The VascuLens: A Handsfree Projector-Based Augmented Reality System for Surgical Guidance During DIEP Flap Harvest
Sebastian Gonzalez, Michael J. Stein, Robert N. Rohling, Philip Edgcumbe · CMBES Proceedings · 2021
Augmented reality technologies are increasinglybeing used to provide enhanced surgical navigation forsurgeons. The goal of such augmented reality technology is toimprove both the safety and efficiency of operations. TheVascuLens, a novel handsfree and focus free projector-basedaugmented reality system, is presented in this paper. Theproposed application for the VascuLens is for improvingvisualization of the vascular anatomy during deep inferiorepigastric perforator (DIEP) flap breast reconstruction. TheDIEP flap is a fasciocutaneous flap that is harvested based onperforating vessels 1-2mm in size and then connected underthe microscope to the internal mammary vessels in the chest tocreate a new breast mound after mastectomy. The VascuLenssystem aims to take preoperative CT scan data, register thepreoperative data to the patient on the operating room table,and project the segmented DIEP arteries directly onto thepatient. The novel aspects of the system include: 1) a handsfreeprojector, 2) a simple preoperative to intraoperative imageregistration technique that does not require a fiducial markeror camera, 3) and intraoperative surgeon-in-the-loop surgicalguidance. This paper describes the proof-of-concept Vasculensworkflow and reports the Vasculens accuracy. The accuracy isreported as a function of registration technique, patient bodytype, projector height and projector angle. Using the idealregistration technique, projector height and projector angle,the mean absolute point reprojection error is 1.7mm, making ita good candidate for DIEP flap breast reconstruction surgery.