New Study Shows Augmented Reality Guidance Improves EVD Placement
A recent study published within the journal Neurosurgery has found that using an external ventricular drain (EVD) at bedside with augmented reality (AR) guidance is more precise than freehand placement and related to fewer reinterventions and complications.
The study, led by Frederick Van Gestel, MD, a neurosurgery resident at Universitair Ziekenhuis Brussel and PhD researcher at Vrije Universiteit Brussel in Brussels, Belgium, used a novel system that pairs a industrial AR headset with a custom-built surgical navigation software.
What is the Problem with Current Techniques?
Conventional neuronavigation systems are limited to the operating room on account of their size and lack of mobility, requiring surgeons to divide their attention between 2D information on distant displays and 3D motion on the patient. In contrast, AR provides an overlay of 3D information onto the actual world, allowing for more precise and intuitive navigation.
How Does the AR System Work?
The AR system uses a industrial AR headset, the Microsoft HoloLens II, and a custom-built surgical navigation software. The system integrates all components mandatory for neuronavigation, including high-accuracy tracking, image display, and processing unit, right into a standalone headset. The process begins with preoperative imaging and creation of a 3D model of the patient’s anatomy, labeled with coordinates relevant for AR guidance. An infrared-labeled reference frame is attached to the patient’s head, allowing the AR application to trace head position and orientation.
Pilot Study Results
The study found that AR guidance resulted in higher placement outcomes and fewer reinterventions in comparison with freehand placement. Specifically, all AR-guided placements were successful, while seven freehand placements were successful, nine were optimal, and one failed. No AR-guided placements required revision, while 4 freehand placements did.
Conclusion
The study’s findings suggest that AR guidance for EVD placement is a promising approach for improving accuracy and reducing complications. The authors plan to launch a multicenter, randomized controlled trial at the tip of 2025 to further investigate the effectiveness of this technology.
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