical navigation system on the basis of MR technique, and pedicle screws were inserted crosswise to C1/C2 pedicles. And we prospectively analyzed the safety and accuracy of C1/C2 pedicle screw placement using MR-based intraoperative 3D imageguided navigation in C1/C2 fractured models.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of mixed reality–based intraoperative three-dimensional image-guided navigation for atlanto-axial pedicle screw placement

Liu

Song

et al. 2019

Proc Inst Mech Eng H

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This study aimed to evaluate the safety and accuracy of mixed reality–based intraoperative three-dimensional navigated pedicle screws in three-dimensional printed model of fractured upper cervical spine. A total of 27 cervical model from patients of upper cervical spine fractures formed the study group. All the C1 and C2 pedicle screws were inserted under mixed reality–based intraoperative three-dimensional image-guided navigation system. The accuracy and safety of the pedicle screw placement were evaluated on the basis of postoperative computerized tomography scans. A total of 108 pedicle screws were properly inserted into the cervical three-dimensional models under mixed reality–based navigation, including 54 C1 pedicle screws and 54 C2 pedicle screws. Analysis of the dimensional parameters of each pedicle at C1/C2 level showed no statistically significant differences in the ideal and the actual entry points, inclined angles, and tailed angles. No screw was misplaced outside the pedicle of the three-dimensional printed model, and no ionizing X-ray radiation was used during screw placement under navigation. It is easy and safe to place C1/C2 pedicle screws under MR surgical navigation. Mixed reality–based navigation is feasible within upper cervical spinal fractures with improved safety and accuracy of C1/C2 pedicle screw insertion.

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Mixed reality navigation system for ultrasound-guided percutaneous punctures: a pre-clinical evaluation

Cited by 17 publications

References 14 publications

Application of a three‐dimensional visualization model in intraoperative guidance of percutaneous nephrolithotomy

Application of a three‐dimensional visualization model in intraoperative guidance of percutaneous nephrolithotomy

Miniaturized electromagnetic tracking enables efficient ultrasound-navigated needle insertions

Feasibility of mixed reality–based intraoperative three-dimensional image-guided navigation for atlanto-axial pedicle screw placement

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