Uses of a dedicated 3D reconstruction software with augmented and mixed reality in planning and performing advanced liver surgery and living donor liver transplantation (with videos)

A decade of progress: bringing mixed reality image-guided surgery systems in the operating room

Advancements in mixed reality (MR) have led to innovative approaches in image-guided surgery (IGS). In this paper, we provide a comprehensive analysis of the current state of MR in image-guided procedures across various surgical domains. Using the Data Visualization View (DVV) Taxonomy, we analyze the progress made since a 2013 literature review paper on MR IGS systems. In addition to examining the current surgical domains using MR systems, we explore trends in types of MR hardware used, type of data visualized, visualizations of virtual elements, and interaction methods in use. Our analysis also covers the metrics used to evaluate these systems in the operating room (OR), both qualitative and quantitative assessments, and clinical studies that have demonstrated the potential of MR technologies to enhance surgical workflows and outcomes. We also address current challenges and future directions that would further establish the use of MR in IGS.

Pre-operative assessment of living liver donors' liver anatomy and volumes

Decades of experience supports LDLT as a favorable strategy to reduce waitlist mortality. The multiple regenerative pathways of hepatocytes and other hepatic cells justify the rationale behind it. Nonetheless, living liver donation is still underused and its broader implementation is challenging, mostly due to variability in practices leading to concerns related to donor safety. A non-systematic literature search was conducted for peer-reviewed original articles related to pre-operative evaluation of living liver donor candidates. Eligible studies were synthesized upon consensus for discussion in this up-to-date review. Review of the literature demonstrate that the importance of preoperative assessment of vascular, biliary and liver volume to ensure donor safety and adequate surgical planning for graft procurement is widely recognized. Moreover, data indicates that anatomic variants in vascular and biliary systems in healthy donors are common, present in up to 50% of the population. Therefore, comprehensive mapping and visualizations of each component is needed. Different imaging modalities are reported across practices and are discussed in detail. Lastly, assessment of liver volume must take into account several technical and donor factors that increase the chances of errors in volume estimation, which occurs in up to 10% of the cases. Experience suggests that maximizing donor safety and lessening their risks is a result of integrated experience between hepatobiliary and transplant surgery, along with multidisciplinary efforts in performing a comprehensive pre-operative donor assessment. Although technical advances have increased the accuracy of volume estimation, over- or under-estimation remains a challenge that needs further attention.

An Improved TransMVSNet Algorithm for Three-Dimensional Reconstruction in the Unmanned Aerial Vehicle Remote Sensing Domain

It is important to achieve the 3D reconstruction of UAV remote sensing images in deep learning-based multi-view stereo (MVS) vision. The lack of obvious texture features and detailed edges in UAV remote sensing images leads to inaccurate feature point matching or depth estimation. To address this problem, this study improves the TransMVSNet algorithm in the field of 3D reconstruction by optimizing its feature extraction network and costumed body depth prediction network. The improvement is mainly achieved by extracting features with the Asymptotic Pyramidal Network (AFPN) and assigning weights to different levels of features through the ASFF module to increase the importance of key levels and also using the UNet structured network combined with an attention mechanism to predict the depth information, which also extracts the key area information. It aims to improve the performance and accuracy of the TransMVSNet algorithm's 3D reconstruction of UAV remote sensing images. In this work, we have performed comparative experiments and quantitative evaluation with other algorithms on the DTU dataset as well as on a large UAV remote sensing image dataset. After a large number of experimental studies, it is shown that our improved TransMVSNet algorithm has better performance and robustness, providing a valuable reference for research and application in the field of 3D reconstruction of UAV remote sensing images.

Assessing the impact of mixed reality-assisted informed consent: A study protocol

Background

Informed consent is a crucial aspect of modern medicine, but it can be challenging due to the complexity of the information involved. Mixed reality (MR) has emerged as a promising technology to improve communication. However, there is a lack of comprehensive research on the impact of MR on medical informed consent. The proposed research protocol provides a solid foundation for conducting future investigations and developing MR-based protocols that can enhance patients' understanding and engagement in the decision-making process.

Methods

This study will employ a randomized controlled trial design. Two arms will be defined: MR-assisted informed consent (MRaIC) as the experimental arm and conventional informed consent (CIC) as the control arm consent, with 52 patients in each group. The protocol includes the use of questionnaires to analyze the anxiety levels and the awareness of the procedure that the patient is going to perform to study the impact of MRaIC versus CIC before medical procedures.

Results

The study will evaluate the impact of MR on patients' information comprehension, engagement during the process of obtaining informed consent, emotional reactions, and consent decisions. Ethical concerns will be addressed.

Conclusion

This study protocol provides a comprehensive approach to investigate the impact of MR on medical informed consent. The findings may contribute to a better understanding of the effects of MR on information comprehension, engagement during the process of obtaining informed consent, psychological experience, consent decisions, and ethical considerations. The integration of MR technology has the potential to enhance surgical communication practices and improve the informed consent process.

Post Living Donor Liver Transplantation Small-for-size Syndrome: Definitions, Timelines, Biochemical, and Clinical Factors for Diagnosis: Guidelines From the ILTS-iLDLT-LTSI Consensus Conference

BACKGROUND

When a partial liver graft is unable to meet the demands of the recipient, a clinical phenomenon, small-for-size syndrome (SFSS), may ensue. Clear definition, diagnosis, and management are needed to optimize transplant outcomes.

METHODS

A Consensus Scientific committee (106 members from 21 countries) performed an extensive literature review on specific aspects of SFSS, recommendations underwent blinded review by an independent panel, and discussion/voting on the recommendations occurred at the Consensus Conference.

RESULTS

The ideal graft-to-recipient weight ratio of ≥0.8% (or graft volume standard liver volume ratio of ≥40%) is recommended. It is also recommended to measure portal pressure or portal blood flow during living donor liver transplantation and maintain a postreperfusion portal pressure of <15 mm Hg and/or portal blood flow of <250 mL/min/100 g graft weight to optimize outcomes. The typical time point to diagnose SFSS is the postoperative day 7 to facilitate treatment and intervention. An objective 3-grade stratification of severity for protocolized management of SFSS is proposed.

CONCLUSIONS

The proposed grading system based on clinical and biochemical factors will help clinicians in the early identification of patients at risk of developing SFSS and institute timely therapeutic measures. The validity of this newly created grading system should be evaluated in future prospective studies.

An analysis of the current status of metaverse research based on bibliometrics

Purpose

The rise of the metaverse has brought profound changes to the economic and social operation models and injected new vitality into academic research. Although a large number of studies have emerged, there are few quantitative analyses of development frontiers and trends.

Design/methodology/approach

From a bibliometric perspective, this paper selects 183 pieces of metaverse-related literature in the WoS core database since 2000 as the object of analysis. This paper sums up the characteristics of the literature using the methods of descriptive statistical analysis, keywords analysis, thematic evolution analysis and summarizes the core themes and the laws of metaverse development in each stage.

Findings

The digital economy vision brought by the metaverse has led to an increasing number of researchers and achievements in this field. But the depth and breadth of research are still insufficient and unevenly distributed in the region, and the cross-fertilization fields need to be expanded. From the industry's point of view, VR games represented by Second Life and My World have contributed to the popularity of the metaverse. As technology progresses, the research hotspots in the field of metaverse gradually develop from conceptual research to artificial intelligence, blockchain, NFT and other technical applications. However, academic research has not yet caught up with the industry's pace and stays more in the concept discussion and preliminary application stage.

Originality/value

A systematic overview of the current status, knowledge structure and hot issues of metaverse research is shown, which provides a thematic axis for this field, enriches and improves the quantitative analysis of its literature and provides a clear picture for researchers to continuously promote the development of this field. At the same time, it is necessary to warn that technological development is a double-edged sword. The process of metaverse development should return to rationality, respect the laws of its development and guarantee the healthy development of the metaverse by strengthening legal regulation and the ethical review of science and technology.