Augmented Reality Environments for Oncoplastic Breast Surgery

11/11/2022

Deep inferior epigastric artery perforator (DIEAP) flap reconstruction surgeries have become a gold standard technique for breast reconstruction surgery. Knowledge of the vascular network of the inferior abdominal wall is crucial for surgery planning. The potential of augmented reality (AR) in these surgeries is very appealing and is expected to help surgery planning without compromising marking accuracy. In this work, we propose BREAST Plus as an AR interface that runs on the Microsoft HoloLens headset, adding relevant and accurate information for marking the location of perforators on the patient's tummy skin, before the surgery starts. This interface allows surgeons to see beyond the patient’s skin. Interface design counted on valuable input from two breast reconstruction surgeons, who provided their needs and requirements. Since BREAST Plus heavily relies on 3D data registration to anchor data on top of a patient, we conducted a skin deformation analysis to measure how deviated the computed tomography angiography (CTA) data is from the patient’s skin when laid on the surgical bed. A total of 20 data sets were analyzed revealing that skin deformation is not neglectable. The root mean square was 2,447 ± 1,1 mm, including 30% cases of deformation above 3 mm and 15% above 4 mm. We also conducted a small user study with three breast surgeons in two DIEAP flap surgeries to collect qualitative data on usability, user satisfaction, and preferences. BREAST Plus aided surgeons to visualize relevant information immediately and helpfully during DIEAP reconstruction surgeries.

Authors in the community:

• 

  R

  Rafaela Jorge Timóteo

  ist190773

Supervisors of this institution:

• 

  D

  Daniel Simões Lopes

  ist151462

electrical-engineering-electronic-engineering-information-engineering - Electrical engineering, electronic engineering, information engineering

eng - English

Instituto Superior Técnico