title: Augmented reality visualization of deformable tubular structures for surgical simulation.
abstract: BACKGROUND
  Surgical simulation based on augmented reality (AR), mixing the benefits of physical and virtual simulation, represents a step forward in surgical training. However, available systems are unable to update the virtual anatomy following deformations impressed on actual anatomy.
  
  
  METHODS
  A proof-of-concept solution is described providing AR visualization of hidden deformable tubular structures using nitinol tubes sensorized with electromagnetic sensors. This system was tested in vitro on a setup comprised of sensorized cystic, left and right hepatic, and proper hepatic arteries. In the trial session, the surgeon deformed the tubular structures with surgical forceps in 10 positions.
  
  
  RESULTS
  The mean, standard deviation, and maximum misalignment between virtual and real arteries were 0.35, 0.22, and 0.99 mm, respectively.
  
  
  CONCLUSIONS
  The alignment accuracy obtained demonstrates the feasibility of the approach, which can be adopted in advanced AR simulations, in particular as an aid to the identification and isolation of tubular structures. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: EndoCAS Center, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy.|Information Engineering Department, University of Pisa, Italy.|Vascular Surgery Unit, Cisanello University Hospital AOUP, Pisa, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ferrari
authors.affiliation: EndoCAS Center, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy.
authors.forename: Rosanna Maria
authors.initials: RM
authors.lastname: Viglialoro
authors.affiliation: EndoCAS Center, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Nicoli
authors.affiliation: EndoCAS Center, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Cutolo
authors.affiliation: EndoCAS Center, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Condino
authors.affiliation: EndoCAS Center, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Carbone
authors.affiliation: EndoCAS Center, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy.
authors.forename: Mentore
authors.initials: M
authors.lastname: Siesto
authors.affiliation: EndoCAS Center, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy.|Vascular Surgery Unit, Cisanello University Hospital AOUP, Pisa, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Ferrari
mesh_terms: D002138:Calibration; D002763:Cholecystectomy / Q000379:methods; D060733:Electromagnetic Radiation; D013502:General Surgery / Q000193:education / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D015203:Reproducibility of Results; D000066908:Simulation Training; D012984:Software; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014584:User-Computer Interface
keywords: augmented reality; soft tissue; surgical simulation