Introduction
A system this researcher published the first article which found an improvement in human performance when using the RA.
For a large number of reasons use of simulators is a prudent choice like Laparoscopic Needle Holder.
Many other actors were then involved in the development of AR. This development was not only very rapid but one of the main characteristics is the miniaturization of the devices necessary for its operation. In 2003, a first study demonstrated the feasibility of using a simple Personal assistant.
A simple smartphone may be sufficient today. One example of the recreational use of AR is the Pokémon go game. At the same time, many open source software have developed and have enabled continuous software improvement). AR is now present in our daily lives with applications available on our Smartphone or the display of information in real time during television programs.
Development In Medicine
In medicine, and in particular in surgery, the evolution is in fact relatively similar: the publication of one of the first uses of augmented reality in medicine dates from the 1990s. Several teams, particularly in Austria and the United States, have reported this. When using AR to facilitate echo-guided biopsy procedures.
The first publication in neurosurgery dates from 1996. It was about surgery for the treatment of epilepsy. As the author describes the system was "rudimentary" but the cost was low. Scanner or MRI data displayed using a Portable PC monitor or a semi-transparent "head-up" system. The registration carried out using visual cues, the tracking carried out with the help of magnetic cues. This first article reports the use of the system in 40 patients. Most of the following series reported in neurosurgery report the use of visual cues.
The registration phase is manual or uses the skin of the face as in the example. In this series, the author also reports the use of the "dextroscope" system, which allows recreating the whole of the cranium and its contents in virtual reality. This study evaluates with 10 surgeons the theoretical contribution of VR on the planning of the surgical procedure. The system used is the one developed by Brain lab. In this series, 5 patients were operated on with a combination of virtual reality, neuro-navigation and endoscopic techniques.
Augmented Reality In Neurosurgery
In their recent review, published in 2016, report that only 195 cases of patients operated on using augmented reality have reported in neurosurgery while the first publication dates from 1996. The majority of studies report the use of a microscope to display preoperative data. This microscope perfectly aligned with respect to the operating field, thus allowing easier registration. However, this alignment requires invasive fixation to the patient's skull or teeth. More recently, a registration based on the analysis of the surface has proposed. This registration is a little closer to the technique that we have developed.
In other specialties, several uses have appeared more recently, such as the display of the venous network of patients, devices already marketed. Other systems make it possible in particular to see in AR the irradiated field intraoperatively but also the locations of the biopsies carried out endoscopy. In psychiatry, AR used for immersion of the patient in order to treat certain types of phobia.
It also used in the treatment of phantom limb pain by integrating a phantom limb projection system linked to the patient's voluntary neurological control. Regarding liver surgery, the Institute reports the first use in 2012 of its AR system using one of its tablet applications.
Use of AR in Laparotomy
In 2009, the same team reported surgery with stereotaxic guidance but it was not strictly speaking RA. One of the pioneering teams is that of Soler who published in 2009 an evaluation of the use of AR. In 2015 they reported the use of AR for performing hepatic segmentectomies and in 2016 the use of AR in laparotomy for resection of hepatic metastases. They use the VR system for preoperative segmentation.
Through this system marketed and developed, any clinician can submit DICOM images of his patients and obtain a 3D reconstruction of these images. In laparotomy the exosome used by this team. Also reported the use of AR for adrenal resection as early as 2004 as well as the performance of robotic duodenopancreatectomy.
Conclusion
Despite their experience, the registration technique used by this team is still largely and essentially manual. It carried out in real time only because of the presence and continuous work of a scientist not operator in the medical sense of "surgeon". This is where our system takes a different approach and allows us to automate and simplify this essential phase of AR.
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