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dc.contributor.authorCofano, Fabio
dc.contributor.authorDi Perna, Giuseppe
dc.contributor.authorBozzaro, Marco
dc.contributor.authorLongo, Alessandro
dc.contributor.authorMarengo, Nicola
dc.contributor.authorZenga, Francesco
dc.contributor.authorZullo, Nicola
dc.contributor.authorCavalieri, Matteo
dc.contributor.authorDamiani, Luca
dc.contributor.authorBoges, Daniya J
dc.contributor.authorAgus, Marco
dc.contributor.authorGarbossa, Diego
dc.contributor.authorCalì, Corrado
dc.date.accessioned2021-04-18T06:20:20Z
dc.date.available2021-04-18T06:20:20Z
dc.date.issued2021-03-30
dc.date.submitted2021-01-24
dc.identifier.citationCofano, F., Di Perna, G., Bozzaro, M., Longo, A., Marengo, N., Zenga, F., … Calì, C. (2021). Augmented Reality in Medical Practice: From Spine Surgery to Remote Assistance. Frontiers in Surgery, 8. doi:10.3389/fsurg.2021.657901
dc.identifier.issn2296-875X
dc.identifier.pmid33859995
dc.identifier.doi10.3389/fsurg.2021.657901
dc.identifier.urihttp://hdl.handle.net/10754/668807
dc.description.abstractBackground: While performing surgeries in the OR, surgeons and assistants often need to access several information regarding surgical planning and/or procedures related to the surgery itself, or the accessory equipment to perform certain operations. The accessibility of this information often relies on the physical presence of technical and medical specialists in the OR, which is increasingly difficult due to the number of limitations imposed by the COVID emergency to avoid overcrowded environments or external personnel. Here, we analyze several scenarios where we equipped OR personnel with augmented reality (AR) glasses, allowing a remote specialist to guide OR operations through voice and $\textit{ad-hoc}$ visuals, superimposed to the field of view of the operator wearing them. Methods: This study is a preliminary case series of prospective collected data about the use of AR-assistance in spine surgery from January to July 2020. The technology has been used on a cohort of 12 patients affected by degenerative lumbar spine disease with lumbar sciatica co-morbidities. Surgeons and OR specialists were equipped with AR devices, customized with P2P videoconference commercial apps, or customized holographic apps. The devices were tested during surgeries for lumbar arthrodesis in a multicenter experience involving author's Institutions. Findings: A total number of 12 lumbar arthrodesis have been performed while using the described AR technology, with application spanning from telementoring (3), teaching (2), surgical planning superimposition and interaction with the hologram using a custom application for Microsoft hololens (1). Surgeons wearing the AR goggles reported a positive feedback as for the ergonomy, wearability and comfort during the procedure; being able to visualize a 3D reconstruction during surgery was perceived as a straightforward benefit, allowing to speed-up procedures, thus limiting post-operational complications. The possibility of remotely interacting with a specialist on the glasses was a potent added value during COVID emergency, due to limited access of non-resident personnel in the OR. Interpretation: By allowing surgeons to overlay digital medical content on actual surroundings, augmented reality surgery can be exploited easily in multiple scenarios by adapting commercially available or custom-made apps to several use cases. The possibility to observe directly the operatory theater through the eyes of the surgeon might be a game-changer, giving the chance to unexperienced surgeons to be virtually at the site of the operation, or allowing a remote experienced operator to guide wisely the unexperienced surgeon during a procedure.
dc.description.sponsorshipWe acknowledge Prof. Alessandro Vercelli (Department of Neuroscience, Università di Torino) for critical review of the manuscript.
dc.description.sponsorshipThis work was supported by the Kaust Innovation Fund POC grant to CC.
dc.publisherFrontiers Media SA
dc.relation.urlhttps://www.frontiersin.org/articles/10.3389/fsurg.2021.657901/full
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.titleAugmented Reality in Medical Practice: From Spine Surgery to Remote Assistance.
dc.typeArticle
dc.contributor.departmentBESE Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia.
dc.identifier.journalFrontiers in surgery
dc.eprint.versionPublisher's Version/PDF
dc.contributor.institutionIntravides SRL, Palazzo degli Istituti Anatomici, Turin, Italy.
dc.identifier.volume8
kaust.personBoges, Daniya J
dc.date.accepted2021-03-08
refterms.dateFOA2021-04-18T06:21:58Z
kaust.acknowledged.supportUnitKAUST Innovative Fund


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This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original
publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Except where otherwise noted, this item's license is described as This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.