A Wearable Augmented Reality Navigation System for Surgical Telementoring Based on Microsoft HoloLens

This paper reports a new type of augmented reality (AR) system that integrates a Microsoft HoloLens device with a three-dimensional (3D) point tracking module for medical training and telementored surgery. In this system, a stereo camera is used to track the 3D position of a scalpel and transfer its coordinates wirelessly to a HoloLens device. In the scenario of surgical training, a virtual surgical scene with pre-recorded surgical annotations is superimposed with the actual surgical scene so that the surgical trainee is able to operate following virtual instructions. In the scenario of telementored surgery, the virtual surgical scene is co-registered with the actual surgical scene so that the virtual scalpel remotely mentored by an experienced surgeon provides the AR guidance for the inexperienced on-site operator. The performance characteristics of the proposed AR telementoring system are verified by benchtop experiments. The clinical applicability of the proposed system in telementored skin grafting surgery and fasciotomy is validated in a New Zealand rabbit model. Our benchtop and in vivo experiments demonstrate the potential to improve surgical performance and reduce healthcare disparities in remote areas with limited resources.

[1]  Michael Marmot,et al.  Health inequalities and the psychosocial environment-two scientific challenges. , 2004, Social science & medicine.

[2]  Voicu Popescu,et al.  Medical telementoring using an augmented reality transparent display. , 2016, Surgery.

[3]  Johan Gustav Bellika,et al.  An Evaluation Framework for Defining the Contributions of Telestration in Surgical Telementoring , 2013, Interactive journal of medical research.

[4]  Qiang Ling,et al.  Designing a Wearable Navigation System for Image-Guided Cancer Resection Surgery , 2014, Annals of Biomedical Engineering.

[5]  B. Guthrie,et al.  Virtual Interactive Presence and Augmented Reality (VIPAR) for Remote Surgical Assistance , 2011, Neurosurgery.

[6]  Ronan A Lyons,et al.  Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016 , 2018, The Lancet.

[7]  Charles R Doarn,et al.  Telemedicine in Tomorrow's Operating Room: A Natural Fit , 2003, Seminars in laparoscopic surgery.

[8]  Mehran Anvari,et al.  Telementoring: An Important Enabling Tool for the Community Surgeon , 2005, Surgical innovation.

[9]  W. Tobler,et al.  Image-guided neurosurgery. , 1998, Surgical technology international.

[10]  K. Augestad,et al.  Overcoming Distance: Video-Conferencing as a Clinical and Educational Tool Among Surgeons , 2009, World Journal of Surgery.

[11]  K. Weimer,et al.  Mixed Reality with HoloLens: Where Virtual Reality Meets Augmented Reality in the Operating Room , 2017, Plastic and reconstructive surgery.

[12]  Jian Yue,et al.  A Wearable Goggle Navigation System for Dual-Mode Optical and Ultrasound Localization of Suspicious Lesions: Validation Studies Using Tissue-Simulating Phantoms and an Ex Vivo Human Breast Tissue Model , 2016, PloS one.

[13]  AndreasWiborg,et al.  Teleneurology to Improve Stroke Care in Rural Areas , 2003 .

[14]  M. Debakey,et al.  Telemedicine Has Now Come of Age , 1995 .

[15]  Seewon Ryu.  History of Telemedicine: Evolution, Context, and Transformation , 2010, Healthcare Informatics Research.

[16]  Rolv-Ole Lindsetmo,et al.  Telementoring in education of laparoscopic surgeons: An emerging technology , 2022 .

[17]  A. di Cerbo,et al.  Narrative review of telemedicine consultation in medical practice , 2015, Patient preference and adherence.

[18]  D Mutter,et al.  An evaluation of telemedicine in surgery: telediagnosis compared with direct diagnosis. , 2000, Archives of surgery.

[19]  A Allen,et al.  Technical and clinical progress in telemedicine. , 1999, JAMA.

[20]  Kathleen M Schmeler,et al.  Telementoring in gynecologic oncology training: changing lives in Mozambique , 2019, International Journal of Gynecological Cancer.

[21]  Jacques Marescaux,et al.  Telementoring for Minimally Invasive Surgical Training by Wireless Robot , 2007, Surgical innovation.

[22]  Johan Gustav Bellika,et al.  Surgical Telementoring in Knowledge Translation—Clinical Outcomes and Educational Benefits , 2013, Surgical innovation.

[23]  Jennifer Rickard,et al.  Global Health in the 21st Century: Equity in Surgical Training Partnerships. , 2019, Journal of Surgical Education.

[24]  B. Widder,et al.  Teleneurology to Improve Stroke Care in Rural Areas: The Telemedicine in Stroke in Swabia (TESS) Project , 2003, Stroke.