Advanced Display and Visualization Concepts for Image Guided Surgery

Thanks to its rapid development in the last decades, image guided surgery (IGS) has been introduced successfully in many modern operating rooms. Current IGS systems provide their navigation information on a standard computer monitor. Alternatively, one could enhance the direct sight of the physician by an overlay of the virtual data onto the real patient view. Such in situ visualization methods have been proposed in the literature for providing a more intuitive visualization, improving the ergonomics as well as the hand-eye coordination. In this paper, we first discuss the fundamental issues and the recent endeavors in advanced display and visualization for IGS. We then present some of our recent work comparing two navigation systems: 1) a classical monitor based navigation and 2) a new navigation system we had developed based on in situ visualization. As both solutions reveal shortcomings as well as complementary advantages, we introduce a new solution that combines both concepts into one hybrid user interface. Finally, experimental results report on the performance of several surgeons using an external monitor as well as a stereo video see-through head-mounted display (HMD). The experiments consist of drilling into a phantom in order to reach planted deep-seated targets only visible in computed tomography (CT) data. We evaluate several visualization techniques, including the new hybrid solution, and study their influence on the performance of the participant surgeons.

I. Introduction

IN THE PAST two decades, computer-assisted surgery systems were introduced into the operation room [1], especially in neuro-, trauma and orthopedic surgery (cf. Fig. 1). Driving motivations for the introduction of IGS systems are •

reduction of invasiveness, e.g., by optimizing the access route, minimizing ionizing radiation and reducing the unnecessary damages to neighboring tissues,

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increase of safety and reliability of therapy e.g. by improving intervention accuracy, visualizing critical organs and detections of human errors as early as possible in the surgical process,

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introduction of novel interventions, e.g., by definition of new noninvasive interventions which are only possible under precise navigation and multi-modal imaging.