Design and Implementation of An Assisted Positioning System for Carotid Endarterectomy Based on Mixed Reality

Determining an accurate surgical target is vitally important in reducing trauma and risk of carotid endarterectomy. This study aims to design and implement a surgical target position determination system, which is used to assist the doctor to determine the location of the surgical target in carotid endarterectomy. Based on mixed reality technology, through a novel method of matching digital virtual organ models and real physical entities, the target assisted positioning system realizes the surgical target auxiliary determination in the analysis of carotid endarterectomy process. The multiple digital three-dimensional models of ROI were visualization in mixed reality vision through the model fusion and RGBA adjustment. During the operation, the doctor aligns the digital 3D models with the physical entity in the mixed reality environment, and then determining the surgical target position through the spatial position of digital models of the carotid stenosis area. The assisted system has been implemented and verified in three carotid endarterectomy operations. To verify the feasibility and practical application value of the system, the cost time of assisted positioning process and the evaluation of doctors' used experience are counted. The results show that the clinicians could achieve intuitive visualization of surgical targets in deep spine positions with mixed reality and the target determining process of carotid endarterectomy takes a shorter time than the traditional image guided system. Conclusion is that the designed surgical target assisted positioning system makes the process of determining the surgical target of the carotid endarterectomy more intuitive. To a large extent, the method helps doctors determine the surgical target and improve the quality and efficiency in operation.