拓展现实技术在临床手术中的应用

Application of extended reality technology for real-time navigation in clinical operation

为了探究拓展现实技术(XR)在临床手术中的应用和发展,促进XR技术高质量辅助临床手术。本研究针对基于二维图像的微创手术导航,医生难以准确判断病灶的位置、大小和几何形状且具有潜在辐射危险等问题,使用CT数据进行三维建模,依托XR技术实现术中导航,采用改进的四元数法提升电磁定位精度,系统定位精度的误差小于2 mm;针对远程手术网络数据传输卡顿、延迟等现象,依托5G网络优化服务器GPU编程算法、视频流实时编码策略和网络设计,实现了数据传输低延迟,平均延迟小于60 ms;采用高斯分布变形模型模拟碰撞检测和组织的应力形变,实现触觉感知效果。研究表明,基于XR技术的术中导航,能够更准确地确定病灶的位置,有效地降低了手术风险,且避免了术中辐射;5G网络低延迟、高保真特性使手术中实时交互成为可能,为多终端远程协同手术提供了技术基础;将力反馈技术与XR技术结合,实现具有触感的体验,使医生能够进行深度沉浸式的术前规划和虚拟手术,提高了手术成功率,缩短医生的学习曲线。XR技术赋能临床手术,对提高我国临床手术领域的源头创新能力具有积极意义,对推动手术模式创新的研究具有重要价值。

Objective To explore the application of extended reality(XR) technology in clinical surgeries for improving the success rate of surgeries. Methods To assist the surgeons to better understand the location, size and geometric shape of the lesions and reduce potential radiation exposure in minimally invasive surgical navigation based on two-dimensional images,we constructed three-dimensional models based on CT data and used XR technology to achieve intraoperative navigation. An improved quaternion method was used to improve the accuracy of electromagnetic positioning, with which the system error of positioning accuracy was reduced to below 2 mm. A 5G network was used to optimize the server GPU programming algorithm, and real-time video stream coding strategy and network design were adopted to reduce data transmission jam and delay in the remote surgery network, which achieved an average delay of less than 60 ms. A Gaussian distribution deformation model was used to simulate collision detection and stress deformation of the tissues to achieve a tactile perception effect.Results and conclusion The intraoperative navigation system based on XR technology allowed more accurate determination of the location of the lesions, effectively reduced the surgical risk, and avoided the risk of intraoperative radiation exposure.The low latency and high fidelity of 5G network achieved real-time interaction during the surgery to provide a technical basis for multi-terminal remote cooperative surgery. The combination of force feedback technology and XR technology enables the surgeons to conduct deep immersion preoperative planning and virtual surgery to improve the success rate of surgery and shorten the learning curve.