Mixed Reality in der Gefäßchirurgie – ein Scoping Review

Zusammenfassung

Hintergrund „Mixed Reality“ (MR) erlaubt die Projektion von virtuellen Objekten in das Sichtfeld des Anwenders durch ein Head-mounted Display (HMD). Im gefäßchirurgischen Behandlungsspektrum könnten MR-Anwendungen in Zukunft einen Nutzen darstellen. Im folgenden Scoping Review soll eine Orientierung über die aktuelle Anwendung der genannten Technologien im Bereich der Gefäßchirurgie gegeben und Forschungsziele für die Zukunft definiert werden. Material und Methoden Es erfolgte eine systematische Literaturrecherche in PubMed (MEDLINE) mit den Suchbegriffen „aorta“, „intervention“, „endovsacular intervention“, „vascular surgery“, „aneurysm“, „endovascular“, „vascular access“ jeweils in Kombination mit „mixed reality“ oder „augmented reality“. Die Suche erfolgte nach PRISMA-Leitlinie (Preferred Reporting Items for Systematic reviews and Meta-Analyses) für Scoping Reviews. Ergebnisse Aus 547 Literaturstellen konnten 8 relevante Studien identifiziert werden. Die Suchergebnisse konnten in 2 Anwendungskategorien eingeteilt werden: (1) MR mit dem Ziel des Informationsmanagements und zur Verbesserung der periprozeduralen Ergonomie gefäßchirurgischer Eingriffe (n = 3) sowie (2) MR mit dem Ziel der intraoperativen Navigation bei gefäßchirurgischen Eingriffen (n = 5). Die Registrierung des physischen Patienten mit dem virtuellen Objekt und das Tracking von Instrumenten in der MR-Umgebung zur intraoperativen Navigation ist dabei im Fokus des wissenschaftlichen Interesses und konnte technisch erfolgreich am Phantom- und Tiermodell gezeigt werden. Die bisher vorgestellten Methoden sind jedoch mit hohem infrastrukturellem Aufwand und relevanten Limitationen verbunden. Schlussfolgerung Der Einsatz von MR im Bereich der Gefäßchirurgie ist grundsätzlich vielversprechend. Für die Zukunft sollten alternative, pragmatische Registrierungsmethoden mit entsprechender Quantifizierung des Positionierungsfehlers angestrebt werden. Die entwickelten Soft- und Hardwarelösungen sollten auf das Anforderungsprofil der Gefäßchirurgie angepasst werden. Das elektromagnetische Instrumenten-Tracking erscheint als sinnvolle, komplementäre Technologie zur Umsetzung der MR-assistierten Navigation.

Abstract

Background “Mixed reality” (MR) allows the projection of virtual objects into the user’s field of view through a head-mounted display (HMD). In the interventional and surgical treatment of vascular diseases MR applications could be of future benefit. The following scoping review aims to provide orientation on the current application of the aforementioned technologies in the field of vascular surgery and to define research goals for the future. Methods A systematic literature search was performed in PubMed (MEDLINE) using the search terms “aorta”, “intervention”, “endovascular intervention”, “vascular surgery”, “aneurysm”, “endovascular”, “vascular access”, each in combination with “mixed reality” or “augmented reality”. The search was performed according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines for scoping reviews. Results From 547 references 8 relevant studies were identified. The search results could be classified into two categories: (1) MR aimed at information management and improving periprocedural ergonomics (n = 3) and (2) MR aimed at intraoperative navigation (n = 5). The registration of the physical patient with the virtual object and the tracking of instruments in the MR environment for intraoperative navigation is currently the focus of scientific interest and could be demonstrated on phantom and animal models with technical success. However, the methods presented so far are associated with high infrastructural costs and important limitations. Conclusion The use of MR in the field of vascular surgery is promising. For the future, alternative, pragmatic registration methods with appropriate quantification of the positional error should be aimed at. The developed software and hardware solutions should be adapted to the requirements of vascular surgery. Electromagnetic instrument tracking appears to be a useful complementary technology for the implementation of MR-assisted navigation.

Schlüsselwörter

Mixed Reality - Virtual Reality - Augmented Reality - Gefäßchirurgie - Chirurgie - endovaskulär

Keywords

Mixed Reality - Virtual Reality - Augmented Reality - vascular surgery - surgery - navigation

Publication History

Received: 29 June 2022

Accepted after revision: 06 September 2022

Article published online:
11 October 2022

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