Augmented reality–assisted ventriculostomy

OBJECTIVE Placement of a ventricular drain is one the most common neurosurgical procedures. However, higher rate successful placements with this freehand procedure desirable. The authors’ objective was to develop compact navigational augmented reality (AR)–based tool that does not require rigid patient head fixation, support surgeon during operation. METHODS Segmentation and tracking algorithms were developed. A commercially available Microsoft HoloLens AR headset in conjunction Vuforia marker-based used provide guidance for ventriculostomy custom-made 3D-printed model. Eleven surgeons conducted series tests place total 110 external drains under holographic guidance. sole active component; no fixation necessary. CT obtain puncture results quantify success rates as well precision suggested setup. RESULTS In proposed setup, system worked reliably performed well. reported application showed an overall 68.2%. offset from reference trajectory displayed hologram 5.2 ± 2.6 mm (mean standard deviation). subgroup second punctures which improved significantly. For participants it their first encounter technology feedback positive. CONCLUSIONS To knowledge, report on marker-based, AR-guided ventriculostomy. are encouraging. authors would expect good acceptance navigation device supposed clinical implementation assume steep learning curve technique. achieve translation, further development marker new hardware generation planned. Further testing address visuospatial issues needed prior humans.