2022 Fiscal Year Final Research Report

System development of intraoperative holography navigation using a mixed-reality wearable computer during laparoscopic surgery

Research Project

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Project/Area Number	19K12836
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 90130:Medical systems-related
Research Institution	医療法人社団あんしん会四谷メディカルキューブ(臨床研究管理部)
Principal Investigator	Kitagawa Michiko 医療法人社団あんしん会四谷メディカルキューブ(臨床研究管理部), 外科・内視鏡外科, 医師 (50747384)
Co-Investigator(Kenkyū-buntansha)	杉本真樹帝京大学, 付置研究所, 教授 (70398733) 春田英律医療法人社団あんしん会四谷メディカルキューブ(臨床研究管理部), 外科・内視鏡外科, 医師 (20406143)
Project Period (FY)	2019-04-01 – 2023-03-31
Keywords	Virtual reality (VR) / MIxed reality (MR) / holography navigation / 空間認識力補強 / 手術支援画像 / 腹腔鏡下手術支援システム / 手術の安全性 / 術者経験年数
Outline of Final Research Achievements	Our study aimed to assess the safety and efficacy of laparoscopic cholecystectomy (LC) using a holography-guided navigation system as an intraoperative support image. Nine patients underwent LC with 3D models generated by a wearable mixed-reality device (LC3D) and 18 underwent LC with conventional two-dimensional images (LC2D) as surgical support images. Surgical outcomes were measured, and a four-item questionnaire was used for subjective assessment. Median operative times were LC3D and LC2D were 74.0 and 58.0 minutes. Although the midcareer surgeon indicated that LC3D was "normal" or “easy” compared LC2D, the experienced surgeon rated LC3D as more difficult in 3(33%) of 9 cases. This study provides evidence that LC3D is feasible. However, the efficacy may depend on the surgeon’s experience, as indicated by the different ratings provided by the surgeons.
Free Research Field	腹腔鏡外科
Academic Significance and Societal Importance of the Research Achievements	ホログラム提示機能を有する頭部搭載型MR端末使用下腹腔鏡下胆嚢摘出術の安全性は従来の２D画像を手術支援画像として用いた手術に劣らないことが判明したが、有用性に関しては術者経験値により評価がわかれることが判明した。理由として既に高い空間認識力を持つ熟練者を執刀医とした事。高度炎症例を除外し解剖理解しやすい症例のみを適応とした事が考えられる。 feasibilityは確認できたため、今後は経験の浅い医師を術者とした場合や解剖理解が難しい高度炎症例にも対象を広げ、MR端末が術者の空間認識力を補強し手術の安全性向上に役立つかどうかについてさらなる研究を進める必要がある。