Using a hologram, a drain was placed in the brain at Amsterdam UMC. Neurosurgeon Maarten Bot used mixed reality, a technique that combines the physical world with digital elements.
Mixed reality is a combination of augmented reality and virtual reality. Augmented reality puts a digital layer over the real world, adding digital elements, while virtual reality puts you in an entirely digital world. Mixed reality, like augmented reality, puts a digital layer over the real world, but the digital elements can also react and interact with the physical world. Think of a hologram that reacts to movements.
Preparing with headset
The neurosurgery department within Amsterdam UMC began researching mixed reality two years ago. Viewing 3D images of the brain of the patient to be operated on via a mixed reality headset helps surgeons prepare accurately for surgery.
"Placing a drain in brain ventricles is something every neurosurgeon does very often. But for the first time, we have a navigation that visualises the right place in the brain and the route to follow while you are operating."
Life-saving operation
The technique is used by Amsterdam UMC specifically to place a drain in the ventricles of the brain. This is a life-saving operation, performed hundreds of times a year in patients where cerebrospinal fluid builds up in the brain. Brain fluid is continuously produced in the brain ventricles and is completely renewed an average of three to four times a day. In the process, the old fluid is drained away by the blood. However, this process can become disrupted. In that case, a drain is needed to drain the excess fluid.
Bot: "Neurosurgeons perform this life-saving operation so often that they are very good at it. Yet in about 2 out of 10 cases, the drain is not placed properly. This means that the surgery has to be performed again, but also that brain damage can occur to the patient. The ventricles are deep in the brain and surrounded by essential structures needed for movement and consciousness. We expect to prevent damage by using this navigation."
Finding the right place
A form of navigation helps neurosurgeons determine the right spot in the brain for surgery. Using this navigation, surgeons see in advance where they need to be in the brain rooms. During surgery, however, it is often impractical to look at this navigation.
The use of a mixed reality headset offers a solution. The headset, a Microsoft HoloLens, projects a hologram of the patient's brain onto the patient's head. Bot: "Think of it as the navigation of a car. The current method is a bit like seeing the route in advance, but not being able to see while driving. With the hologram, you can see where you are and where you need to go while driving without taking your eyes off the road."
Clinical study
Together with UMC Utrecht, Bot is starting a clinical study in which patients at Amsterdam UMC who need a brain drain can be operated on using the new technique. This should show whether the drain is placed incorrectly less often by using a hologram.
