1
|
Völk C, Bernhard L, Völk D, Weiten M, Wilhelm D, Biberthaler P. [Mobile C-arm-Radiation exposure and workflow killer? : Potential of an innovative assistance system for intraoperative positioning]. UNFALLCHIRURGIE (HEIDELBERG, GERMANY) 2023; 126:928-934. [PMID: 37878125 DOI: 10.1007/s00113-023-01380-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/28/2023] [Indexed: 10/26/2023]
Abstract
Despite its versatile applicability the intraoperative use of a mobile C‑arm is often problematic and potentially associated with increased radiation exposure for both the patient and the personnel. In particular, the correct positioning for adequate imaging can become a problem as the nonsterile circulating nurse has to coordinate the various maneuvers together with the surgeon without having a good view of the surgical field. The sluggishness of the equipment and the intraoperative setting (sterile borders, additional hardware, etc.) pose further challenges. A light detection and ranging (LIDAR)-based assistance system shows promise to provide accurate and intuitive repositioning support as part of an initial series of experimental trials. For this purpose, the sensors are attached to the C‑arm base unit and enable navigation of the device in the operating room to a stored target position using a simultaneous localization and mapping (SLAM) algorithm. An improvement of the workflow as well as a reduction of radiation exposure represent the possible potential of this system. The advantages over other experimental approaches are the lack of external hardware and the ease of use without isolating the operator from the rest of the operating room environment; however, the suitability for daily use in the presence of additional interfering factors should be verified in further studies.
Collapse
Affiliation(s)
- Christopher Völk
- Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar der TU München, Ismaningerstr. 22, 81675, München, Deutschland.
| | - Lukas Bernhard
- Forschungsgruppe MITI, Klinikum rechts der Isar der TU München, München, Deutschland
| | - Dominik Völk
- Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar der TU München, Ismaningerstr. 22, 81675, München, Deutschland
| | | | - Dirk Wilhelm
- Forschungsgruppe MITI, Klinikum rechts der Isar der TU München, München, Deutschland
- Klinik und Poliklinik für Chirurgie, Klinikum rechts der Isar der TU München, München, Deutschland
| | - Peter Biberthaler
- Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar der TU München, Ismaningerstr. 22, 81675, München, Deutschland
| |
Collapse
|
2
|
Gsaxner C, Li J, Pepe A, Jin Y, Kleesiek J, Schmalstieg D, Egger J. The HoloLens in medicine: A systematic review and taxonomy. Med Image Anal 2023; 85:102757. [PMID: 36706637 DOI: 10.1016/j.media.2023.102757] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 01/05/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023]
Abstract
The HoloLens (Microsoft Corp., Redmond, WA), a head-worn, optically see-through augmented reality (AR) display, is the main player in the recent boost in medical AR research. In this systematic review, we provide a comprehensive overview of the usage of the first-generation HoloLens within the medical domain, from its release in March 2016, until the year of 2021. We identified 217 relevant publications through a systematic search of the PubMed, Scopus, IEEE Xplore and SpringerLink databases. We propose a new taxonomy including use case, technical methodology for registration and tracking, data sources, visualization as well as validation and evaluation, and analyze the retrieved publications accordingly. We find that the bulk of research focuses on supporting physicians during interventions, where the HoloLens is promising for procedures usually performed without image guidance. However, the consensus is that accuracy and reliability are still too low to replace conventional guidance systems. Medical students are the second most common target group, where AR-enhanced medical simulators emerge as a promising technology. While concerns about human-computer interactions, usability and perception are frequently mentioned, hardly any concepts to overcome these issues have been proposed. Instead, registration and tracking lie at the core of most reviewed publications, nevertheless only few of them propose innovative concepts in this direction. Finally, we find that the validation of HoloLens applications suffers from a lack of standardized and rigorous evaluation protocols. We hope that this review can advance medical AR research by identifying gaps in the current literature, to pave the way for novel, innovative directions and translation into the medical routine.
Collapse
Affiliation(s)
- Christina Gsaxner
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria; BioTechMed, 8010 Graz, Austria.
| | - Jianning Li
- Institute of AI in Medicine, University Medicine Essen, 45131 Essen, Germany; Cancer Research Center Cologne Essen, University Medicine Essen, 45147 Essen, Germany
| | - Antonio Pepe
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria; BioTechMed, 8010 Graz, Austria
| | - Yuan Jin
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria; Research Center for Connected Healthcare Big Data, Zhejiang Lab, Hangzhou, 311121 Zhejiang, China
| | - Jens Kleesiek
- Institute of AI in Medicine, University Medicine Essen, 45131 Essen, Germany; Cancer Research Center Cologne Essen, University Medicine Essen, 45147 Essen, Germany
| | - Dieter Schmalstieg
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria; BioTechMed, 8010 Graz, Austria
| | - Jan Egger
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria; Institute of AI in Medicine, University Medicine Essen, 45131 Essen, Germany; BioTechMed, 8010 Graz, Austria; Cancer Research Center Cologne Essen, University Medicine Essen, 45147 Essen, Germany
| |
Collapse
|
3
|
Remote Interactive Surgery Platform (RISP): Proof of Concept for an Augmented-Reality-Based Platform for Surgical Telementoring. J Imaging 2023; 9:jimaging9030056. [PMID: 36976107 PMCID: PMC10054087 DOI: 10.3390/jimaging9030056] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 02/26/2023] Open
Abstract
The “Remote Interactive Surgery Platform” (RISP) is an augmented reality (AR)-based platform for surgical telementoring. It builds upon recent advances of mixed reality head-mounted displays (MR-HMD) and associated immersive visualization technologies to assist the surgeon during an operation. It enables an interactive, real-time collaboration with a remote consultant by sharing the operating surgeon’s field of view through the Microsoft (MS) HoloLens2 (HL2). Development of the RISP started during the Medical Augmented Reality Summer School 2021 and is currently still ongoing. It currently includes features such as three-dimensional annotations, bidirectional voice communication and interactive windows to display radiographs within the sterile field. This manuscript provides an overview of the RISP and preliminary results regarding its annotation accuracy and user experience measured with ten participants.
Collapse
|
4
|
Ma L, Huang T, Wang J, Liao H. Visualization, registration and tracking techniques for augmented reality guided surgery: a review. Phys Med Biol 2023; 68. [PMID: 36580681 DOI: 10.1088/1361-6560/acaf23] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 12/29/2022] [Indexed: 12/31/2022]
Abstract
Augmented reality (AR) surgical navigation has developed rapidly in recent years. This paper reviews and analyzes the visualization, registration, and tracking techniques used in AR surgical navigation systems, as well as the application of these AR systems in different surgical fields. The types of AR visualization are divided into two categories ofin situvisualization and nonin situvisualization. The rendering contents of AR visualization are various. The registration methods include manual registration, point-based registration, surface registration, marker-based registration, and calibration-based registration. The tracking methods consist of self-localization, tracking with integrated cameras, external tracking, and hybrid tracking. Moreover, we describe the applications of AR in surgical fields. However, most AR applications were evaluated through model experiments and animal experiments, and there are relatively few clinical experiments, indicating that the current AR navigation methods are still in the early stage of development. Finally, we summarize the contributions and challenges of AR in the surgical fields, as well as the future development trend. Despite the fact that AR-guided surgery has not yet reached clinical maturity, we believe that if the current development trend continues, it will soon reveal its clinical utility.
Collapse
Affiliation(s)
- Longfei Ma
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, 100084, People's Republic of China
| | - Tianqi Huang
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, 100084, People's Republic of China
| | - Jie Wang
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, 100084, People's Republic of China
| | - Hongen Liao
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, 100084, People's Republic of China
| |
Collapse
|
5
|
Fan X, Zhu Q, Tu P, Joskowicz L, Chen X. A review of advances in image-guided orthopedic surgery. Phys Med Biol 2023; 68. [PMID: 36595258 DOI: 10.1088/1361-6560/acaae9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022]
Abstract
Orthopedic surgery remains technically demanding due to the complex anatomical structures and cumbersome surgical procedures. The introduction of image-guided orthopedic surgery (IGOS) has significantly decreased the surgical risk and improved the operation results. This review focuses on the application of recent advances in artificial intelligence (AI), deep learning (DL), augmented reality (AR) and robotics in image-guided spine surgery, joint arthroplasty, fracture reduction and bone tumor resection. For the pre-operative stage, key technologies of AI and DL based medical image segmentation, 3D visualization and surgical planning procedures are systematically reviewed. For the intra-operative stage, the development of novel image registration, surgical tool calibration and real-time navigation are reviewed. Furthermore, the combination of the surgical navigation system with AR and robotic technology is also discussed. Finally, the current issues and prospects of the IGOS system are discussed, with the goal of establishing a reference and providing guidance for surgeons, engineers, and researchers involved in the research and development of this area.
Collapse
Affiliation(s)
- Xingqi Fan
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Qiyang Zhu
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Puxun Tu
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Leo Joskowicz
- School of Computer Science and Engineering, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Xiaojun Chen
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China.,Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| |
Collapse
|
6
|
Navab N, Martin-Gomez A, Seibold M, Sommersperger M, Song T, Winkler A, Yu K, Eck U. Medical Augmented Reality: Definition, Principle Components, Domain Modeling, and Design-Development-Validation Process. J Imaging 2022; 9:jimaging9010004. [PMID: 36662102 PMCID: PMC9866223 DOI: 10.3390/jimaging9010004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 12/28/2022] Open
Abstract
Three decades after the first set of work on Medical Augmented Reality (MAR) was presented to the international community, and ten years after the deployment of the first MAR solutions into operating rooms, its exact definition, basic components, systematic design, and validation still lack a detailed discussion. This paper defines the basic components of any Augmented Reality (AR) solution and extends them to exemplary Medical Augmented Reality Systems (MARS). We use some of the original MARS applications developed at the Chair for Computer Aided Medical Procedures and deployed into medical schools for teaching anatomy and into operating rooms for telemedicine and surgical guidance throughout the last decades to identify the corresponding basic components. In this regard, the paper is not discussing all past or existing solutions but only aims at defining the principle components and discussing the particular domain modeling for MAR and its design-development-validation process, and providing exemplary cases through the past in-house developments of such solutions.
Collapse
Affiliation(s)
- Nassir Navab
- Computer Aided Medical Procedures & Augmented Reality, Technical University Munich, DE-85748 Garching, Germany
| | - Alejandro Martin-Gomez
- Computer Aided Medical Procedures & Augmented Reality, Technical University Munich, DE-85748 Garching, Germany
- Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Matthias Seibold
- Computer Aided Medical Procedures & Augmented Reality, Technical University Munich, DE-85748 Garching, Germany
- Research in Orthopedic Computer Science, Balgrist University Hospital, University of Zurich, CH-8008 Zurich, Switzerland
| | - Michael Sommersperger
- Computer Aided Medical Procedures & Augmented Reality, Technical University Munich, DE-85748 Garching, Germany
| | - Tianyu Song
- Computer Aided Medical Procedures & Augmented Reality, Technical University Munich, DE-85748 Garching, Germany
| | - Alexander Winkler
- Computer Aided Medical Procedures & Augmented Reality, Technical University Munich, DE-85748 Garching, Germany
- Department of General, Visceral, and Transplant Surgery, Ludwig-Maximilians-University Hospital, DE-80336 Munich, Germany
| | - Kevin Yu
- Computer Aided Medical Procedures & Augmented Reality, Technical University Munich, DE-85748 Garching, Germany
- medPhoton GmbH, AT-5020 Salzburg, Austria
| | - Ulrich Eck
- Computer Aided Medical Procedures & Augmented Reality, Technical University Munich, DE-85748 Garching, Germany
- Correspondence:
| |
Collapse
|
7
|
Birlo M, Edwards PJE, Clarkson M, Stoyanov D. Utility of optical see-through head mounted displays in augmented reality-assisted surgery: A systematic review. Med Image Anal 2022; 77:102361. [PMID: 35168103 PMCID: PMC10466024 DOI: 10.1016/j.media.2022.102361] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 11/17/2021] [Accepted: 01/10/2022] [Indexed: 12/11/2022]
Abstract
This article presents a systematic review of optical see-through head mounted display (OST-HMD) usage in augmented reality (AR) surgery applications from 2013 to 2020. Articles were categorised by: OST-HMD device, surgical speciality, surgical application context, visualisation content, experimental design and evaluation, accuracy and human factors of human-computer interaction. 91 articles fulfilled all inclusion criteria. Some clear trends emerge. The Microsoft HoloLens increasingly dominates the field, with orthopaedic surgery being the most popular application (28.6%). By far the most common surgical context is surgical guidance (n=58) and segmented preoperative models dominate visualisation (n=40). Experiments mainly involve phantoms (n=43) or system setup (n=21), with patient case studies ranking third (n=19), reflecting the comparative infancy of the field. Experiments cover issues from registration to perception with very different accuracy results. Human factors emerge as significant to OST-HMD utility. Some factors are addressed by the systems proposed, such as attention shift away from the surgical site and mental mapping of 2D images to 3D patient anatomy. Other persistent human factors remain or are caused by OST-HMD solutions, including ease of use, comfort and spatial perception issues. The significant upward trend in published articles is clear, but such devices are not yet established in the operating room and clinical studies showing benefit are lacking. A focused effort addressing technical registration and perceptual factors in the lab coupled with design that incorporates human factors considerations to solve clear clinical problems should ensure that the significant current research efforts will succeed.
Collapse
Affiliation(s)
- Manuel Birlo
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London (UCL), Charles Bell House, 43-45 Foley Street, London W1W 7TS, UK.
| | - P J Eddie Edwards
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London (UCL), Charles Bell House, 43-45 Foley Street, London W1W 7TS, UK
| | - Matthew Clarkson
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London (UCL), Charles Bell House, 43-45 Foley Street, London W1W 7TS, UK
| | - Danail Stoyanov
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London (UCL), Charles Bell House, 43-45 Foley Street, London W1W 7TS, UK
| |
Collapse
|
8
|
Bernhard L, Völk C, Völk D, Rothmeyer F, Xu Z, Ostler D, Biberthaler P, Wilhelm D. RAY-POS: a LIDAR-based assistance system for intraoperative repositioning of mobile C-arms without external aids. Int J Comput Assist Radiol Surg 2022; 17:719-729. [PMID: 35195830 PMCID: PMC8948129 DOI: 10.1007/s11548-022-02571-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 01/26/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE In current clinical practice, intraoperative repositioning of mobile C-arms is challenging due to a lack of visual cues and efficient guiding tools. This can be detrimental to the surgical workflow and lead to additional radiation burdens for both patient and personnel. To overcome this problem, we present our novel approach Lidar-based X-ray Positioning for Mobile C-arms (RAY-POS) for assisting circulating nurses during intraoperative C-arm repositioning without requiring external aids. METHODS RAY-POS consists of a localization module and a graphical user interface for guiding the user back to a previously recorded C-Arm position. We conducted a systematic comparison of simultaneous localization and mapping (SLAM) algorithms using different attachment positions of light detection and ranging (LIDAR) sensors to benchmark localization performance within the operating room (OR). For two promising combinations, we conducted further end-to-end repositioning tests within a realistic OR setup. RESULTS SLAM algorithm gmapping with a LIDAR sensor mounted 40 cm above the C-arm's horizontal unit performed best regarding localization accuracy and long-term stability. The distribution of the repositioning error yielded an effective standard deviation of 7.61 mm. CONCLUSION We conclude that a proof-of-concept for LIDAR-based C-arm repositioning without external aids has been achieved. In future work, we mainly aim at extending the capabilities of our system and evaluating the usability together with clinicians.
Collapse
Affiliation(s)
- Lukas Bernhard
- Klinikum Rechts Der Isar der Technischen Universität München, Research Group MITI, Munich, Germany.
| | - Christopher Völk
- Department of Trauma Surgery, Klinikum Rechts Der Isar der Technischen Universität München, Munich, Germany
| | - Dominik Völk
- Department of Trauma Surgery, Klinikum Rechts Der Isar der Technischen Universität München, Munich, Germany
| | - Florian Rothmeyer
- Technische Universität München, Chair of Materials Handling, Material Flow, Logistics, Munich, Germany
| | - Zhencan Xu
- Klinikum Rechts Der Isar der Technischen Universität München, Research Group MITI, Munich, Germany
| | - Daniel Ostler
- Klinikum Rechts Der Isar der Technischen Universität München, Research Group MITI, Munich, Germany
| | - Peter Biberthaler
- Department of Trauma Surgery, Klinikum Rechts Der Isar der Technischen Universität München, Munich, Germany
| | - Dirk Wilhelm
- Klinikum Rechts Der Isar der Technischen Universität München, Research Group MITI, Munich, Germany
- Department of Surgery, Klinikum Rechts Der Isar der Technischen Universität München, Munich, Germany
| |
Collapse
|
9
|
Augmented Reality, Virtual Reality and Artificial Intelligence in Orthopedic Surgery: A Systematic Review. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11073253] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background: The application of virtual and augmented reality technologies to orthopaedic surgery training and practice aims to increase the safety and accuracy of procedures and reducing complications and costs. The purpose of this systematic review is to summarise the present literature on this topic while providing a detailed analysis of current flaws and benefits. Methods: A comprehensive search on the PubMed, Cochrane, CINAHL, and Embase database was conducted from inception to February 2021. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were used to improve the reporting of the review. The Cochrane Risk of Bias Tool and the Methodological Index for Non-Randomized Studies (MINORS) was used to assess the quality and potential bias of the included randomized and non-randomized control trials, respectively. Results: Virtual reality has been proven revolutionary for both resident training and preoperative planning. Thanks to augmented reality, orthopaedic surgeons could carry out procedures faster and more accurately, improving overall safety. Artificial intelligence (AI) is a promising technology with limitless potential, but, nowadays, its use in orthopaedic surgery is limited to preoperative diagnosis. Conclusions: Extended reality technologies have the potential to reform orthopaedic training and practice, providing an opportunity for unidirectional growth towards a patient-centred approach.
Collapse
|
10
|
Fotouhi J, Mehrfard A, Song T, Johnson A, Osgood G, Unberath M, Armand M, Navab N. Development and Pre-Clinical Analysis of Spatiotemporal-Aware Augmented Reality in Orthopedic Interventions. IEEE TRANSACTIONS ON MEDICAL IMAGING 2021; 40:765-778. [PMID: 33166252 PMCID: PMC8317976 DOI: 10.1109/tmi.2020.3037013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Suboptimal interaction with patient data and challenges in mastering 3D anatomy based on ill-posed 2D interventional images are essential concerns in image-guided therapies. Augmented reality (AR) has been introduced in the operating rooms in the last decade; however, in image-guided interventions, it has often only been considered as a visualization device improving traditional workflows. As a consequence, the technology is gaining minimum maturity that it requires to redefine new procedures, user interfaces, and interactions. The main contribution of this paper is to reveal how exemplary workflows are redefined by taking full advantage of head-mounted displays when entirely co-registered with the imaging system at all times. The awareness of the system from the geometric and physical characteristics of X-ray imaging allows the exploration of different human-machine interfaces. Our system achieved an error of 4.76 ± 2.91mm for placing K-wire in a fracture management procedure, and yielded errors of 1.57 ± 1.16° and 1.46 ± 1.00° in the abduction and anteversion angles, respectively, for total hip arthroplasty (THA). We compared the results with the outcomes from baseline standard operative and non-immersive AR procedures, which had yielded errors of [4.61mm, 4.76°, 4.77°] and [5.13mm, 1.78°, 1.43°], respectively, for wire placement, and abduction and anteversion during THA. We hope that our holistic approach towards improving the interface of surgery not only augments the surgeon's capabilities but also augments the surgical team's experience in carrying out an effective intervention with reduced complications and provide novel approaches of documenting procedures for training purposes.
Collapse
|