HAPPY: Hip Arthroscopy Portal Placement Using Augmented Reality

Correct positioning of the endoscope is crucial for successful hip arthroscopy. Only with adequate alignment can the anatomical target area be visualized and the procedure be successfully performed. Conventionally, surgeons rely on anatomical landmarks such as bone structure, and on intraoperative X...

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Main Authors: Tianyu Song, Michael Sommersperger, The Anh Baran, Matthias Seibold, Nassir Navab
Format: Article
Language:English
Published: MDPI AG 2022-11-01
Series:Journal of Imaging
Subjects:
Online Access:https://www.mdpi.com/2313-433X/8/11/302
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author Tianyu Song
Michael Sommersperger
The Anh Baran
Matthias Seibold
Nassir Navab
author_facet Tianyu Song
Michael Sommersperger
The Anh Baran
Matthias Seibold
Nassir Navab
author_sort Tianyu Song
collection DOAJ
description Correct positioning of the endoscope is crucial for successful hip arthroscopy. Only with adequate alignment can the anatomical target area be visualized and the procedure be successfully performed. Conventionally, surgeons rely on anatomical landmarks such as bone structure, and on intraoperative X-ray imaging, to correctly place the surgical trocar and insert the endoscope to gain access to the surgical site. One factor complicating the placement is deformable soft tissue, as it can obscure important anatomical landmarks. In addition, the commonly used endoscopes with an angled camera complicate hand–eye coordination and, thus, navigation to the target area. Adjusting for an incorrectly positioned endoscope prolongs surgery time, requires a further incision and increases the radiation exposure as well as the risk of infection. In this work, we propose an augmented reality system to support endoscope placement during arthroscopy. Our method comprises the augmentation of a tracked endoscope with a virtual augmented frustum to indicate the reachable working volume. This is further combined with an in situ visualization of the patient anatomy to improve perception of the target area. For this purpose, we highlight the anatomy that is visible in the endoscopic camera frustum and use an automatic colorization method to improve spatial perception. Our system was implemented and visualized on a head-mounted display. The results of our user study indicate the benefit of the proposed system compared to baseline positioning without additional support, such as an increased alignment speed, improved positioning error and reduced mental effort. The proposed approach might aid in the positioning of an angled endoscope, and may result in better access to the surgical area, reduced surgery time, less patient trauma, and less X-ray exposure during surgery.
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spelling doaj.art-cf708ca6761e4c09939302719f2b7e9e2023-11-24T05:20:55ZengMDPI AGJournal of Imaging2313-433X2022-11-0181130210.3390/jimaging8110302HAPPY: Hip Arthroscopy Portal Placement Using Augmented RealityTianyu Song0Michael Sommersperger1The Anh Baran2Matthias Seibold3Nassir Navab4Chair for Computer Aided Medical Procedures & Augmented Reality, Technical University Munich, 85748 Munich, GermanyChair for Computer Aided Medical Procedures & Augmented Reality, Technical University Munich, 85748 Munich, GermanyLaboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, MD 21205, USAResearch in Orthopedic Computer Science, Balgrist University Hospital, University of Zurich, 8008 Zurich, SwitzerlandChair for Computer Aided Medical Procedures & Augmented Reality, Technical University Munich, 85748 Munich, GermanyCorrect positioning of the endoscope is crucial for successful hip arthroscopy. Only with adequate alignment can the anatomical target area be visualized and the procedure be successfully performed. Conventionally, surgeons rely on anatomical landmarks such as bone structure, and on intraoperative X-ray imaging, to correctly place the surgical trocar and insert the endoscope to gain access to the surgical site. One factor complicating the placement is deformable soft tissue, as it can obscure important anatomical landmarks. In addition, the commonly used endoscopes with an angled camera complicate hand–eye coordination and, thus, navigation to the target area. Adjusting for an incorrectly positioned endoscope prolongs surgery time, requires a further incision and increases the radiation exposure as well as the risk of infection. In this work, we propose an augmented reality system to support endoscope placement during arthroscopy. Our method comprises the augmentation of a tracked endoscope with a virtual augmented frustum to indicate the reachable working volume. This is further combined with an in situ visualization of the patient anatomy to improve perception of the target area. For this purpose, we highlight the anatomy that is visible in the endoscopic camera frustum and use an automatic colorization method to improve spatial perception. Our system was implemented and visualized on a head-mounted display. The results of our user study indicate the benefit of the proposed system compared to baseline positioning without additional support, such as an increased alignment speed, improved positioning error and reduced mental effort. The proposed approach might aid in the positioning of an angled endoscope, and may result in better access to the surgical area, reduced surgery time, less patient trauma, and less X-ray exposure during surgery.https://www.mdpi.com/2313-433X/8/11/302augmented realityhip arthroscopyendoscope placement
spellingShingle Tianyu Song
Michael Sommersperger
The Anh Baran
Matthias Seibold
Nassir Navab
HAPPY: Hip Arthroscopy Portal Placement Using Augmented Reality
Journal of Imaging
augmented reality
hip arthroscopy
endoscope placement
title HAPPY: Hip Arthroscopy Portal Placement Using Augmented Reality
title_full HAPPY: Hip Arthroscopy Portal Placement Using Augmented Reality
title_fullStr HAPPY: Hip Arthroscopy Portal Placement Using Augmented Reality
title_full_unstemmed HAPPY: Hip Arthroscopy Portal Placement Using Augmented Reality
title_short HAPPY: Hip Arthroscopy Portal Placement Using Augmented Reality
title_sort happy hip arthroscopy portal placement using augmented reality
topic augmented reality
hip arthroscopy
endoscope placement
url https://www.mdpi.com/2313-433X/8/11/302
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AT nassirnavab happyhiparthroscopyportalplacementusingaugmentedreality