Abstract
The advent of mixed reality (MR) has revolutionized human activities on a daily basis, striving for augmenting professional and social interactions at all levels. In medicine, MR tools have been developed and tested at an increasing rate over the years, playing a promising role in assisting physicians while improving patient care. In this chapter, the authors present their initial experience in introducing different MR algorithms in routine clinical practice from their implementation in several neurosurgical procedures to their use during the COVID-19 pandemic. A general summary of the current literature on MR in medicine has also been reported.
TopBackground
The hardware that we use is HoloLens 2 (HL2) (Microsoft TM). It is a head-mounted display unit connected with a remote cloud for images reconstruction and audio-video storage (Figure 1).
Figure 1. HoloLens 2 (HL2) (Microsoft TM)
The headset can be adjusted on the user head and tilted up, down, forward, or backward through a posterior crown (Davies, 2015). The anterior part of the device contains several sensors and their related hardware, including the processors, cameras and projection lenses. The visor is dark-coloured and includes two transparent combiner lenses, in whose inferior portion are shown the projected images (Kipman & Juarez, 2015). The device’s settings can be personalized based on the user’s vision characteristics (the interpupillary distance (IPD), or accustomed vision of the user) (Hachman, 2015; Hollister, 2015). Two 3D audio speakers are site close to the user’s ears, allowing to simultaneously listen sounds from the real world and virtual reality. Using head-related transfer functions (HRTF), the HL2 produces binaural audio, offering a real-life virtual experience (Holmdahl, 2015; Microsoft., 2020).
The frontal portion of the device contains two buttons, one at the right for volume control and one at the left for brightness control. The posterior portion has a concave power button and 5 lightning spots, showing battery levels (Munzer et al., 2019). Connectivity include Wi-Fi 802.11 ac, Bluetooth 5.0 e USB C and overall technical characteristics can be summarized as follows: transparent holographic lenses, resolution 2k 3: 2 LED light engine, radians> 2.5k, eye-based rendering optimization of the display for 3D eye position, tracking for head and eyes, depth by Azure Kinect sensor, accelerometer, gyroscope, magnetometer, camera: 8MP still images, 1080p30 video (Hempel, 2015; Holmdahl, 2015; Microsoft, 2015; Rubino, 2018).
TopMixed Reality Tests In Neurosurgery
MR offers the opportunity to record video and audio during the holographic representation. This is of special interest during informed consent as it can enhance and augment patient’s understanding of surgical risks and goals. The possibility to record the discussion between physicians, patients and family members may be also useful to minimize the risk of possible legal issue related to patient’s misunderstanding of the therapeutic plan.
Key Terms in this Chapter
Proctoring: In medicine, objective evaluation of a physician’s clinical competence by someone serving as a proctor who represents and is responsible to the medical staff.
Telemedicine: Distribution of health-related services and information via electronic information and telecommunication technologies.
Intensive Care Unit: Special department of a hospital catering to patients with severe or life-threatening illnesses and injuries, which require constant care, close supervision from life support equipment and medication in order to ensure normal bodily functions.
COVID-19: Viral infection spread in the year 2020 responsible for a worldwide pandemic.
Neurosurgery: Medical subspecialty focusing on the treatment of patients with pathologies involving the brain and/or the spine.
Mixed Reality: Science within the realm of virtual reality, allowing direct interactions between the physical and digital worlds through intuitive 3D human, computer, and environmental actions.
Burnout: Physical, emotional, or mental exhaustion, accompanied by decreased motivation, lowered performance and negative attitudes towards oneself and others.