Safety and Feasibility of Augmented Reality Assistance in Minimally Invasive and Open Resection of Benign Intradural Extramedullary Tumors
Objective Surgical resection of benign intradural extramedullary tumors (BIETs) is effective for appropriately selected patients. Minimally invasive surgical (MIS) techniques have been described for successful resection of BIET while minimizing soft tissue injury. Augmented reality (AR) is a promisi...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Spinal Neurosurgery Society
2022-09-01
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| Series: | Neurospine |
| Subjects: | |
| Online Access: | http://e-neurospine.org/upload/pdf/ns-2244222-111.pdf |
| _version_ | 1797334176385466368 |
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| author | Fabian Sommer Ibrahim Hussain Sertac Kirnaz Jacob Goldberg Lynn McGrath Rodrigo Navarro-Ramirez Francois Waterkeyn Franziska Schmidt Pravesh Shankar Gadjradj Roger Härtl |
| author_facet | Fabian Sommer Ibrahim Hussain Sertac Kirnaz Jacob Goldberg Lynn McGrath Rodrigo Navarro-Ramirez Francois Waterkeyn Franziska Schmidt Pravesh Shankar Gadjradj Roger Härtl |
| author_sort | Fabian Sommer |
| collection | DOAJ |
| description | Objective Surgical resection of benign intradural extramedullary tumors (BIETs) is effective for appropriately selected patients. Minimally invasive surgical (MIS) techniques have been described for successful resection of BIET while minimizing soft tissue injury. Augmented reality (AR) is a promising new technology that can accurately allow for intraoperative localization from skin through the intradural compartment. We present a case series evaluating the timing, steps, and accuracy at which this technology is able to enhance BIET resection. Methods A protocol for MIS and open AR-guided BIET resection was developed and applied to determine the feasibility. The tumor is marked on diagnostic magnetic resonance imaging (MRI) using AR software. Intraoperatively, the planning MRI is fused with the intraoperative computed tomography. The position and size of the tumor is projected into the surgical microscope and directly into the surgeon's field of view. Intraoperative orientation is performed exclusively via navigation and AR projection. Demographic and perioperative factors were collected. Results Eight patients were enrolled. The average operative time for MIS cases was 128 ±8 minutes and for open cases 206 ±55 minutes. The estimated intraoperative blood loss was 97 ±77 mL in MIS and 240 ±206 mL in open procedures. AR tumor location and margins were considered sufficiently precise by the surgeon in every case. Neither correction of the approach trajectory nor ultrasound assistance to localize the tumor were necessary in any case. No intraoperative complications were observed. Conclusion Current findings suggest that AR may be a feasible technique for tumor localization in the MIS and open resection of benign spinal extramedullary tumors. |
| first_indexed | 2024-03-08T08:16:56Z |
| format | Article |
| id | doaj.art-f9466a51efd142a98c74d1343a9aa2a7 |
| institution | Directory Open Access Journal |
| issn | 2586-6583 2586-6591 |
| language | English |
| last_indexed | 2024-03-08T08:16:56Z |
| publishDate | 2022-09-01 |
| publisher | Korean Spinal Neurosurgery Society |
| record_format | Article |
| series | Neurospine |
| spelling | doaj.art-f9466a51efd142a98c74d1343a9aa2a72024-02-02T07:26:30ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912022-09-0119350151210.14245/ns.2244222.1111294Safety and Feasibility of Augmented Reality Assistance in Minimally Invasive and Open Resection of Benign Intradural Extramedullary TumorsFabian Sommer0Ibrahim Hussain1Sertac Kirnaz2Jacob Goldberg3Lynn McGrath4Rodrigo Navarro-Ramirez5Francois Waterkeyn6Franziska Schmidt7Pravesh Shankar Gadjradj8Roger Härtl9 Department of Neurosurgery, Weill Cornell Medicine, New York Presbyterian Hospital/Och Spine, New York, NY, USA Department of Neurosurgery, Weill Cornell Medicine, New York Presbyterian Hospital/Och Spine, New York, NY, USA Department of Neurosurgery, Weill Cornell Medicine, New York Presbyterian Hospital/Och Spine, New York, NY, USA Department of Neurosurgery, Weill Cornell Medicine, New York Presbyterian Hospital/Och Spine, New York, NY, USA Department of Neurosurgery, Weill Cornell Medicine, New York Presbyterian Hospital/Och Spine, New York, NY, USA Department of Neurosurgery, Weill Cornell Medicine, New York Presbyterian Hospital/Och Spine, New York, NY, USA Department of Neurosurgery, Weill Cornell Medicine, New York Presbyterian Hospital/Och Spine, New York, NY, USA Department of Neurosurgery, Weill Cornell Medicine, New York Presbyterian Hospital/Och Spine, New York, NY, USA Department of Neurosurgery, Weill Cornell Medicine, New York Presbyterian Hospital/Och Spine, New York, NY, USA Department of Neurosurgery, Weill Cornell Medicine, New York Presbyterian Hospital/Och Spine, New York, NY, USAObjective Surgical resection of benign intradural extramedullary tumors (BIETs) is effective for appropriately selected patients. Minimally invasive surgical (MIS) techniques have been described for successful resection of BIET while minimizing soft tissue injury. Augmented reality (AR) is a promising new technology that can accurately allow for intraoperative localization from skin through the intradural compartment. We present a case series evaluating the timing, steps, and accuracy at which this technology is able to enhance BIET resection. Methods A protocol for MIS and open AR-guided BIET resection was developed and applied to determine the feasibility. The tumor is marked on diagnostic magnetic resonance imaging (MRI) using AR software. Intraoperatively, the planning MRI is fused with the intraoperative computed tomography. The position and size of the tumor is projected into the surgical microscope and directly into the surgeon's field of view. Intraoperative orientation is performed exclusively via navigation and AR projection. Demographic and perioperative factors were collected. Results Eight patients were enrolled. The average operative time for MIS cases was 128 ±8 minutes and for open cases 206 ±55 minutes. The estimated intraoperative blood loss was 97 ±77 mL in MIS and 240 ±206 mL in open procedures. AR tumor location and margins were considered sufficiently precise by the surgeon in every case. Neither correction of the approach trajectory nor ultrasound assistance to localize the tumor were necessary in any case. No intraoperative complications were observed. Conclusion Current findings suggest that AR may be a feasible technique for tumor localization in the MIS and open resection of benign spinal extramedullary tumors.http://e-neurospine.org/upload/pdf/ns-2244222-111.pdfminimally invasive surgerybenign extramedullary intradural tumoraugmented realitybenign intradural extramedullary tumor |
| spellingShingle | Fabian Sommer Ibrahim Hussain Sertac Kirnaz Jacob Goldberg Lynn McGrath Rodrigo Navarro-Ramirez Francois Waterkeyn Franziska Schmidt Pravesh Shankar Gadjradj Roger Härtl Safety and Feasibility of Augmented Reality Assistance in Minimally Invasive and Open Resection of Benign Intradural Extramedullary Tumors Neurospine minimally invasive surgery benign extramedullary intradural tumor augmented reality benign intradural extramedullary tumor |
| title | Safety and Feasibility of Augmented Reality Assistance in Minimally Invasive and Open Resection of Benign Intradural Extramedullary Tumors |
| title_full | Safety and Feasibility of Augmented Reality Assistance in Minimally Invasive and Open Resection of Benign Intradural Extramedullary Tumors |
| title_fullStr | Safety and Feasibility of Augmented Reality Assistance in Minimally Invasive and Open Resection of Benign Intradural Extramedullary Tumors |
| title_full_unstemmed | Safety and Feasibility of Augmented Reality Assistance in Minimally Invasive and Open Resection of Benign Intradural Extramedullary Tumors |
| title_short | Safety and Feasibility of Augmented Reality Assistance in Minimally Invasive and Open Resection of Benign Intradural Extramedullary Tumors |
| title_sort | safety and feasibility of augmented reality assistance in minimally invasive and open resection of benign intradural extramedullary tumors |
| topic | minimally invasive surgery benign extramedullary intradural tumor augmented reality benign intradural extramedullary tumor |
| url | http://e-neurospine.org/upload/pdf/ns-2244222-111.pdf |
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