In orthopaedic oncology, surgical planning and intraoperative execution errors may result in positive tumor resection margins that increase the risk of local recurrence and adversely affect patients' survival. Computer navigation and 3D-printed resection guides have been reported to address surgical inaccuracy by replicating surgical plans in complex cases. However, limitations include surgeons' attention shift from the operative field and expensive navigation facilities in computer navigation surgery. Practical concerns are the lack of real-time visual feedback of preoperative images and the lead time for manufacturing 3D-printed objects.
When surgeons clinically examine bone tumor patients, they must mentally process and correctly overlay the patients' virtual 2D medical images and 3D bone-tumor models onto their anatomy. Appropriate surgical exposures and the osteotomies along desired planes are then decided. This spatial ability to mentally generate and manipulate abstract models is difficult for tumors of various extents and regions with complex anatomies. Both computer navigation and 3D-printed resection guides facilitate precise osteotomies only after surgical exposure.
Mixed Reality (MR) is an immersive technology that merges real and virtual worlds, and users can interact with digital objects in real time. Through Head-Mounted Displays (HMDs), holographic 3D models generated from 2D medical images are superimposed on the patient's anatomy in their physical environment. It enables surgeons to better spatially understand bone tumors in actual patients before the surgery starts. The emerging MR technology adds a new dimension to digital assistive tools with a more accessible and less costly alternative in orthopaedic oncology. The MR HMD and hand-free control may allow additional on-demand medical information with online assistance from remote users, greatly facilitating clinical point-of-care inside or outside the operating room and improving service efficiency and patient safety.
The talk includes the background of MR technology, how to integrate it into the existing clinical workflow, early clinical experience in an HA setting, and the challenges ahead.
