Mixed reality Standard data glasses enable navigation in neurosurgical procedures

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Fraunhofer-Institut für Werkzeugmaschinen und Umformtechnik IWU

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Medical procedures should put as little strain on patients as possible: on a precisely determined path to the area that needs to be operated on, no tissue should be injured. This is especially true for operations on sensitive organs like the brain. In procedures through the nose, a new app will show the surgeon what cannot be seen from the outside.

Precise, high-resolution image data of the patient, as provided by magnetic resonance imaging (MRI), serve as a map for navigation; the operating physician views this image data as a projection in smart glasses. The central link between MRI data and the glasses is a newly developed app, which is now available as a result of years of research and development. It was created in collaboration between the Legend research group of the Clinic and Polyclinic for Neurosurgery at Leipzig University Hospital (UKL) and the Zittau division of the Fraunhofer IWU (Germany).

Milestone in neurosurgical navigation

The app integrates the pre-operatively acquired MRI image with the real surgical situation, allowing for precise topographical and structural mapping of the surgical findings. Similar to a GPS system, it guides the surgeon along the best, most gentle path to the intended target. System-side integration of surgical instruments also allows them to be mapped in the navigation system or used as pointing devices. The exact position of the surgical instrument is displayed to the surgeon in real-time. Important additional information, such as the distance to the target area, is in the physician's direct line of sight, providing further valuable insights.

Within one second, calibration and registration are complete, and navigation for real-time recognition of instrument position is ready to go. The developed system is very intuitive to use and is very similar to using GPS assistance.

PD Dr. habil. Ronny Grunert

PD Dr. habil. Ronny Grunert, a research associate at Fraunhofer IWU (Zittau, Germany) and head of the Legend research group at UKL, is particularly proud of the practically latency-free operational readiness of the system: "Our team has achieved a worldwide first with fully automated registration in neurosurgical spatial computing navigation. Calibration and registration are completed within one second, and the navigation for real-time instrument position detection is ready to go. The developed system is very intuitive to operate and is very close to the use of GPS assistance."

Developed by physicians for physicians

The team placed great emphasis on a clear user interface that optimally supports the operating physician, eliminates operational errors, and is limited to displaying essential information. An example of the clear, precise display logic is a green crosshair that indicates the position of the instrument tip and is perfectly integrated into the previously created or imported MRI image in the smart glasses.

Very economical thanks to standard data glasses

The principle of so-called neurosurgical spatial computing navigation is not fundamentally new. Today's systems, suitable for use in hospitals, start at around half a million euros. An important motivation for the joint efforts of IWU and UKL was that precise navigation technology should no longer be reserved for financially strong healthcare systems or institutions. They designed their new app from the outset for use with standardized smart glasses, which are now priced within the consumer range. Grunert: "These glasses cost a fraction of computer-assisted navigation systems for neurosurgery."

Handpiece for connecting surgical instruments from the 3D printer

At Fraunhofer IWU, the team led by Ronny Grunert advanced the development of the handpiece that holds the instruments and enables their exact position determination. It contains special markers whose geometries and patterns are recognized by the smart glasses. These geometries can be small spheres, cuboids, or other shapes. The plastic handpieces are 3D-printed at IWU in Zittau and at UKL in Leipzig (Germany).

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