By Jacques Kpodonu, MD
Introduction.
Minimally invasive surgery represents one of the main evolutions of surgical techniques aimed at providing a greater benefit to the patient. However, minimally invasive surgery increases the operative difficulty since the depth perception is usually dramatically reduced, the field of view is limited and the sense of touch is transmitted by an instrument. However, these drawbacks can currently be reduced by computer technology guiding the surgical gesture. Indeed, from a patient’s medical image (US, CT or MRI), Augmented Reality (AR) can increase the surgeon’s intra-operative vision by providing a virtual transparency of the patient. AR is based on two main processes: the 3D visualization of the anatomical or pathological structures appearing in the medical image, and the registration of this visualization on the real patient. 3D visualization can be performed directly from the medical image without the need for a pre-processing step thanks to volume rendering, surface rendering and 3D modeling. Registration can be performed interactively or automatically.
Virtual reality techniques allow a pre-operative 3D visualization of the patient that can be manipulated in real time through the use of a patient-specific surgical simulation .In addition, augmented reality techniques superimpose this 3D image on the real image .Thanks to augmented reality it is thus possible to compensate the lack of the sense of touch with visualization of these forces by providing an artificial 3D view included transparency.The combination of visualization software, augmented reality and robotic technology should overcome the current limitations of minimal access surgery and perform extremely safe procedures with no scars. The goal is to develop Virtual Patient Modeling software that uses patient-specific data to enable pre-operative assessment and the diagnosis. Virtual planning software enables navigation and tool positioning within 3D images that can be reconstructed from any multimedia-equipped computer.
