Resection of thoracic meningioma with hoth augmented reality system: technical note and operative video

Background

Augmented Reality (AR) is an emerging technology in the field of neurosurgery. It allows surgeons to view three-dimensional (3D) patient anatomy overlaid onto the surgical field in real time. In this technical report, we describe the preoperative and intraoperative use of the Hoth AR system for resection of a thoracic meningioma.

Methods

Prior to surgery, the 3D model of the patient’s tumor and surrounding anatomy is rendered from the patient’s preoperative imaging, and it is uploaded into the AR headset. Once the patient is positioned in the operating room, registration is performed by tracing reference points on the skin while wearing the headset. The surgeon wears the headset while operating, and they can toggle on–off and transparency of each component of the model using voice commands to best visualize the 3D rendering overlaid on the patient’s anatomy.

Results

We provide a video case demonstrating the use of the Hoth AR system for resection of a thoracic meningioma. The system was able to register the model to the patient accurately in under 30 s. It was used to accurately plan the incision preoperatively, determine levels for laminectomy intraoperatively, and for precise localization of the tumor prior to opening the dura.

Conclusion

This case describes the clinical integration of a novel AR system for preoperative localization and intraoperative visualization during a resection of a thoracic meningioma. As AR systems continue to evolve and become more accessible, they are poised to become a standard tool in the surgical arsenal.