Currently, the method of evaluating a student’s skill is a professor’s observation of the student performing the intervention. The novel system developed here (EDU) provides quantitative metrics by continuously tracking the position of the probe and the instrument [1]. EDU provides artificial intelligence-based instrument guidance. The device allows students to select a target and receive guidance about the orientation of the needle required to reach that target prior to insertion. The device also provides continuous visual overlay of the needle trajectory and the needle tip location at all times during the procedure. EDU can operate under a with-guidance and without-guidance mode, with the ability to evaluate the same performance metrics in both modes. A total of 5 different scoring criteria were identified for use in assessing student performance.
srbadv0208
Augmented Reality Based Surgical Navigation of Complex Pelvic Osteotomies—A Feasibility Study on Cadavers
Augmented reality (AR)-based surgical navigation may offer new possibilities for safe and accurate surgical execution of complex osteotomies. In this study we investigated the feasibility of navigating the periacetabular osteotomy of Ganz (PAO), known as one of the most complex orthopedic interventions, on two cadaveric pelves under realistic operating room conditions. Preoperative planning was conducted on computed tomography (CT)-reconstructed 3D models using an in-house developed software, which allowed creating cutting plane objects for planning of the osteotomies and reorientation of the acetabular fragment. An AR application was developed comprising point-based registration, motion compensation and guidance for osteotomies as well as fragment reorientation. Navigation accuracy was evaluated on CT-reconstructed 3D models, resulting in an error of 10.8 mm for osteotomy starting points and 5.4° for osteotomy directions. The reorientation errors were 6.7°, 7.0° and 0.9° for the x-, y- and z-axis, respectively. Average postoperative error of LCE angle was 4.5°. Our study demonstrated that the AR-based execution of complex osteotomies is feasible. Fragment realignment navigation needs further improvement, although it is more accurate than the state of the art in PAO surgery.
Use of Computer-Assisted Instrument Guidance Technology by Student Registered Nurse Anesthetists for Simulated Invasive Procedures
This study was conducted to determine if computer-assisted instrument guidance (CAIG, Clear Guide Medical), with an optical tracking mechanism, enhances simulated transversus abdominis plane (TAP) block performance in a porcine model by novice student registered nurse anesthetists (SRNAs) compared with standalone ultrasonography (US). In a crossover design, 26 students were randomly assigned into 2 groups: US only and CAIG. Performance was assessed using a task-specific checklist survey tool and a global rating scale to assess performance. Time to hydrodissection and number of insertion attempts were recorded. A pre-procedure and postprocedure survey obtained participants’ demographics and measured overall experience. Results revealed higher mean scores for all items in the global rating scale and overall performance (P = .010). The checklist survey results indicated no significant between-group differences. The CAIG group was observed to have significantly lower simulated block performance times (P = .037) and number of attempts (P = .002). The postprocedure survey results showed most participants (88%) reported an enhanced experience using the CAIG. Use of the CAIG showed favorable results in novice SRNAs performing the simulated block. Procedure performance, number of attempts, and time to complete were significantly lower, with a strong preference for the CAIG system.
Computer-Assisted Needle Navigation for Pediatric Internal Jugular Central Venous Cannulation: A Feasibility Study
Vascular access for central venous catheter (CVC) placement is technically challenging in children. Ultrasound (US) guidance is recommended for pediatric CVC placement, yet many practitioners rely on imprecise anatomic landmark techniques risking procedure failure due to difficulty mastering US guidance. A novel navigation system provides a visual overlay on real-time US images to depict needle trajectory and tip location during cannulation. We report the first pediatric study assessing feasibility and preliminary safety of using a computer-assisted needle navigation system to aid in central venous access.
Registration made easy – standalone orthopedic navigation with HoloLens
In surgical navigation, finding correspondence between preoperative plan and intraoperative anatomy, the so-called registration task, is imperative. One promising approach is to intraoperatively digitize anatomy and register it with the preoperative plan. State-of-the-art commercial navigation systems implement such approaches for pedicle screw placement in spinal fusion surgery. Although these systems improve surgical accuracy, they are not gold standard in clinical practice. Besides economical reasons, this may be due to their difficult integration into clinical workflows and unintuitive navigation feedback. Augmented Reality has the potential to overcome these limitations. Consequently, we propose a surgical navigation approach comprising intraoperative surface digitization for registration and intuitive holographic navigation for pedicle screw placement that runs entirely on the Microsoft HoloLens. Preliminary results from phantom experiments suggest that the method may meet clinical accuracy requirements.
Kenny Harlan
Kenny directs the sales and clinical segment of our company. Working side by side with physicians to maximize their efforts in radiation reduction, procedure time as well as overall patient and staff satisfaction.He has over 25years of experience in capital medical sales with focus on diagnostic and surgical ultrasound. He holds BS in Biology.
Paul C Clark
Paul is steering the company through its expanded launch and adoption in the marketplace, guiding its accelerated growth. Dr. Clark’s technical expertise includes network systems and security, computer graphics systems and intellectual property law. He also creates and invests in leading edge technology companies and is the named inventor on several patents. He serves on Federal Advisory and other Boards and has served as an invited expert before Congress.
Dr. Clark holds a BS in Mathematics from the University of California, Irvine, and an MS in Electrical Engineering from University of Southern California. He completed his doctorate in Electrical Engineering and Computer Science at the George Washington University.
James J Condon
Jim provides guidance to the company, and has more than 30 years of broad-based experience in running existing companies, scaling start-ups, and repairing troubled companies. He has an established skill set in instituting sound operational, information technology, human resources, marketing and financial infrastructures, negotiating business relationships and acquisitions, raising capital and hiring senior staff.
He holds an MBA in Finance from the University of Chicago and a BS in Mathematical Sciences from the Johns Hopkins University. He is currently Chairman of the Johns Hopkins Computer Science program’s Advisory board, and a Blue & Gold Officer for the United States Naval Academy.
Nick Karahalios
Nick is using his clinical expertise to integrate and facilitate development of ClearGuide Synergy Systems. Karahalios’ clinical expertise is centered around 25 years of both inpatient and outpatient medical care.
Karahalios holds a BS in Biology from the University of California Irvine and an MD from University of Southern California and an Internal Medical Residency from University of California Irvine. He is a Board-Certified Internist since 1995 and currently President of San Clemente Internal Medical Group. Karahalios has Chaired the Pharmacy and Therapeutic committee, been a member of General Executive Committee, as well as a Delegate of the Medicine Executive committee at San Clemente Hospital.
