Scientists and developers from the VIVATOP research network have developed 3D technologies that enable new, fast and precise OP preparation for surgical procedures. The results of the project are also useful during an operation and in medical training.
When a tumor is too close to important blood vessels, surgical removal can be dangerous, if not impossible. In the VIVATOP research project, scientists from the universities of Bremen and Oldenburg and their partners have now developed 3D technologies that allow the team of doctors to better assess the situation before and during the intervention. As a result, they expect better assessment of surgical options, especially in difficult cases, and a higher associated success rate. The Fraunhofer Institute MEVIS and the sales partners SZENARIS, cirp and apoQlar also participated in the association.
The joint project, which was completed at the end of June and led by the Technology Center for IT and Information Technology (TZI) at the University of Bremen, aimed to develop innovative and interactive 3D technologies at clinical use. “Modern technologies such as virtual reality, augmented reality and 3D printing offer untapped potential to improve both surgical planning and implementation as well as training,” emphasizes Prof. Rainer Malaka, CEO of the TZI.
3D organs – touch and look
Surgeons now have the ability to create realistic 3D models of affected organs, which can be both digitally viewed and made physically tangible through 3D printing. The project consortium focused primarily on the liver, but due to the pandemic also added lung imaging to support the diagnosis of COVID-19 diseases.
3D visualization of an organ in virtual or augmented reality (VR/AR) offers significant advantages over the two-dimensional images from computer or magnetic resonance imaging (CT/MRI) that have been common until now. Using special AR glasses, surgeons can view the patient-specific 3D model as a “hologram” during surgery, allowing them to rotate and rotate it using gesture control or place it manually. Before the procedure, you can visualize the effects of an incision on the liver, which is heavily supplied with blood, so that you can estimate the amount of tissue that will no longer be functional. A 3D physical model, combined with a training system, also makes it possible to practice complex interventions and stressful situations.
Successful tests in the operating room
University Medical Center Oldenburg was involved with visceral surgeon Prof. Dirk Weyhe from Pius-Hospital Oldenburg as application partner. The prototypes of the VIVATOP project have passed clinical tests there. “With the help of 3D models, we can register the complex anatomy of vessels and organs much faster,” Weyhe reports. “In CT and MRI, you have to put this together on two levels.” The hospital is run by the International Holomedicine Association as one of three “Centres of Excellence” in the world.
The researchers also incorporated a “multi-user” feature that allows multiple people to work with the model at the same time. It doesn’t matter whether the participants are in the same room or not, experts from other continents can also be connected via AR telephony. For remote experts of the operating room live streams, different displays are tested in order to present them in the most realistic way possible and give them a realistic impression of what is happening in the operating room. In preliminary discussions, however, the very real models of the 3D printer also show their strengths, since they can serve as visual objects without resorting to technology.
BMBF financing for a total amount of 2.2 million euros
The project was coordinated at the TZI of the University of Bremen by the working group “Digital Media” (Professor Rainer Malaka) and by the working group “Virtual Reality and Computer Graphics” (Professor Gabriel Zachmann). The University Clinic for Visceral Surgery at the Pius Hospital in Oldenburg (Professor Dirk Weyhe) provided the medical expertise and made the image data available. The Fraunhofer Institute for Computational Medicine MEVIS used it to create virtual and realistic organ models for AR/VR and 3D printing and researched realistic display methods. apoQlar GmbH acted as a specialist in the field of “innovative interactions, multi-user use and visualization in augmented reality”. The 3D printing specialist cirp GmbH has researched and developed innovative planning and training models. SZENARIS GmbH was responsible for the area “Training and Education” and successfully combined all technologies into a new type of training system.
The VIVATOP project was funded by the Federal Ministry of Education and Research (BMBF) to the tune of 2.2 million euros. The project partners are already transferring the results to daily practice and surgical training.