THE APPLICATION OF NAVIGATION SYSTEM BASED ON THE AUGMENTED REALITY TECHNOLOGY FOR THE SURGICAL TREATMENT OF ORBITAL TUMORS
Authors:   N.N. Alexandrov National Cancer Center of Belarus, Zherka I.Y. , Zhiliayeva K.P. ,   N.N. Alexandrov National Cancer Center of Belarus, Naumenka L.V. ,   N.N. Alexandrov National Cancer Center of Belarus, Kaliadzich Zh.V. ,   N.N. Alexandrov National Cancer Center of Belarus, Ena D.L. ,   N.N. Alexandrov National Cancer Center of Belarus, Zamotin I.D. ,   International Software Development Company Innowise, Arlou P.A. ,   International Software Development Company Innowise, Volchenko O.V. ,   V. T. Zaytsev Institute of General and Urgent Surgery of the National Academy of Medical Sciences of Ukraine
Published: April 2021

Objective. To assess the effectiveness and feasibility of using an intraoperative navigation system based on augmented reality technology in the surgical treatment of intra-orbital tumors. Methods. Two patients with intra-orbital tumors were operated on with the application of the intraoperative navigation system. The virtual volumetric model was designed on the basis of files in the Digital Imaging and Communications in Medicine (DICOM) format, taking into account the fact that the quality of reconstruction depends on the quality of the input data and the accuracy of the reconstruction system. The required structures and parameters of color rendering for inclusion in the model were selected taking into consideration a specific clinical situation. Then the model was subjected to processing and modification to facilitate visualization. The prepared and optimized model was loaded into Microsoft HoloLens2 augmented reality glasses. In the preoperative period, using the possibilities of full screen image zoom and rotation of 3D model, the planning of the surgical intervention was carried out with the participation of all members of the surgical team. Intraoperatively, a 3D skull model was superimposed on the patient along bony landmarks (lower orbital edge and nasal bones). Surgical access and surgery were performed in the projection of the visualized tumor. Results. In the first case, the surgical planningas the preoperative method of pre-visualising asurgical intervention was used by means of the possibilities of model zooming and rotating; a detailed preoperative tumor assessment was made. In the second case, the navigation system was used in the process of diagnostic orbitotomy to facilitate the access to the tumor. Conclusion. Augmented reality allows highly detail visualization of individual anatomical models. Models are interactive, adaptive to real time and manipulating does not require the special skills. The technologies are flexible and can be programmed to perform a number of tasks (diagnostics, preoperative planning and intraoperative navigation). Models might be used for surgical training of surgeons to possess the skills. What this paper adds For the first time, the possibility of a navigation system application based on augmented reality technology in the surgical treatment of intra-orbital tumors has been shown. The technique has been found to be useful both in the preoperative planning and during surgical intervention.