High-Quality See-Through Surgical Guidance System Using Enhanced 3-D Autostereoscopic Augmented Reality

Objective: Precise minimally invasive surgery (MIS) has significant advantages over traditional open surgery in clinic. Although pre-/intraoperative diagnosis images can provide necessary guidance for therapy, hand-eye discoordination occurs when guidance information is displayed away from the surgical area. In this study, we introduce a real three-dimensional (3-D) see-through guidance system for precision surgery. Methods: To address the resolution and viewing angle limitation as well as the accuracy degradation problems of autostereoscopic 3-D display, we design a high quality and high accuracy 3-D integral videography (IV) medical image display method. Furthermore, a novel see-through microscopic device is proposed to assist surgeons with the superimposition of real 3-D guidance onto the surgical target is magnified by an optical visual magnifier module. Results: Spatial resolutions of 3-D IV image in different depths have been increased 50%~70%, viewing angles of different image sizes have been increased 9%~19% compared with conventional IV display methods. Average accuracy of real 3-D guidance superimposed on surgical target was 0.93 mm ± 0.41 mm. Preclinical studies demonstrated that our system could provide real 3-D perception of anatomic structures inside the patient's body. Conclusion: The system showed potential clinical feasibility to provide intuitive and accurate in situ see-through guidance for microsurgery without restriction on observers' viewing position. Significance: Our system can effectively improve the precision and reliability of surgical guidance. It will have wider applicability in surgical planning, microscopy, and other fields.