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January 2006 - present
Publications
Publications (203)
Wearable augmented reality in neurosurgery offers significant advantages by enabling the visualization of navigation information directly on the patient, seamlessly integrating virtual data with the real surgical field. This ergonomic approach can facilitate a more intuitive understanding of spatial relationships and guidance cues, potentially redu...
Rhinoplasty is one of the major surgical procedures most popular and it is generally performed modelling the internal bones and cartilage using a closed approach to reduce the damage of soft tissue, whose final shape is determined by means of their new settlement over the internal remodelled rigid structures. An optimal planning, achievable thanks...
For an optical see-through (OST) augmented reality (AR) head-mounted display (HMD) to assist in performing high-precision activities in the peripersonal space, a fundamental requirement is the correct spatial registration between the virtual information and the real environment. This registration can be achieved through a calibration procedure invo...
Neuronavigation is integral to modern neurosurgery. Clinical studies demonstrate its effectiveness. The primary tracking modalities in neurosurgical navigation are optical tracking systems (OTS) and electromagnetic tracking systems (EMTS). OTS remains the gold standard due to its accuracy and reliability. However, inherent inaccuracies due to brain...
This study explores and preliminarily validates an online calibration method for Augmented Reality Optical See-Through Head-Mounted Displays. One of the major obstacles with those devices concerns the complexity and the unreliability of the calibration procedures for a correct virtual-to-real alignment, a key aspect of medical and industrial settin...
Objective: The use of commercially available optical-see-through (OST) head-mounted displays (HMDs) in their own peripersonal space leads the user to experience two perception conflicts that deteriorate their performance in precision manual tasks: the vergence-accommodation conflict (VAC) and the focus rivalry. In this work, we aim characterizing f...
Head-mounted displays (HMDs) are hands-free devices particularly useful for guiding near-field tasks such as manual surgical procedures. See-through HMDs do not significantly alter the user’s direct view of the world, but the optical merging of real and virtual information can hinder their coherent and simultaneous perception. In particular, the co...
Recent research studies reported that the employment of wearable augmented reality (AR) systems such as head‐mounted displays for the in situ visualisation of ultrasound (US) images can improve the outcomes of US‐guided biopsies through reduced procedure completion times and improved accuracy. Here, the authors continue in the direction of recent d...
Aortic valve surgery is the preferred procedure for replacing a damaged valve with an artificial one. The ValveTech robotic platform comprises a flexible articulated manipulator and surgical interface supporting the effective delivery of an artificial valve by teleoperation and endoscopic vision. This article presents our recent work on force-perce...
Achieving and maintaining proper image registration accuracy is an open challenge of image-guided surgery. This work explores and assesses the efficacy of a registration sanity check method for augmented reality-guided navigation (AR-RSC), based on the visual inspection of virtual 3D models of landmarks. We analyze the AR-RSC sensitivity and specif...
This study proposes a preliminary new simulation approach using an immersive AR device for medical and paramedical complex training scenarios in hospital and pre-hospital tasks as a substitute for the current real and virtual simulations. The simulation activities selected for testing the proposed AR-based approach consist of: 1) setting up an oper...
Giant Cell Tumor of Bone is a benign tumor with high local aggressive expansion, which, in rare cases, spreads metastasis. Surgical treatment, which often consists of wide curettage to reduce recurrence risk, can lower the quality of life for those affected. Along with aggressive surgery, adjuvant intraoperative techniques have been implemented suc...
Robotic surgery has reached a very high level of advancement, in particular, Da Vinci Xi robotic system allows the execution of surgical tasks of the highest precision. It offers advantages in terms of reduced blood loss, reduced postoperative hospital stay, and less postoperative pain. The disadvantage the surgeon has found is progressive tactile...
Research studies show that serious games can increase patient motivation regardless of age or illness and be an affordable and promising solution with respect to conventional physiotherapy. In this paper, we present the latest evolution of our system for shoulder rehabilitation based on hand-finger tracking and projected augmented reality. This ver...
This study aims to critically analyse the workflow of the in situ bioprinting procedure, presenting a simulated neurosurgical case study, based on a real traumatic event, for collecting quantitative data in support of this innovative approach. After a traumatic event involving the head, bone fragments may have to be removed and a replacement implan...
The growing interest in augmented reality applications has led to an in-depth look at the performance of head-mounted displays and their testing in numerous domains. Other devices for augmenting the real world with virtual information are presented less frequently and usually focus on the description of the device rather than on its performance ana...
The adoption of extended reality solutions is growing rapidly in the healthcare world. Augmented reality (AR) and virtual reality (VR) interfaces can bring advantages in various medical-health sectors; it is thus not surprising that the medical MR market is among the fastest-growing ones. The present study reports on a comparison between two of the...
In the original article, there was a mistake in the content of Table 2 page 8 column 1 as published. The values of the mean and standard deviation of the virtual-to-real overlay error in visual angles, which are reported for different checkerboard distances, are to be corrected. Due to a typing error within the data analysis code, we mistakenly con...
The growing interest in augmented reality applications has led to an in-depth look at the performance of head-mounted displays and their testing in numerous domains. Other devices for augmenting the real world with virtual information are presented less frequently and usually focus on the description of the device rather than on its performance ana...
In the field of image-guided surgery, Augmented Reality wearable displays are a widely studied and documented technology for their ability to provide egocentric vision together with the overlap between real and virtual content. In particular, optical see-through (OST) displays have the advantage of maintaining visual perception of the real world. H...
Patient-specific templates (PST) have become a useful tool for guiding osteotomy in complex surgical scenarios such as pelvic resections. The design of the surgical template results in sharper, less jagged resection margins than freehand cuts. However, their correct placement can become difficult in some anatomical regions and cannot be verified du...
Augmented Reality (AR) can avoid some of the drawbacks of Minimally Invasive Surgery and may provide opportunities for developing innovative tools to assist surgeons. In laparoscopic surgery, the achievement of easy and sufficiently accurate registration is an open challenge. This is particularly true in procedures, such as laparoscopic abdominal S...
[This corrects the article DOI: 10.3389/frobt.2020.572001.].
In recent years, huge progress has been made in the management of brain tumors, due to the availability of imaging devices, which provide fundamental anatomical and pathological information not only for diagnostic purposes [...]
In the context of a European project, we identified over 150 requirements for the development of an augmented reality (AR) head-mounted display (HMD) specifically tailored to support highly challenging manual surgical procedures. The requirements were established by surgeons from different specialties and by industrial players working in the surgic...
In the context of image-guided surgery, augmented reality (AR) represents a ground-breaking enticing improvement, mostly when paired with wearability in the case of open surgery. Commercially available AR head-mounted displays (HMDs), designed for general purposes, are increasingly used outside their indications to develop surgical guidance applica...
Augmented reality (AR) devices are gaining popularity in industrial development and healthcare as they provide information that would not be accessible in a rapid and intuitive way. Head-mounted displays dominate in this field and are currently being comprehensively tested. Alongside its informative function, AR can be used to steer the user's acti...
Nowadays, ultrasound (US) is increasingly being chosen as imaging modality for both diagnostic and interventional applications, owing to its positive characteristics in terms of safety, low footprint and low cost. The combination of this imaging modality with wearable augmented reality (AR) systems, such as the head-mounted displays (HMD), comes fo...
Visual augmented reality (AR) headsets have the potential to enhance surgical navigation by providing physicians with an egocentric visualization interface capable of seamlessly blending the virtual navigation aid with the real surgical scenario. However, technological and human-factor limitations still hinder the routine use of commercial AR heads...
Background:
This report discusses the utility of a wearable augmented reality platform in neurosurgery for parasagittal and convexity en plaque meningiomas with bone flap removal and custom-made cranioplasty.
Methods:
A real patient with en plaque cranial vault meningioma with diffuse and extensive dural involvement, extracranial extension into...
Augmented Reality (AR) headsets have become the most ergonomic and efficient visualization devices to support complex manual tasks performed under direct vision. Their ability to provide hands-free interaction with the augmented scene makes them perfect for manual procedures such as surgery. This study demonstrates the reliability of an AR head-mou...
Wearable Video See-Through (VST) devices for Augmented Reality (AR) and for obtaining a Magnified View are taking hold in the medical and surgical fields. However, these devices are not yet usable in daily clinical practice, due to focusing problems and a limited depth of field. This study investigates the use of liquid-lens optics to create an aut...
INTRODUCTION: Mastering surgery and treatments of spine-related conditions require long training times. The need for cost-effective structured training is raising. Training through simulation can potentially revolutionize the standard paradigm if proper simulators are developed and tested. The purpose of this review was to evaluate the literature l...
Today, neuronavigation is widely used in daily clinical routine to perform safe and efficient surgery. Augmented reality (AR) interfaces can provide anatomical models and preoperative planning contextually blended with the real surgical scenario, overcoming the limitations of traditional neuronavigators. This study aims to demonstrate the reliabili...
Cryosurgery is a technique of growing popularity involving tissue ablation under controlled freezing. Technological advancement of devices along with surgical technique improvements have turned cryosurgery from an experimental to an established option for treating several diseases. However, cryosurgery is still limited by inaccurate planning based...
In situ fenestration of stent-graft represents a potential option for the treatment of aortic diseases in patients unsuitable for standard endovascular repair. The best fenestration strategy to restore perfusion of collateral vessels after their coverage by an endograft depends mainly on the anatomical area. Several tools are employed as fenestrati...
Simulation-based medical training is considered an effective tool to acquire/refine technical skills, mitigating the ethical issues of Halsted’s model. This review aims at evaluating the literature on medical simulation techniques based on augmented reality (AR), mixed reality (MR), and hybrid approaches. The research identified 23 articles that me...
Simulation for surgical training is increasingly being considered a valuable addition to traditional teaching methods. 3D-printed physical simulators can be used for preoperative planning and rehearsal in spine surgery to improve surgical workflows and postoperative patient outcomes. This paper proposes an innovative strategy to build a hybrid simu...
Optical see-through (OST) augmented reality head-mounted displays are quickly emerging as a key asset in several application fields but their ability to profitably assist high precision activities in the peripersonal space is still sub-optimal due to the calibration procedure required to properly model the user's viewpoint through the see-through d...
Background:
In the context of guided surgery, augmented reality (AR) represents a groundbreaking improvement. The Video and Optical See-Through Augmented Reality Surgical System (VOSTARS) is a new AR wearable head-mounted display (HMD), recently developed as an advanced navigation tool for maxillofacial and plastic surgery and other non-endoscopic...
In pedicle screws placement using a free-hand technique or a fluoroscopic guided technique the main difficulties are facing to the bone morphology (i.e in deformity cases) and it could be easily reproduced in a patient’s specific spine simulator (we can choose the case). The aim of this work is to evaluate the use of 3D printed patient- specific mo...
In the last years also in orthopedic surgery, there was an increasing interest in the development of surgical simulators using methods of additive manufacturing combined or not with augmented reality systems (hybrid simulators). Aim of this work was to evaluate the use of a new patient’s specific tibial plateau fractures simulator for surgical trai...
In recent years, the spreading of visual augmented reality as an effective tool in image-guided surgery, has stimulated the research community to investigate the use of commercial augmented reality headsets a broad range of potential applications. This aroused enthusiasm among clinicians for the potential of augmented reality, but also revealed som...
Objective:
Aortic valve disease is the most common heart disease in the elderly calling for replacement with an artificial valve. The presented surgical robot aims to provide a highly controllable instrument for efficient delivery of an artificial valve by the help of integrated endoscopic vision.
Methods:
A robot (called ValveTech), intended fo...
Egocentric augmented reality (AR) interfaces are quickly becoming a key asset for assisting high precision activities in the peripersonal space in several application fields. In these applications, accurate and robust registration of computer-generated information to the real scene is hard to achieve with traditional Optical See-Through (OST) displ...
Recently, the explainability of Artificial Intelligence (AI) models and algorithms is becoming an important requirement in real-world applications. Indeed, although AI allows us to address and solve very difficult and complicated problems, AI-based tools act as a black box and, usually, do not explain how/why/when a specific decision has been taken...
Objective
At present, there is no proficiency-based curriculum for endovascular treatment of aortic aneurysm repair (EVAR) using virtual reality (VR) surgical simulators, whereas such curricula are available for the treatment of iliac and/or superficial femoral artery disease. The purpose of this work was to compute proficiency, defined by a benchm...
Augmented reality (AR) head-mounted displays (HMDs) combine the user's natural view of the real world with virtual data. Thus, they might be particularly suited to guide manual tasks as in computer-aided-surgery.
However, the typical focal plane of commercial devices is outside the user's peripersonal space (i.e. the space containing reachable obje...
Background:
Virtual reality is becoming popular in the rehabilitation field thanks to the several advantages it can offer to patients and physicians. Indeed, serious games can: motivate and engage the patient; offer different levels of challenge and difficulty based on the patient baseline, and integrate objective measures of the patient's perform...
Objective:
This work presents a device for non-invasive wound parameters assessment, designed to overcome the drawbacks of traditional methods, which are mostly rough, inaccurate, and painful for the patient. The device estimates the morphological parameters of the wound and provides augmented reality (AR) visual feedback on the wound healing stat...
Augmented reality (AR) Head-Mounted Displays (HMDs) are emerging as the most efficient output medium to support manual tasks performed under direct vision. Despite that, technological and human-factor limitations still hinder their routine use for aiding high-precision manual tasks in the peripersonal space. To overcome such limitations, in this wo...
The increasing capability of computing power and mobile graphics has made possible the release of self-contained augmented reality (AR) headsets featuring efficient head-anchored tracking solutions. Ego motion estimation based on well-established infrared tracking of markers ensures sufficient accuracy and robustness. Unfortunately, wearable visibl...
Objective: This work aims at providing novel endovascular instrumentation to overcome current technical limitations of in situ endograft fenestration including challenges in targeting the fenestration site under fluoroscopic control and supplying mechanical support during endograft perforation. Technology: Novel electromagnetically trackable instru...
In recent years, there has been an increasing interest towards the augmented reality as applied to the surgical field. We conducted a systematic review of literature classifying the augmented reality applications in oral and cranio-maxillofacial surgery (OCMS) in order to pave the way to future solutions that may ease the adoption of AR guidance in...
Physiologically relevant in vitro models of stretchable biological tissues, such as muscle, lung, cardiac and gastro-intestinal tissues, should mimic the mechanical cues which cells are exposed to in their dynamic microenvironment in vivo. In particular, in order to mimic the mechanical stimulation of tissues in a physiologically relevant manner, c...
In recent years, the entry into the market of self contained optical see-through headsets with integrated multi-sensor capabilities has led the way to innovative and technology driven augmented reality applications and has encouraged the adoption of these devices also across highly challenging medical and industrial settings. Despite this, the disp...
The growing availability of self-contained and affordable augmented reality headsets such as the Microsoft HoloLens is encouraging the adoption of these devices also in the healthcare sector. However, technological and human-factor limitations still hinder their routine use in clinical practice. Among them, the major drawbacks are due to their gene...
In non-orthostereoscopic video see-through (VST) head-mounted displays (HMDs), the perception of the three-dimensional space is negatively altered by geometrical aberrations, which may lead to perceptual errors, problems of hand-eye coordination, and discomfort for the user. Parallax-free VST HMDs have been proposed, yet their embodiments are gener...