Abstracts

Rationale:  The neuronavigator has become indispensable for brain surgery and works in the manner of point-to-point navigation. Because the positional information is indicated on a personal computer (PC) monitor, surgeons are required to rotate the dimension of the magnetic resonance imaging/computed tomography scans to match the surgical field. In addition, they must frequently alternate their gaze between the surgical field and the PC monitor.To overcome these difficulties, we developed an augmented reality-based navigation system, and applied in the epilepsy surgery. Methods: A tablet PC or a surgical microscope is used for visualization. The patient’s head is captured by the back-face camera of the tablet/microscope. Three-dimensional images of intracranial structures are extracted from magnetic resonance imaging/computed tomography and are superimposed on the video image of the head. When viewed from various directions around the head, intracranial structures are displayed with corresponding angles as viewed from the camera direction, thus giving the surgeon the sensation of seeing through the head.  Results: The present system was evaluated in 2 patients who underwent trans-sylvian uncal selective amygdalo-hippocampectomy, and we showed that the system is useful for planning uncal incisions intruding into the inferior horn of lateral ventricles with the real time acquisition of the 3D structures of the mesial structures. Conclusions: The main advantage of the present system is that it achieves volumetric navigation in contrast to conventional point-to-point navigation. It extends augmented reality images directly onto real surgical images, thus helping the surgeon to integrate these 2 dimensions intuitively.  Funding: None