Scientists and developers of the VIVATOP research network have developed 3D technologies that enable novel, fast and precise OP preparation for surgical interventions. The project results also help during an operation and in medical training.
When a tumor is too close to important blood vessels, surgical removal can be dangerous or even impossible. In the VIVATOP research project, scientists from the Universities of Bremen and Oldenburg and their partners have now developed 3D technologies that enable the team of doctors to better assess the situation before and during the procedure. As a result, they expect a better assessment of the surgical options, especially in difficult cases, and an associated higher success rate. The Fraunhofer Institute MEVIS and the business 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 Information Technology and Information Technology (TZI) at the University of Bremen, aimed to develop innovative and interactive 3D technologies for 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 Professor Rainer Malaka, Managing Director of the TZI.
Organs in 3D – to touch and to look at
Surgeons now have the opportunity to create realistic 3D models of the affected organs, which can be both digitally visualized and made physically tangible using 3D printing. The project consortium focused mainly on the liver, but due to the pandemic, also added imaging of lungs to support the diagnosis of COVID-19 diseases.
The 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 customary up to now. With the help of special AR glasses, surgeons can view the patient-specific 3D model as a ‘hologram’ during the operation, where by they can rotate and turn it using gesture control or place it manually. Before the procedure, you can view the effects of an incision on the liver, which is heavily supplied with blood, in order to be able to estimate how much tissue will then no longer be functional. A physical 3D model, in combination with a training system, also allows complex interventions and stressful situations to be practiced.
Tests passed in the OR
The University Medical Center Oldenburg was involved with the visceral surgeon Professor Dirk Weyhe from the Pius-Hospital Oldenburg as an application partner. The prototypes from the VIVATOP project passed clinical testing there. “With the help of the 3D models, we can record the complex vascular and organ anatomy much more quickly,” reports Weyhe. “In CT and MRI, you have to put this together from two levels.” The hospital is run by the international Holomedicine Association as one of three “Centers of Excellence” worldwide.
The researchers have also built in a “multi-user” functionality that allows several 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 the remote experts in the live streams from the OR, various displays are tested in order to present them as realistically as possible and to give them a realistic impression of what is happening in the OR. In preliminary discussions, however, the very real models from the 3D printer also show their strengths, because they can serve as visual objects without the use of technology.
BMBF funding with a total 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 Oldenburg (Professor Dirk Weyhe) provided the medical expertise and made the image data available. The Fraunhofer Institute for Digital Medicine MEVIS used this to create virtual, realistic organ models for AR/VR and 3D printing and researched realistic display methods. apoQlar GmbH was involved as a specialist in the field of “innovative interactions, multi-user use and visualization in augmented reality”. The 3D printing specialist cirp GmbH researched and developed innovative planning and training models. SZENARIS GmbH was responsible for the “Training and Education” area and successfully combined all technologies in a new type of training system.
The VIVATOP project was funded by the Federal Ministry of Education and Research (BMBF) with a total of 2.2 million euros. The project partners are already transferring the results to everyday practice and surgical training.