Augmented reality-assisted systematic mapping of anterolateral thigh perforators
Abstract Purpose In soft tissue reconstructive surgery, perforator localization and flap harvesting have always been critical challenges, but augmented reality (AR) has become a dominant technology to help map perforators. Methods The lateral circumflex femoral artery (LCFA) and its perforators were...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-022-06013-1 |
| _version_ | 1811190283027611648 |
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| author | Yifu Tang Qiang Guo Xiaoning Li Yuzhao Huang Wei Kuang Ling Luo |
| author_facet | Yifu Tang Qiang Guo Xiaoning Li Yuzhao Huang Wei Kuang Ling Luo |
| author_sort | Yifu Tang |
| collection | DOAJ |
| description | Abstract Purpose In soft tissue reconstructive surgery, perforator localization and flap harvesting have always been critical challenges, but augmented reality (AR) has become a dominant technology to help map perforators. Methods The lateral circumflex femoral artery (LCFA) and its perforators were reconstructed by CTA in consecutive patients (N = 14). Then, the anterolateral thigh perforators and the points from which the perforators emerged from the deep fascia were marked and projected onto the skin surface. As the virtual images were projected onto patients according to bony markers, the courses of the LCFA and its perforators were depicted on the skin surface for intraoperative guidance. Finally, the locations of the emergence points were verified by intraoperative findings and compared to those determined by handheld Doppler ultrasound. Results The sources, locations, and numbers of perforators were determined by CTA. The perforators and their emergence points were accurately mapped on the skin surface by a portable projector to harvest the anterolateral thigh perforator flap. During the operation, the accuracy of the CTA & AR method was 90.2% (37/41), and the sensitivity reached 97.4% (37/38), which were much higher than the corresponding values of Doppler ultrasound. Additionally, the differences between the AR-marked points and the intraoperative findings were much smaller than those seen with Doppler ultrasound (P < 0.001). Consequently, all of the flaps were well designed and survived, and only one complication occurred. Conclusion Augmented reality, namely, CTA combined with projection in this study, plays a vital and reliable role in locating the perforator emergence points and guiding the procedure to harvest flaps and has fewer potential risks. |
| first_indexed | 2024-04-11T14:48:45Z |
| format | Article |
| id | doaj.art-e89ce619cc0f409488432d27dd8e731f |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-11T14:48:45Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-e89ce619cc0f409488432d27dd8e731f2022-12-22T04:17:34ZengBMCBMC Musculoskeletal Disorders1471-24742022-12-0123111310.1186/s12891-022-06013-1Augmented reality-assisted systematic mapping of anterolateral thigh perforatorsYifu Tang0Qiang Guo1Xiaoning Li2Yuzhao Huang3Wei Kuang4Ling Luo5Department of Orthopaedics, The Third Xiangya Hospital, Central South UniversityDepartment of Orthopaedics, The Third Xiangya Hospital, Central South UniversityDepartment of Orthopaedics, The Third Xiangya Hospital, Central South UniversityDepartment of Orthopaedics, The Third Xiangya Hospital, Central South UniversityDepartment of Orthopaedics, The Third Xiangya Hospital, Central South UniversityDepartment of Orthopaedics, The Third Xiangya Hospital, Central South UniversityAbstract Purpose In soft tissue reconstructive surgery, perforator localization and flap harvesting have always been critical challenges, but augmented reality (AR) has become a dominant technology to help map perforators. Methods The lateral circumflex femoral artery (LCFA) and its perforators were reconstructed by CTA in consecutive patients (N = 14). Then, the anterolateral thigh perforators and the points from which the perforators emerged from the deep fascia were marked and projected onto the skin surface. As the virtual images were projected onto patients according to bony markers, the courses of the LCFA and its perforators were depicted on the skin surface for intraoperative guidance. Finally, the locations of the emergence points were verified by intraoperative findings and compared to those determined by handheld Doppler ultrasound. Results The sources, locations, and numbers of perforators were determined by CTA. The perforators and their emergence points were accurately mapped on the skin surface by a portable projector to harvest the anterolateral thigh perforator flap. During the operation, the accuracy of the CTA & AR method was 90.2% (37/41), and the sensitivity reached 97.4% (37/38), which were much higher than the corresponding values of Doppler ultrasound. Additionally, the differences between the AR-marked points and the intraoperative findings were much smaller than those seen with Doppler ultrasound (P < 0.001). Consequently, all of the flaps were well designed and survived, and only one complication occurred. Conclusion Augmented reality, namely, CTA combined with projection in this study, plays a vital and reliable role in locating the perforator emergence points and guiding the procedure to harvest flaps and has fewer potential risks.https://doi.org/10.1186/s12891-022-06013-1Augmented realityVascularized flapsSoft tissue reconstructionMicrosurgeryComputed tomography angiography |
| spellingShingle | Yifu Tang Qiang Guo Xiaoning Li Yuzhao Huang Wei Kuang Ling Luo Augmented reality-assisted systematic mapping of anterolateral thigh perforators BMC Musculoskeletal Disorders Augmented reality Vascularized flaps Soft tissue reconstruction Microsurgery Computed tomography angiography |
| title | Augmented reality-assisted systematic mapping of anterolateral thigh perforators |
| title_full | Augmented reality-assisted systematic mapping of anterolateral thigh perforators |
| title_fullStr | Augmented reality-assisted systematic mapping of anterolateral thigh perforators |
| title_full_unstemmed | Augmented reality-assisted systematic mapping of anterolateral thigh perforators |
| title_short | Augmented reality-assisted systematic mapping of anterolateral thigh perforators |
| title_sort | augmented reality assisted systematic mapping of anterolateral thigh perforators |
| topic | Augmented reality Vascularized flaps Soft tissue reconstruction Microsurgery Computed tomography angiography |
| url | https://doi.org/10.1186/s12891-022-06013-1 |
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