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Augmented reality in the operating room: a clinical feasibility study

Cyrill Dennler, David E Bauer, Anne-Gita Scheibler, José Spirig, Tobias Götschi, Philipp Fürnstahl & Mazda Farshad

abstract

BACKGROUND
Augmented Reality (AR) is a rapidly emerging technology finding growing acceptance and application in different fields of surgery. Various studies have been performed evaluating the precision and accuracy of AR guided navigation. This study investigates the feasibility of a commercially available AR head mounted device during orthopedic surgery.

METHODS
Thirteen orthopedic surgeons from a Swiss university clinic performed 25 orthopedic surgical procedures wearing a holographic AR headset (HoloLens, Microsoft, Redmond, WA, USA) providing complementary three-dimensional, patient specific anatomic information. The surgeon's experience of using the device during surgery was recorded using a standardized 58-item questionnaire grading different aspects on a 100-point scale with anchor statements.

RESULTS
Surgeons were generally satisfied with image quality (85 ± 17 points) and accuracy of the virtual objects (84 ± 19 point). Wearing the AR device was rated as fairly comfortable (79 ± 13 points). Functionality of voice commands (68 ± 20 points) and gestures (66 ± 20 points) provided less favorable results. The greatest potential in the use of the AR device was found for surgical correction of deformities (87 ± 15 points). Overall, surgeons were satisfied with the application of this novel technology (78 ± 20 points) and future access to it was demanded (75 ± 22 points).

CONCLUSION
AR is a rapidly evolving technology with large potential in different surgical settings, offering the opportunity to provide a compact, low cost alternative requiring a minimum of infrastructure compared to conventional navigation systems. While surgeons where generally satisfied with image quality of the here tested head mounted AR device, some technical and ergonomic shortcomings were pointed out. This study serves as a proof of concept for the use of an AR head mounted device in a real-world sterile setting in orthopedic surgery.
   
citation Dennler C, Bauer D E, Scheibler A G, Spirig J, Götschi T, Fürnstahl P, Farshad M. Augmented reality in the operating room: a clinical feasibility study. BMC Musculoskelet Disord 2021; 22:451.
   
type journal paper/review (English)
date of publishing 18-05-2021
journal title BMC Musculoskelet Disord (22/1)
ISSN electronic 1471-2474
pages 451
PubMed 34006234
DOI 10.1186/s12891-021-04339-w