著者らは、この研究に対する資金提供がないことを認めています。

1.手術環境
<ol><li>図 1 に示すように、手術環境を設計します。物体を運ぶプラッター、ロボットアーム、2つの側面にぶら下がったアームがあり、1つはカメラのプレースホルダーを保持し、もう1つはバランスをとるための白い背景を持つように環境にあることを確認してください。</li>
	<li>ステップ 2.1 から 2.10 で説明したように、ライブ手術環境のスナッ...

リモートAR支援手術のための最適化された3D再構成とモーションマッピング

<ol>
	<li>Wang, L. J., Casto, B., Reyes-Molyneux, N., Chance, W. W., Wang, S. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Smartphone-based+augmented+reality+patient+education+in+radiation+oncology.">Smartphone-based augmented reality patient education in radiation oncology.</a> Tech Innov Patient Supp Radiation Oncol. 29, 100229 (2024).</li><li>Guerroudji, M. A., Amara, K., Lichouri, M., Zenati, N., Masmoudi, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+3D+visualization-based+augmented+reality+application+for+brain+tumor+segmentation.">A 3D visualization-based augmented reality application for brain tumor segmentation.</a> Comput Anim Virtual Worlds. 35 (1), e2223 (2024).</li><li>Xia, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Augmented+reality+and+indoor+positioning+based+mobile+production+monitoring+system+to+support+workers+with+human-in-the-loop.">Augmented reality and indoor positioning based mobile production monitoring system to support workers with human-in-the-loop.</a> Robotic Comput Integ Manufac. 86, 102664 (2024).</li><li>Preece, C., Skandalis, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Time+to+imagine+an+escape:+investigating+the+consumer+timework+at+play+in+augmented+reality.">Time to imagine an escape: investigating the consumer timework at play in augmented reality.</a> Eur J Market. 58, 92-118 (2024).</li><li>Suresh, D., Aydin, A., James, S., Ahmed, K., Dasgupta, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+role+of+augmented+reality+in+surgical+training:+a+systematic+review.">The role of augmented reality in surgical training: a systematic review.</a> Surg Innov. 30, 366-382 (2023).</li><li>Moreta-Martinez, R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Combining+augmented+reality+and+3D+printing+to+display+patient+models+on+a+smartphone.">Combining augmented reality and 3D printing to display patient models on a smartphone.</a> J Vis Exp. (155), 60618 (2020).</li><li>Ma, L., Huang, T., Wang, J., Liao, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Visualization,+registration+and+tracking+techniques+for+augmented+reality+guided+surgery:+a+review.">Visualization, registration and tracking techniques for augmented reality guided surgery: a review.</a> Phys Med Biol. 68, 04TR02 (2023).</li><li>Hofman, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=First-in-human+real-time+ai-assisted+instrument+deocclusion+during+augmented+reality+robotic+surgery.">First-in-human real-time ai-assisted instrument deocclusion during augmented reality robotic surgery.</a> Healthc Technol Lett. 11 (2-3), 33-39 (2023).</li><li>Thiene, G., Rizzo, S., Basso, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Bicuspid+aortic+valve:+The+most+frequent+and+not+so+benign+congenital+heart+disease.">Bicuspid aortic valve: The most frequent and not so benign congenital heart disease.</a> Cardiovasc Pathol. 70, 107604 (2024).</li><li>Mack, M. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transcatheter+aortic-valve+replacement+in+low-risk+patients+at+five+years.">Transcatheter aortic-valve replacement in low-risk patients at five years.</a> New Engl J Med. 389, 1949-1960 (2023).</li><li>Vitanova, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Aortic+valve+versus+root+surgery+after+failed+transcatheter+aortic+valve+replacement.">Aortic valve versus root surgery after failed transcatheter aortic valve replacement.</a> J Thorac Cardiovas Surg. 166, 1418-1430 (2023).</li><li>Bydlon, T. M., Torjesen, A., Fokkenrood, S., Di Tullio, A., Flexman, M. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=3d+visualisation+of+navigation+catheters+for+endovascular+procedures+using+a+3d+hub+and+fiber+optic+realshape+technology:+phantom+study+results.">3d visualisation of navigation catheters for endovascular procedures using a 3d hub and fiber optic realshape technology: phantom study results.</a> EJVES Vascular Forum. 59, 24-30 (2023).</li><li>Faris, H., Harfouche, C., Bandle, J., Wisbach, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Surgical+tele-mentoring+using+a+robotic+platform:+initial+experience+in+a+military+institution.">Surgical tele-mentoring using a robotic platform: initial experience in a military institution.</a> Surg Endosc. 37, 9159-9166 (2023).</li><li>Fitzgerald, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mentoring+approaches+in+a+safe+surgery+program+in+tanzania:+Lessons+learned+during+covid-19+and+recommendations+for+the+future.">Mentoring approaches in a safe surgery program in tanzania: Lessons learned during covid-19 and recommendations for the future.</a> Surg Open Sci. 14, 109-113 (2023).</li><li>de Turenne, A., Eug&#232;ne, F., Blanc, R., Szewczyk, J., Haigron, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Catheter+navigation+support+for+mechanical+thrombectomy+guidance:+3d/2d+multimodal+catheter-based+registration+with+no+contrast+dye+fluoroscopy.">Catheter navigation support for mechanical thrombectomy guidance: 3d/2d multimodal catheter-based registration with no contrast dye fluoroscopy.</a> Int J Comput Assist Radiol Surg. 19 (3), 459-468 (2023).</li><li>Tang, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+multiple+catheter+tips+tracking+method+in+x-ray+fluoroscopy+images+by+a+new+lightweight+segmentation+network+and+bayesian+filtering.">A multiple catheter tips tracking method in x-ray fluoroscopy images by a new lightweight segmentation network and bayesian filtering.</a> Int J Med Robotics Comput Assist Surg. 19, e2569 (2023).</li><li>Annabestani, M., Caprio, A., Wong, S. C., Mosadegh, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+machine+learning-based+roll+angle+prediction+for+intracardiac+echocardiography+catheter+during+bi-plane+fluoroscopy.">A machine learning-based roll angle prediction for intracardiac echocardiography catheter during bi-plane fluoroscopy.</a> Appl Sci. 13, 3483 (2023).</li><li>Thourani, V. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Survival+after+surgical+aortic+valve+replacement+in+low-risk+patients:+a+contemporary+trial+benchmark.">Survival after surgical aortic valve replacement in low-risk patients: a contemporary trial benchmark.</a> Ann Thorac Surg. 117, 106-112 (2024).</li><li>Dom&#237;nguez-Velasco, C. F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Augmented+reality+simulation+as+training+model+of+ventricular+puncture:+Evidence+in+the+improvement+of+the+quality+of+punctures.">Augmented reality simulation as training model of ventricular puncture: Evidence in the improvement of the quality of punctures.</a> Int J Med Robotics Comput Assist Surg. 19, e2529 (2023).</li><li>Wang, Q., Xie, Z. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Arias:+An+ar-based+interactive+advertising+system.">Arias: An ar-based interactive advertising system.</a> Plos One. 18, e0285838 (2023).</li><li>Ji, F., Chong, F., Wang, F., Bai, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Augmented+reality+platform+for+the+unmanned+mining+process+in+underground+mines.">Augmented reality platform for the unmanned mining process in underground mines.</a> Mining,Metal Explor. 39 (2), 385-395 (2022).</li><li>Indhumathi, S., Clement, J. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Directional+intensified+feature+description+using+tertiary+filtering+for+augmented+reality+tracking.">Directional intensified feature description using tertiary filtering for augmented reality tracking.</a> Sci Rep. 13, 20311 (2023).</li><li>Gao, L., Zhao, Y., Han, J., Liu, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Research+on+multi-view+3D+reconstruction+technology+based+on+SFM.">Research on multi-view 3D reconstruction technology based on SFM.</a> Sensors. 22 (12), 4366 (2022).</li><li>Su&#225;rez, I., Sfeir, G., Buenaposada, J. M., Baumela, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=BEBLID:+Boosted+efficient+binary+local+image+descriptor.">BEBLID: Boosted efficient binary local image descriptor.</a> Pattern Recog Lett. 133, 366-372 (2020).</li><li>Borman, R. I., Harjoko, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Improved+ORB+algorithm+through+feature+point+optimization+and+Gaussian+pyramid.">Improved ORB algorithm through feature point optimization and Gaussian pyramid.</a> Int J Adv Comp Sci Appl. 15 (2), 268-275 (2024).</li></ol>

著者は、利益相反を宣言しません。

既存の研究15では、X線およびCTスキャンを検査して、心臓内のカテーテルの位置を特定する。しかし、AR TAVRの置換は、3D再構成を使用した自動モデルの実装により、TAVR18の外科的処置に新たな可能性を確立します。プロトコルのセクションで述べたように、この作業には設計するための5つの段階があります。前回の研究22で提案したセク?...

ARは、3Dモデルを現実世界の環境に重ね合わせることができます。ARに向けた技術開発は、教育1、医療2、ものづくり3、エンターテインメント4など、多くの分野でパラダイムシフトを起こしています。AR技術は、超高信頼性の低遅延通信とともに、医療分野での必然的な役割を証明しています。人体解剖学の学習段階から外科的指導まで、ARを利用したソフトウェア5,6とハードウェアを使用して学習段階を視覚化できます。ARは、外科環境7,8の医療従事者に重要で信頼性の高いソリューションを提供します。
大動脈弁狭窄症は、人類に最も多く見られる心臓弁膜症です9。この病気の根本的な原因は、貧しい食生活と日常生活の不規則なルーチンです。この疾患の症状と結果は、心臓弁の狭窄とそれに続く血流の減少です。この問題は、人間の心臓に損傷が生じる前に対処する必要があります。したがって、心臓は血流を処理するために過度の負担がかかります。したがって、損傷が発生する前に、手術を行う必要がありますが、これは最近の技術開発により、TAVR手順を使用して行うこともできます。この手順は、患者の心臓やその他の体の部分の状態に基づいて採用できます。このTAVR10,11では、カテーテルを挿入して心臓の損傷した弁を交換します。しかし、カテーテルの位置12をバルブと交換するために配置することは、施術者にとって面倒な作業である。このアイデアから、AR13,14 に基づく自動手術モデルを設計することになりました。これにより、外科医は置換プロセス中に弁を正確に配置できます。さらに、手術は、遠隔地からキャプチャされた外科医の動きをロボットアームにマッピングするモーションマッピングアルゴリズムによって実行できます。
既存の作品15、16、17では、TAVR18 の手順の視覚化が透視法を通じて監視されている。したがって、心臓弁を分析することは困難であり、交換場所を見つけるのは面倒です。これにより、カテーテルを人間の心臓に配置する際の障壁が設定されます。さらに、リモートモーションは手術野にマッピングされ、プロセスが自動化されます。しかし、この研究ギャップを克服するために、AR支援技術を用いたロボットによる弁置換術の自動化を提案します。
このプロトコルは、すべての手術環境に適用できる汎用モデルです。作業の初期段階では、手術環境全体の2D画像が、最大自由度の最大の空間分解能でキャプチャされます。これは、3D再構成19 の目的に十分な画像がキャプチャされ、続いてハンドジェスチャトラッキング20によるモーションマッピングが続くことを意味する。

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>android IDE</td>
			<td>software</td>
			<td>https://developer.android.com/studio</td>
			<td>software can be downloaded from this link</td>
		</tr>
		<tr>
			<td>Arduino Board</td>
			<td>Ardunio Uno</td>
			<td>Ardunio Uno</td>
			<td>Microcontroller for processing</td>
		</tr>
		<tr>
			<td>arduino software</td>
			<td>software</td>
			<td>https://www.arduino.cc/en/software.</td>
			<td>software can be downloaded from this link</td>
		</tr>
		<tr>
			<td>Human Heart phantom model</td>
			<td>Biology Lab Equipment Manufacturer and Exporter</td>
			<td>B071YBLX2V(8B-ZB2Q-H3MS-1)</td>
			<td>light weight model with 3parts to the deep analysis of heart.</td>
		</tr>
		<tr>
			<td>mobile holder</td>
			<td>Humble universal monopoad holder</td>
			<td>B07S9KNGVS</td>
			<td>To carry the mobile in surgical field</td>
		</tr>
		<tr>
			<td>pycharm IDE</td>
			<td>software</td>
			<td>https://www.jetbrains.com/pycharm/</td>
			<td>software can be downloaded from this link</td>
		</tr>
		<tr>
			<td>Robot arm</td>
			<td>Printed-bots</td>
			<td>B08R2JLKYM(P0-E2UT-JSOU)</td>
			<td>arm can be controlled through control signal.it has 5 degree of freedom to access.</td>
		</tr>
		<tr>
			<td>servo motor</td>
			<td>Kollmorgen Co-Engineers Motors</td>
			<td>MG-966R</td>
			<td>high-torque servo motor,servo pulses ranging from 500 to 2500 microseconds (&#181;s), with a frequency of 50Hz to 333Hz.&#160;</td>
		</tr>
		<tr>
			<td>servomotor</td>
			<td>Kollmorgen Co-Engineers&#160;Motors</td>
			<td>SG-90R</td>
			<td>1.8 kg-cm to 2.5 kg-cm load can be applied to SG-90R servo.</td>
		</tr>
		<tr>
			<td>Stepper Motor</td>
			<td>28BYJ-48</td>
			<td>28BYJ-48</td>
			<td>Steper motor, 5V DC, 100 Hz frequency, torque 1200 Gf.cm</td>
		</tr>
		<tr>
			<td>Stepper Motor</td>
			<td>Nema 23</td>
			<td>Nema</td>
			<td>Steper motor, 9V - 42 V DC, 100 Hz frequency</td>
		</tr>
	</tbody>
</table>

automatic surgery in transcatheter aortic valve replacement using augmented reality

拡張現実(AR)は、医療用途で高い需要があります。この論文の目的は、経カテーテル大動脈弁置換術 (TAVR) に AR を使用した自動手術を提供することです。TAVRは、開心術の代替医療処置です。TAVRは、カテーテルを使用して負傷した弁を新しい弁に交換します。既存のモデルでは、遠隔指導が行われていますが、ARによる手術の自動化は行われていません。この記事では、手術環境での画像キャプチャを自動化するために、モーターに接続された空間的に整列したカメラを展開しました。カメラは、カテーテルテストベッドとともに患者の心臓の2D高解像度画像を追跡します。これらのキャプチャされた画像は、モバイルアプリを使用して、心臓病学の専門家である遠隔外科医にアップロードされます。この画像は、2D画像トラッキングからの3D再構成に利用されます。これは、ラップトップのエミュレーターのように HoloLens に表示されます。外科医は、回転やスケーリングなどの追加の変換機能を使用して、3D再構築された画像をリモートで検査できます。これらの変換機能は、手のジェスチャによって有効になります。外科医のガイダンスは手術環境に送信され、リアルタイムのシナリオでプロセスが自動化されます。手術野のカテーテルテストベッドは、遠隔外科医の手のジェスチャーガイダンスによって制御されます。開発した試作モデルは、ARによる遠隔手術指導の有効性を実証しています。

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 software5,6 and hardware. AR provides a crucial and reliable solution to the medical practitioner in a surgical environment7,8.
Aortic valve stenosis is the heart valve disease, which is most common among mankind9. The root cause of the disease is poor food habits and irregular routines of day-to-day life. The symptom and result of the disease is the narrowing of the heart valve, followed by a reduction in the blood flow. This problem needs to be addressed before any damage takes place to the human heart. Thus, the heart is overburdened to process the blood flow. So, before any damage happens, surgery needs to be done, which, owing to technological developments in recent days, can also be done using the TAVR procedure. The procedure can be adopted based on the condition of the heart and other body parts of patients. In this TAVR10,11, the catheter is inserted to replace the damaged valve in the heart. However, placing the catheter position12 to replace the valve is tedious for the practitioner. This idea motivated us to design an automated surgery model based on AR13,14, which helps the surgeon to precisely position the valve during the replacement process. Moreover, the surgery can be performed by a motion mapping algorithm, which maps the surgeon&#39;s movement captured from a remote location to the robotic arm.
In the existing work15,16,17, the visualization of the TAVR18 procedure is monitored through fluoroscopy. Hence, it is difficult to analyze the heart valve and tedious to find the replacement location. This sets up a barrier to positioning the catheter in the human heart. In addition, the remote motion is mapped to the surgical field to make the process automated. However, to overcome the research gap, we propose an automated robotic-based surgery for valve replacement using AR-assisted technology.
The protocol is a generic model that can be applied to all surgical environments. In the beginning stage of the work, 2D images are captured all around the surgical environment with the fullest spatial resolution of the largest degree of freedom. This means that enough images are captured for 3D reconstruction19 purpose, followed by motion mapping through hand gesture tracking20.

著者スポットライト:拡張現実とロボティクスによる遠隔手術の革命による精度とアクセシビリティの向上

拡張現実(AR)を用いた経カテーテル的大動脈弁置換術における自動手術

Our research focuses on revolutionizing remote surgery through augmented reality and robotics, aiming to enhance precision and accessibility in medical procedures. We are exploring how real-time 3D reconstruction and feature extraction can provide surgeons with unprecedented control and visualization, even from a distance. We have implemented our own directional intensified feature extraction to ensure precise and accurate detection of surgical features, enhancing the surgeon's control over the robotic arm.By using 3D reconstruction from minimal 2D images, we have significantly reduced the hardware complexity and improved the efficiency of our system. Our system provides the best surveillance of the surgical environment using a single mobile camera synchronized to take snaps every two seconds, ensuring real-time updates for the remote surgeon. We have developed seamless communication protocols with low latency and high reliability using Bluetooth and LAN, ensuring uninterrupted and accurate data transmission.Our approach to achieve precise, real-time synchronization between video feeds and robotic arm responses can serve as a benchmark for future research in remote surgery and telemedicine. It offers a model for integrating real-time data with robotic control systems. Our approach to achieve precise real-time synchronization between video feeds and robotic arm responses can serve as a benchmark for future research in remote surgery and telemedicine.It offers a model for integrating real-time data with robotic control systems.

プロトコルは、心臓ファントムモデルでテストされました。 図2 は、空間的に分散したカメラを使用した術野のライブ監視に期待されるセットアップを示しています。 図 2 に示すように、分散カメラは、フィールドの空間分解能を向上させ、効果的な 3D 再構成に役立ちます。ただし、これらのカメラをさまざまな空間場所に物理的に配置するに?...

この記事では、拡張現実(AR)ベースの3D再構成に基づく自動手術モジュールの設計と実装について説明します。このシステムは、外科医が再構築された特徴を検査し、手術の手の動きをあたかも近くで手術を行っているかのように再現できるようにすることで、遠隔手術を可能にします。

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 ...

automatic-surgery-transcatheter-aortic-valve-replacement-using

Research

JoVE Journal

Medicine

Automatic Surgery in Transcatheter Aortic Valve Replacement Using Augmented Reality

297 Views.  Vellore Institute of Technology, Vellore. Our research focuses on revolutionizing remote surgery through augmented reality and robotics, aiming to enhance precision and accessibility in medical procedures. We are exploring how real-time 3D reconstruction and feature extraction can provide surgeons with unprecedented control and visualization, even from a distance. We have implemented our own directional intensified feature extraction to ensure precise and accurate detection of surgical features, enhancing the surgeon's control over t...