An Interactive Holographic Curriculum for Urogynecologic Surgery (original) (raw)
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Medical Research Archives, 2023
ABSTRACT: Image-guided surgery using XR (extended reality: VR/AR/MR) technology has the potential to revolutionize the field of surgery by improving surgical accuracy, reducing procedure time, and enhancing communication and collaboration among the surgical team. We have developed a web-based system, Holoeyes, integrating XR, AI, and metaverse technology to facilitate holographic image- guided surgery. Holoeyes extracts organ shape data from CT or MRI scans and renders them with positional information to obtain X, Y, and Z coordinates. These coordinates are then converted into polygonal information for use in XR technology. The medical device, Holoeyes MD, was developed to create XR applications for surgical planning and navigation. It provides an immersive experience for the surgical team, improving both accuracy and efficiency. The integration of the metaverse in surgery allows for spatial conferencing and review of training, and the avatars replicate the hand and eye movements of the actual surgical procedure. Our Holoeyes system has already been utilized in numerous institutions for pre-and post-operative conferences, surgical planning, and surgical records, with multiple people wearing the headset and sharing information about the pathology, extent of resection, and layers of dissection from all directions. We conducted a systematic review of the literature to investigate the effectiveness of Holoeyes, focusing on the use of XR and the metaverse in surgery. We believe that Holoeyes has the potential to become an indispensable tool in the field of surgery, and we encourage further research and development in this field.
The Virtual Pelvic Floor, a tele-immersive educational environment
Proceedings / AMIA ... Annual Symposium. AMIA Symposium, 1999
This paper describes the development of the Virtual Pelvic Floor, a new method of teaching the complex anatomy of the pelvic region utilizing virtual reality and advanced networking technology. Virtual reality technology allows improved visualization of three-dimensional structures over conventional media because it supports stereo vision, viewer-centered perspective, large angles of view, and interactivity. Two or more ImmersaDesk systems, drafting table format virtual reality displays, are networked together providing an environment where teacher and students share a high quality three-dimensional anatomical model, and are able to converse, see each other, and to point in three dimensions to indicate areas of interest. This project was realized by the teamwork of surgeons, medical artists and sculptors, computer scientists, and computer visualization experts. It demonstrates the future of virtual reality for surgical education and applications for the Next Generation Internet.
EAI Endorsed Trans. Pervasive Health Technol., 2021
INTRODUCTION: Mixed reality (MR) allows surgeons to pre-operatively assess patients’ anatomy (e.g., tissue to be removed). However, medical students have limited access to this technology, and express both the desire to try it and suspicious attitudes. OBJECTIVES: To assess students’ experience with traditional vs. innovative technology for pre-operative planning. METHODS: 11 medical students analyzed a lung cancer case using CT scans or a 3D hologram (MR) and assessed the technology in terms of mental workload, emotions and formative value. RESULTS: MR resulted in less cognitive load and effort, shorter response time and more positive emotions. No differences emerged in formative value, but the students expressed the desire to be trained both in traditional and innovative technology for pre-operative planning. CONCLUSION: Medical students respond positively to “hands-on” experiences of technology for pre-operative planning. The time may be ripe to include MR in medical formation.
Interactive Holograms and Tutorials in Healthcare Education: Case Studies from the e-REAL Experience
International Journal of Advanced Corporate Learning (iJAC), 2016
With both portable and permanent fixtures available, the e-REAL lab encompasses users in an entirely interactive and immersive ecosystem; advanced medical simulation reaches its best thanks to interactive 3D holographic visualization. Using a number of tools, e-REAL enables not only face-to-face training, but also e-learning and remote communication across the globe.
LUCY: a 3-D Pelvic Model for Surgical Simulation
The Journal of the …, 2004
LUCY Heinrichs et al 326 During the past decade, two converging developments in the 3-D modeling of human anatomic structures have been the preparation of the National Library of Medicine's Visible Humans and patient-specific 3-D models introduced into standard practice during presurgical planning. Computer models are an underutilized resource in surgical training for minimal-access procedures such as laparoscopy. Laparoscopic techniques provide clear advantages to patients. However, laparoscopic surgeons face additional challenges in training, such as a longer learning curve and increased requirements for sustained concentration and psychomotor skills, compared with open surgical techniques. Mastery of laparoscopic surgery is not easily compatible with traditional models of surgical training wherein the trainee observes and mimics the trainers' actions. In fact, laparoscopy requires special adaptation of eye-hand coordination of instruments in a 2-D visual environment. During the learning of these procedures, movement of a surgical instrument as seen on the video monitor often occurs in the opposite direction of the actual movement, the consequence of the "fulcrum effect" produced at the point of entry of the instruments into the body. Not surprisingly, surgical complications from laparoscopy occur frequently during the early training, and the perception of resident trainees is that at least eight procedures must be conducted before minimal competency is acquired. 6 Furthermore, teaching basic surgical skills for laparoscopy in the operating room is not cost effective. Thus, implementation of simulators that allow practice and assessment of complex psychomotor-based tasks is essential. An essential step in the development of such computer-based simulators is the utilization of anatomically accurate virtual models. 4 Toward that end, we report here on the completion of an anatomically realistic female pelvic model set, named "LUCY" after the 3-million-year-old hominid biped discovered in Ethiopia a quarter century ago. The model set contains 40 anatomic structures that can be explored visually or manipulated by haptically enabled, force-feedback user devices.
Towards X‐ray free endovascular interventions – using HoloLens for on‐line holographic visualisation
Healthcare Technology Letters, 2017
A major challenge during endovascular interventions is visualising the position and orientation of the catheter being inserted. This is typically achieved by intermittent X-ray imaging. Since the radiation exposure to the surgeon is considerable, it is desirable to reduce X-ray exposure to the bare minimum needed. Additionally, transferring two-dimensional (2D) X-ray images to 3D locations is challenging. The authors present the development of a real-time navigation framework, which allows a 3D holographic view of the vascular system without any need of radiation. They extract the patient's surface and vascular tree from pre-operative computed tomography data and register it to the patient using a magnetic tracking system. The system was evaluated on an anthropomorphic full-body phantom by experienced clinicians using a four-point questionnaire. The average score of the system (maximum of 20) was found to be 17.5. The authors' approach shows great potential to improve the workflow for endovascular procedures, by simultaneously reducing X-ray exposure. It will also improve the learning curve and help novices to more quickly master the required skills.
Evaluating the effectiveness of learning ear anatomy using holographic models
Journal of Otolaryngology - Head & Neck Surgery
Background Computer-assisted learning has been shown to be an effective means of teaching anatomy, with 3-D visualization technology more successfully improving participants’ factual and spatial knowledge in comparison to traditional methods. To date, however, the effectiveness of teaching ear anatomy using 3-D holographic technology has not been studied. The present study aimed to evaluate the feasibility and effectiveness of learning ear anatomy using a holographic (HG) anatomic model in comparison to didactic lecture (DL) and a computer module (CM). Methods A 3-D anatomic model of the middle and inner ear was created and displayed using presentation slides in a lecture, computer module, or via the Microsoft HoloLens. Twenty-nine medical students were randomized to one of the three interventions. All participants underwent assessment of baseline knowledge of ear anatomy. Immediately following each intervention, testing was repeated along with completion of a satisfaction survey. R...
Surgical Endoscopy, 2016
Background Substantial evidence in the scientific literature supports the use of simulation for surgical education. However, curricula lack for complex laparoscopic procedures in gynecology. The objective was to evaluate the validity of a program that reproduces key specific components of a laparoscopic hysterectomy (LH) procedure until colpotomy on a virtual reality (VR) simulator and to develop an evidence-based and stepwise training curriculum. Methods This prospective cohort study was conducted in a Marseille teaching hospital. Forty participants were enrolled and were divided into experienced (senior surgeons who had performed more than 100 LH; n = 8), intermediate (surgical trainees who had performed 2-10 LH; n = 8) and inexperienced (n = 24) groups. Baselines were assessed on a validated basic task. Participants were tested for the LH procedure on a high-fidelity VR simulator. Validity evidence was proposed as the ability to differentiate between the three levels of experience. Inexperienced subjects performed ten repetitions for learning curve analysis. Proficiency measures were based on experienced surgeons' performances. Outcome measures were simulator-derived metrics and Objective Structured Assessment of Technical Skills (OSATS) scores. Results Quantitative analysis found significant inter-group differences between experienced intermediate and inexperienced groups for time (1369, 2385 and 3370 s; p \ 0.001), number of movements (2033, 3195 and 4056; p = 0.001), path length (3390, 4526 and 5749 cm; p = 0.002), idle time (357, 654 and 747 s; p = 0.001), respect for tissue (24, 40 and 84; p = 0.01) and number of bladder injuries (0.13, 0 and 4.27; p \ 0.001). Learning curves plateaued at the 2nd to 6th repetition. Further qualitative analysis found significant inter-group OSATS score differences at first repetition (22, 15 and 8, respectively; p \ 0.001) and second repetition (25.5, 19.5 and 14; p \ 0.001). Conclusions The VR program for LH accrued validity evidence and allowed the development of a training curriculum using a structured scientific methodology.
Toward Holographic-Guided Surgery
Surgical Innovation, 2018
The implementation of augmented reality (AR) in image-guided surgery (IGS) can improve surgical interventions by presenting the image data directly on the patient at the correct position and in the actual orientation. This approach can resolve the switching focus problem, which occurs in conventional IGS systems when the surgeon has to look away from the operation field to consult the image data on a 2-dimensional screen. The Microsoft HoloLens, a head-mounted AR display, was combined with an optical navigation system to create an AR-based IGS system. Experiments were performed on a phantom model to determine the accuracy of the complete system and to evaluate the effect of adding AR. The results demonstrated a mean Euclidean distance of 2.3 mm with a maximum error of 3.5 mm for the complete system. Adding AR visualization to a conventional system increased the mean error by 1.6 mm. The introduction of AR in IGS was promising. The presented system provided a solution for the switchi...