Besides challenges in registration accuracy, which is a known limitation up to the current software generation, the aspects of visualization quality in particular proved to be one limiting factor to broader clinical application. However, while intraoperative utilization of AR is increasingly discussed as beneficial, the exact impact of AR-guided interventions on surgical decision-making, intraoperative workflow, and patient outcome still remains unclear.
Adobe illustrator icon lesions skin#
Its clinical feasibility and overall usefulness in the areas of skin incision planning, craniotomy, subsurface lesion targeting, and risk management across the neurosurgical subspecialties have been claimed in recent studies. While many applications continue to be limited to research only, commercial software development focused on the integration of AR functionalities into the surgical microscope, thus making the navigated microscope the most popular and most easily available sub-modality of AR in neurosurgery today. Potential benefits include reduced surgical risk and the reduction of intraoperative cognitive load as well as the increased availability of detailed visual representations for the whole surgical team. Integrating the overlay at the correct position, scale and orientation mark the ideal of AR visualization. Thereby, AR integration of surgically relevant information can provide a situated visualization, i.e., a virtual manifestation of the surgeon’s mental projections - such as tumor borders, adjacent risk structures - applied to the surgical area. AR includes a real-world view (i.e., the surgical site) as the main visual reference plane, which is augmented by an overlay of digital virtual information typically provided by volumetric imaging (CT, MRI, functional information). Consequently, several types of AR technology have been subject to both preclinical and early clinical investigation, such as image projection techniques, additional head-up or head-mounted displays (HUD, HMD), tablet- or monitor-based systems, and image injection into the surgical microscope. The demand for the inclusion of surgically relevant information directly into the surgical field of view has been discussed ever since. Conventional neuronavigation introduced the separate navigation display as a “second screen” into the operating room (OR), necessitating the exchange of surgical instruments and a dedicated navigation pointer on the one hand, as well as alternate viewing directions between the surgical site and the extra display on the other hand. While the history of augmented reality (AR) visualization in neurosurgery already began in 1986, subsequent years of technological innovation have been dominated by more prominent clinical developments in frameless neuronavigation, which is now a widely established technique to guide the intervention. The increase of visual information provided during neurosurgical procedures poses the threat of unwanted interference and cognitive overload for the surgeon.
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