Abdominal aortic aneurysm surgery with CarnaLife Holo.
A breakthrough technology for three-dimensional visualisation of diagnostic imaging data in vascular surgery.
- ≈1 hour
- Duration of the stent graft implantation, with no unexpected complications
- HoloLens 2
- A hologram built from CT data, available to the operators throughout the procedure
- First in the region
- A pioneering abdominal aortic aneurysm operation supported by mixed reality
- Product
- CarnaLife Holo
- Client
- Department of Vascular Surgery and Angiology, University Hospital No. 1 in Lublin
- Field
- Vascular surgery
The technology.
CarnaLife Holo is a technology that supports the planning and performance of medical procedures. With Microsoft HoloLens 2 goggles, the physician sees in real space a three-dimensional hologram reflecting the structure of the imaged anatomical area. CarnaLife Holo works with hospital PACS (Picture Archiving and Communication System), which makes visualisation possible directly from the hospital's IT system and keeps the physician's workflow uninterrupted.
CarnaLife Holo works well for different teams within a single hospital and suits physicians of every specialty who already use, or would like to adopt, 3D imaging in their practice. Vascular surgery — of both the lymphatic and the blood vessels — is one example of the wide range of surgical specialties that can benefit from mixed reality technology.
The procedure.
The team of vascular surgeons from the Department of Vascular Surgery and Angiology at University Hospital No. 1 in Lublin was the first in this part of the country to successfully perform a pioneering operation on a patient with an abdominal aortic aneurysm. The procedure went ahead without unexpected complications.
The experienced operators were supported throughout by mixed reality, which gave them constant access to the patient's medical imaging data acquired from computed tomography and visualised as a hologram. The technology proved useful both for the surgeons and for the patient, indirectly helping to shorten the operation, which lasted about an hour. The patient tolerated the procedure very well, remaining under epidural anaesthesia throughout.
It is extremely important that physicians from further medical specialties appreciate and use our solution in their daily practice. We are also delighted with the positive assessment of the new CarnaLife Holo functionalities by the team at the Department of Vascular Surgery and Angiology at SPSK1 in Lublin. It is an additional motivation to develop and deploy solutions that make physicians' everyday work easier and that can, in consequence, improve patient safety and health.
Measuring anatomical structures.
An important element of the procedure was the ability to parameterise the dimensions of the aneurysm located in the patient's abdominal aorta. CarnaLife Holo includes a function for measuring anatomical structures. This feature is already medically certified for diagnostic purposes and offers:
- Unique, instant conversion of measurements from 2D into 3D and into holographic space.
- The “Cut Smart” function, showing any plane within the hologram through head movement.
- Presentation of measurements in holographic space.
- Annotations – marking a point or points of interest in the medical data that are then easy to find in holographic space. This makes it possible to mark the successive steps of a procedure and to place annotations for the operator in real time.
- Customisation options: displaying measurements to suit the operator, using different sizes, colours and modes.
What the physicians say.
It is an enormous help and it opens up additional possibilities during a procedure, as the operation confirmed. The benefits are, however, much greater. Thanks to the software we will be able to connect with other centres, also abroad, and help physicians live during surgery — or draw on such help ourselves.
Until now we performed imaging examinations on the patient before surgery and analysed the results, but we had no access to them during the procedure. They stayed in our heads. Thanks to the software we could obtain a spatial image that reproduced the patient's anatomy. We could “place” that image in front of us, touch it, rotate it freely and measure it. We saw what the arteries looked like and where the aneurysm was located. We analysed what was happening as it happened. The virtual image is so credible that the boundary between reality and the virtual world becomes blurred.
Abdominal aortic aneurysms.
Year after year, the number of abdominal aortic aneurysms diagnosed and operated on increases. They occur most often in people over 65. They are thought to be present in 2–4% of people up to the age of 65 and in around 9% of people over 75.
The presence of abdominal aortic aneurysms in older people is directly related to the half-life of elastin, which is 70 years. Abdominal aortic aneurysms are three to as much as nine times more frequent in men than in women.
Main risk factors
- Age over 65
- Male sex
- Smoking
- Genetic predisposition
- Arterial hypertension
- Pulmonary emphysema
References
- Steckmeier B: Epidemiology of aortic disease: aneurysm, dissection, occlusion. Radiologe 2001; 41(8): 624-632.
- Ligush J Jr, Pearce JD, Edwards MS et al.: Analysis of medical risk factors and outcomes in patients undergoing open versus endovascular abdominal aortic aneurysm repair. J Vasc Surg 2002; 36(3): 492-499.
- Clouse WD, Hallett JW Jr, Schaff HV: Acute aortic dissection: population-based incidence compared with degenerative aortic aneurysm rupture. Mayo Clin Proc 2004; 79(2): 176-180.
- Prisant LM, Mondy JS 3rd: Abdominal aortic aneurysm. J Clin Hypertens (Greenwich) 2004; 6(2): 85-89.
- Collin J, Araujo L, Walton J et al.: Oxford screening programme for abdominal aortic aneurysm in men aged 65 to 74 years. Lancet 1988; 2(8611): 613-615.
Summary.
The surgeons at SPSK1 were able to visualise the operated abdominal aorta holographically thanks to CarnaLife Holo and Microsoft HoloLens 2 goggles. In real space they saw a three-dimensional hologram that precisely reproduced the anatomical region being operated on. The ability to interact with the displayed hologram — rotating it, enlarging or shrinking it while maintaining sterility — was described by the Lublin surgical team as a breakthrough in their practice to date.
Not only is it easier for the surgeon to operate; as they all agree, patient safety increases as well, because the hologram helps to avoid errors in complex procedures. In this patient's case, the success of CarnaLife Holo lay in supporting a life-saving procedure: implanting a stent graft into the aorta without using a scalpel. Early diagnosis also proved crucial, as it made it possible to avoid an uncontrolled rupture of the aortic aneurysm.
Three-dimensional data visualisation during surgical interventions is already used in cardiology, interventional cardiology, orthopaedics, ENT and surgical oncology. The procedure at University Hospital No. 1 in Lublin adds vascular surgery to the list of specialties using CarnaLife Holo.
Would you like more details of the deployment?.
The PDF document contains the details of the CarnaLife Holo deployment at University Hospital No. 1 in Lublin.
See the other case studies.
Surgical oncology, interventional cardiology and orthopaedics — the full list of clinical deployments.
Would you like to see CarnaLife Holo in your centre?.
We will arrange a demonstration on your own imaging data and walk you through how the deployment in Lublin went.