A newly developed augmented reality (AR) system enables plastic surgeons to create 3D simulations of the desired results of facial reconstructive procedures and project them over the patient’s face during surgery.
Going forward, the AR system may be a useful guide to planning, performing and evaluating the results of facial reconstruction and other procedures.
Koichi Ueda, MD, PhD, Daisuke Mitsuno, MD, and colleagues of Osaka Medical College in Japan, report on the development and initial experience with the system in eight cases in Plastic and Reconstructive Surgery—Global Open® .
The researchers used a high-definition digital camera to capture 3D image of the facial surface and computed tomography scans to obtain digital information on the underlying facial bones for each patient. These digital data were then manipulated to create 3D simulations of the ideal final results. For example, in a patient with a fractured cheekbone, the reconstruction was simulated by obtaining and reversing an image of the opposite, uninjured bone.
Using a pair of commercially available smart glasses, the surgeon was able to superimpose the 3D digital simulation image of the desired appearance over the patient’s face during surgery. The group used free, open source software products to solve various technical problems, including manipulating and displaying the 3D simulations and lining them up with the surgical field.
They found that AR system helped in planning and confirming reconstruction of the underlying facial bones, for example, in a patient with a congenital bone development disorder and another patient with a complex facial fracture. In all cases, the 3D simulation of the body surface provided a visual reference of the final facial appearance.
With each new case, the group made additional technical refinements to address limitations of the AR system. Although the experimental system was not actually used to guide surgery in this initial experience, it helped in visualizing the planned correction and confirming the final outcome.
The group plans further studies to confirm the benefits of using the AR system during plastic and reconstructive surgery and to refine the display method for comparing before-and-after images. Future innovations may include the ability to quantitatively evaluate the improvements in body surface and even to enable simple navigation of internal organs.
What’s more, Drs. Ueda and Mitsuno believe AR technology could become a useful tool for teaching surgical skills.