Precision of Low-Cost Augmented Reality in Prefabricated Cutting Guide for Fibular Free Flap Surgery

Abstract

Background: Augmented reality (AR) is an imaging technology encompassing an interactive experience of a real-world environment enhanced by computer-generated perceptual information. It has been introduced to current medical practice to help the preoperative planning in many surgical fields. Methods: The authors applied AR to the computed tomography angiography of 8 patient's legs. Computed tomography angiography images were processed into Digital Imaging and communications in Medicine files to make a prefabricated cutting guide and customized titanium plate. Also, three-dimensional reconstruction of the arterial supply of the leg was performed to identify the perforators. Results: Followed by preoperative marking of operative details on patient's skins in antero-posterior view, lateral view, and combination of both views. Inaccuracy of measurement was confirmed by duplex ultrasound which average error of the combination of antero-posterior and lateral viewed of both legs was lowest (0.7 AE 0.2 cm). Followed by lateral view (1.0 AE 0.3 cm) and antero-posterior view (1.2 AE 0.4 cm), respectively. Conclusions: Augmented reality can improve patient's safety by directly locate the perforator and easily to design the skin paddle. Followed by satisfaction and confidence in patients and their relatives. Augmented reality also promoted understanding of operative steps for related assistants, residents, or fellows. Augmented reality can perform with existing equipment, mobile phone application, and can save the cost for preoperative planning. Distortion in the depth view can be more accurate by combining of AR in antero-posterior and lateral view.

Augmented Reality Integration in Skull Base Neurosurgery: A Systematic Review

“…Presently, low-cost AR devices show significant promise for surgery [39][40][41][42]; however, there is a lack of reports on their technical feasibility [43][44][45]. Kubben and Sinlae [43] conducted a pilot study to assess the feasibility of using the Microsoft HoloLens, a lowcost head-mounted holographic AR device, in SB neurosurgery.…”

Augmented and Virtual Reality Applications in Facial Plastic Surgery: A Scoping Review

“…31 Six articles described AR for free flap harvest, including fibula and ALT flaps. 19,[32][33][34][35][36] These groups utilized either a smartphone, tablet, overhead projector, or HMD to display digital images of relevant anatomy, skin perforators, and VSPs onto the surgical site. In several studies, landmarks were verified with Doppler and surgical dissection.…”