Unbounded surgical reality: Development and assessment of augmented reality navigation for image-guided surgery

Image-guided surgery with navigation technology has significantly improved procedures in neurosurgery, orthopedic surgery and craniomaxillofacial surgery. Navigation systems have become standard and are commonly used in today’s operating rooms. With new technological advancements such as artificial intelligence (AI) and extended reality (XR), surgical navigation can be further improved. Current surgical navigation systems, while effective, suffer from several limitations, including bulky hardware setups, 2D visualization, and the need of surgeons to frequently shift their attention between the patient and navigation display. Augmented reality (AR), a new visualization paradigm, permits overlaying virtual content onto the physical environment while maintaining direct access to the real world. Head-mounted display (HMD) AR headsets, such as the Microsoft HoloLens 2 and Magic Leap 2, are compact computing devices equipped with integrated sensors and optical-see through displays. These devices hold the potential to transform surgical navigation by offering more intuitive 3D visualization with integrated tracking capabilities.

This thesis investigates the potential of AR HMDs for surgical navigation and assesses their feasibility for clinical use. The work focuses on three main objectives: First, to investigate and validate the core components required in surgical navigation and evaluate their applicability with AR HMDs. Second, to integrate these components into a complete end-to-end AR-based surgical navigation system. And third, to assess the accuracy and performance of such systems in guiding surgical tasks.