Automatic Surgery in Transcatheter Aortic Valve Replacement Using Augmented Reality

Summary

This article presents the design and implementation of an automatic surgery module based on augmented reality (AR)- based 3D reconstruction. The system enables remote surgery by allowing surgeons to inspect reconstructed features and replicate surgical hand movements as if they were performing the surgery in close proximity.

Abstract

Augmented Reality (AR) is in high demand in medical applications. The aim of the paper is to provide automatic surgery using AR for the Transcatheter Aortic Valve Replacement (TAVR). TAVR is the alternate medical procedure for open-heart surgery. TAVR replaces the injured valve with the new one using a catheter. In the existing model, remote guidance is given, while the surgery is not automated based on AR. In this article, we deployed a spatially aligned camera that is connected to a motor for the automation of image capture in the surgical environment. The camera tracks the 2D high-resolution image of the patient's heart along with the catheter testbed. These captured images are uploaded using the mobile app to a remote surgeon who is a cardiology expert. This image is utilized for the 3D reconstruction from 2D image tracking. This is viewed in a HoloLens like an emulator in a laptop. The surgeon can remotely inspect the 3D reconstructed images with additional transformation features such as rotation and scaling. These transformation features are enabled through hand gestures. The surgeon's guidance is transmitted to the surgical environment to automate the process in real-time scenarios. The catheter testbed in the surgical field is controlled by the hand gesture guidance of the remote surgeon. The developed prototype model demonstrates the effectiveness of remote surgical guidance through AR.

Introduction

AR can superimpose the 3D model in a real-world environment. The technological development towards AR has made a paradigm shift in many fields, namely education¹, medical², manufacturing³, and entertainment⁴. AR technology, along with ultra-reliable low-latency communication, proves its inevitable role in the medical field. From the learning stage of human anatomy to surgical guidance, the stages of learning can be visualized with AR-powered software^5,6 and hardware. AR provides a crucial and r....

Protocol

1. Surgical environment

1. Design a surgery environment as shown in Figure 1. Make sure the environment has an object-carrying platter, a robotic arm, and two side-hanging arms, one to hold a camera placeholder and the other to have a consistent white background along with the weighing module for balance.
2. Develop two drivers, one for the snapshot of the live surgical environment, as mentioned in steps 2.1 to 2.10, and the other to control the revolving mec.......

Discussion

In an existing work¹⁵, X-ray and CT scans are examined to locate the catheter in the heart. However, AR TAVR replacement establishes a new possibility in TAVR¹⁸ surgical procedure by the implementation of an automated model using 3D reconstruction. As mentioned in the protocol section this work has five stages to design. The first stage of DITF²², mentioned in section 6, which we proposed in our previous work²², is enhanced in.......

Materials

Name	Company	Catalog Number	Comments
android IDE	software	https://developer.android.com/studio	software can be downloaded from this link
Arduino Board	Ardunio Uno	Ardunio Uno	Microcontroller for processing
arduino software	software	https://www.arduino.cc/en/software.	software can be downloaded from this link
Human Heart phantom model	Biology Lab Equipment Manufacturer and Exporter	B071YBLX2V(8B-ZB2Q-H3MS-1)	light weight model with 3parts to the deep analysis of heart.
mobile holder	Humble universal monopoad holder	B07S9KNGVS	To carry the mobile in surgical field
pycharm IDE	software	https://www.jetbrains.com/pycharm/	software can be downloaded from this link
Robot arm	Printed-bots	B08R2JLKYM(P0-E2UT-JSOU)	arm can be controlled through control signal.it has 5 degree of freedom to access.
servo motor	Kollmorgen Co-Engineers Motors	MG-966R	high-torque servo motor,servo pulses ranging from 500 to 2500 microseconds (µs), with a frequency of 50Hz to 333Hz.
servomotor	Kollmorgen Co-Engineers Motors	SG-90R	1.8 kg-cm to 2.5 kg-cm load can be applied to SG-90R servo.
Stepper Motor	28BYJ-48	28BYJ-48	Steper motor, 5V DC, 100 Hz frequency, torque 1200 Gf.cm
Stepper Motor	Nema 23	Nema	Steper motor, 9V - 42 V DC, 100 Hz frequency