If a tumor is located too close to important blood vessels, its surgical removal may prove to be dangerous or even impossible. In the VIVATOP research project, scientists from the Universities of Bremen and Oldenburg and their collaborative partners have now developed 3D technologies that enable the medical team to assess the situation before and during surgery much more accurately. As a result, they expect a better assessment of surgical options and an associated higher success rate, especially in difficult cases. The network included Fraunhofer Institute MEVIS and the business partners SZENARIS, cirp, and apoQlar.
The joint project, which was completed at the end of June and led by the Technology Center Informatics and Information Technology (TZI) at the University of Bremen, aimed to develop innovative and interactive 3D technologies for clinical use. “Modern technologies such as virtual reality, augmented reality and 3D printing offer previously untapped potential to improve surgery planning and execution as well as training,” emphasizes Professor Rainer Malaka, Managing Director of TZI.
3D Organs That Can Be Touched and Observed
Surgeons now have the ability to create realistic 3D models of affected organs that can be both digitally visualized and made physically tangible via 3D printing. The project consortium focused primarily on the liver, but due to the pandemic, added imaging of lungs to aid in the diagnosis of COVID-19 illnesses.
The 3D visualization of an organ in virtual or augmented reality (VR/AR) offers significant advantages over the two-dimensional images from computer tomography or magnetic resonance imaging (CT/MRI) that have been common in the past. With the help of special AR glasses, surgeons can view the patient-specific 3D model as a “hologram” during surgery, using gesture control to rotate and turn it or place it manually. Before the procedure, you can already view the effects of an incision on the liver, which has a large blood supply, thus allowing you to estimate how much tissue will no longer be functional afterward. A physical 3D model, in combination with a training system, also allows the practice of complex interventions and stress situations.
Making the Cut in the Operating Room
Oldenburg University’s Faculty of Medicine and Health Sciences was involved as an application partner together with visceral surgeon Professor Dirk Weyhe from Pius Hospital Oldenburg. The prototypes from the VIVATOP project passed clinical trials there. “With the help of the 3D models, we can capture the complex vascular and organ anatomy much faster,” Weyhe reports. “CTs and MRIs require a composition from two levels.” The hospital is listed by the international Holomedicine Association as one of three Centers of Excellence worldwide.
The researchers have also included a “multiuser” functionality that allows several people to work with the model at the same time. It doesn’t matter whether the participants are together in the same room or not – experts from other continents can also be dialed in via AR telephony. For remote experts participating from the operating room via livestream, various representations are being tested in order to show these models as realistically as possible and to give them a realistic impression of what is happening in the operating room. In preliminary meetings, however, the actual models from the 3D printer also prove their strengths, because they serve as visual objects without the use of technology.
BMBF Funding Totaling 2.2 Million Euros
The project was coordinated at the TZI of the University of Bremen by the Digital Media working group (Professor Rainer Malaka) and supported by the Virtual Reality and Computer Graphics working group (Professor Gabriel Zachmann). The University Clinic for Visceral Surgery at Pius Hospital Oldenburg (Professor Dirk Weyhe) provided the medical expertise and the image data. From this, the Fraunhofer Institute for Digital Medicine MEVIS created virtual realistic organ models for AR/VR and 3D printing and researched realistic display methods. ApoQlar GmbH was involved as a specialist in the area of innovative interactions and multiuser use as well as visualizations in augmented reality. 3D printing specialist cirp GmbH researched and developed novel planning and training models. SZENARIS GmbH was responsible for training and education, and successfully combined all technologies into an innovative training system.
The project is funded by the Federal Ministry of Education and Research (BMBF – Bundesministerium für Bildung und Forschung) with a sum of 2.2 million euros. The project partners are already putting the results into everyday practice and surgical training.
Professor Rainer Malaka
Digital Media Lab
Technology Center Informatics and Information Technology (TZI)
University of Bremen
Tel. +49 0421 218-64401
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