Use of virtual reality for pre-surgical planning in separation of conjoined twins: A case report

Bethany Juhnke; Alex R. Mattson; Daniel Saltzman; Anthony Azakie; Eric Hoggard; Matthew Ambrose; Paul A. Iaizzo; Arthur Erdman; Gwenyth Fischer

doi:10.1177/0954411919878067

Use of virtual reality for pre-surgical planning in separation of conjoined twins: A case report

Bethany Juhnke, Alex R. Mattson, Daniel Saltzman, Anthony Azakie, Eric Hoggard, Matthew Ambrose, Paul A. Iaizzo, Arthur Erdman, Gwenyth Fischer

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

We describe the use of virtual reality technology for surgical planning in the successful separation of thoracopagus conjoined twins. Three-dimensional models were created from computed tomography angiograms to simulate the patient’s anatomy on a virtual stereoscopic display. Members of the surgical teams reviewed the anatomical models to localize an interatrial communication that allowed blood to flow between the two hearts. The surgical plan to close the 1-mm interatrial communication was significantly modified based on the pre-procedural spatial awareness of the anatomy presented in the virtual visualization. The virtual stereoscopic display was critical for the surgical team to successfully separate the twins and provides a useful case study for the use of virtual reality technology in surgical planning. Both twins survived the operation and were subsequently discharged from the hospital.

Original language	English (US)
Pages (from-to)	1327-1332
Number of pages	6
Journal	Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine
Volume	233
Issue number	12
DOIs	https://doi.org/10.1177/0954411919878067
State	Published - Dec 1 2019

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the National Science Foundation (IIS-1251069), the National Institute of Health (1R01EB018205-01) and the Institute for Engineering in Medicine at the University of Minnesota.

Funding Information:
https://orcid.org/0000-0003-0312-9961 Juhnke Bethany 1 Mattson Alex R 2 3 Saltzman Daniel 3 Azakie Anthony 4 Hoggard Eric 5 Ambrose Matthew 6 Iaizzo Paul A 2 3 Erdman Arthur 1 Fischer Gwenyth 6 1 Earl E. Bakken Medical Devices Center, University of Minnesota, Minneapolis, MN, USA 2 Visible Heart® Laboratories, University of Minnesota, Minneapolis, MN, USA 3 Department of Surgery, University of Minnesota, Minneapolis, MN, USA 4 Pediatric Cardiovascular Surgery and Congenital Heart Program, Peyton Manning Children’s Hospital at St. Vincent, Indianapolis, IN, USA 5 Department of Radiology, University of Minnesota, Minneapolis, MN, USA 6 Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA Bethany Juhnke, Earl E. Bakken Medical Devices Center, University of Minnesota, MMC 95, G217 Mayo Building, 420 Delaware Street SE, Minneapolis, MN 55455, USA. Email: juhnk006@umn.edu 9 2019 0954411919878067 13 5 2019 30 8 2019 © IMechE 2019 2019 Institution of Mechanical Engineers We describe the use of virtual reality technology for surgical planning in the successful separation of thoracopagus conjoined twins. Three-dimensional models were created from computed tomography angiograms to simulate the patient’s anatomy on a virtual stereoscopic display. Members of the surgical teams reviewed the anatomical models to localize an interatrial communication that allowed blood to flow between the two hearts. The surgical plan to close the 1-mm interatrial communication was significantly modified based on the pre-procedural spatial awareness of the anatomy presented in the virtual visualization. The virtual stereoscopic display was critical for the surgical team to successfully separate the twins and provides a useful case study for the use of virtual reality technology in surgical planning. Both twins survived the operation and were subsequently discharged from the hospital. Conjoined twins separation procedure surgical planning virtual reality stereoscopic visualization National Institutes of Health https://doi.org/10.13039/100000002 1R01EB018205-01 National Science Foundation https://doi.org/10.13039/100000001 IIS-1251069 university of minnesota https://doi.org/10.13039/100007249 edited-state corrected-proof Declaration of conflicting interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the National Science Foundation (IIS-1251069), the National Institute of Health (1R01EB018205-01) and the Institute for Engineering in Medicine at the University of Minnesota. ORCID iD Bethany Juhnke https://orcid.org/0000-0003-0312-9961

Keywords

Conjoined twins
separation procedure
stereoscopic visualization
surgical planning
virtual reality

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10.1177/0954411919878067

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Juhnke, B., Mattson, A. R., Saltzman, D., Azakie, A., Hoggard, E., Ambrose, M., Iaizzo, P. A., Erdman, A., & Fischer, G. (2019). Use of virtual reality for pre-surgical planning in separation of conjoined twins: A case report. Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, 233(12), 1327-1332. https://doi.org/10.1177/0954411919878067

Use of virtual reality for pre-surgical planning in separation of conjoined twins : A case report. / Juhnke, Bethany; Mattson, Alex R.; Saltzman, Daniel et al.

In: Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, Vol. 233, No. 12, 01.12.2019, p. 1327-1332.

Research output: Contribution to journal › Article › peer-review

Juhnke, B, Mattson, AR, Saltzman, D, Azakie, A, Hoggard, E , Ambrose, M , Iaizzo, PA , Erdman, A & Fischer, G 2019, 'Use of virtual reality for pre-surgical planning in separation of conjoined twins: A case report', Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, vol. 233, no. 12, pp. 1327-1332. https://doi.org/10.1177/0954411919878067

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abstract = "We describe the use of virtual reality technology for surgical planning in the successful separation of thoracopagus conjoined twins. Three-dimensional models were created from computed tomography angiograms to simulate the patient{\textquoteright}s anatomy on a virtual stereoscopic display. Members of the surgical teams reviewed the anatomical models to localize an interatrial communication that allowed blood to flow between the two hearts. The surgical plan to close the 1-mm interatrial communication was significantly modified based on the pre-procedural spatial awareness of the anatomy presented in the virtual visualization. The virtual stereoscopic display was critical for the surgical team to successfully separate the twins and provides a useful case study for the use of virtual reality technology in surgical planning. Both twins survived the operation and were subsequently discharged from the hospital.",

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note = "Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the National Science Foundation (IIS-1251069), the National Institute of Health (1R01EB018205-01) and the Institute for Engineering in Medicine at the University of Minnesota. Funding Information: https://orcid.org/0000-0003-0312-9961 Juhnke Bethany 1 Mattson Alex R 2 3 Saltzman Daniel 3 Azakie Anthony 4 Hoggard Eric 5 Ambrose Matthew 6 Iaizzo Paul A 2 3 Erdman Arthur 1 Fischer Gwenyth 6 1 Earl E. Bakken Medical Devices Center, University of Minnesota, Minneapolis, MN, USA 2 Visible Heart{\textregistered} Laboratories, University of Minnesota, Minneapolis, MN, USA 3 Department of Surgery, University of Minnesota, Minneapolis, MN, USA 4 Pediatric Cardiovascular Surgery and Congenital Heart Program, Peyton Manning Children{\textquoteright}s Hospital at St. Vincent, Indianapolis, IN, USA 5 Department of Radiology, University of Minnesota, Minneapolis, MN, USA 6 Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA Bethany Juhnke, Earl E. Bakken Medical Devices Center, University of Minnesota, MMC 95, G217 Mayo Building, 420 Delaware Street SE, Minneapolis, MN 55455, USA. Email: juhnk006@umn.edu 9 2019 0954411919878067 13 5 2019 30 8 2019 {\textcopyright} IMechE 2019 2019 Institution of Mechanical Engineers We describe the use of virtual reality technology for surgical planning in the successful separation of thoracopagus conjoined twins. Three-dimensional models were created from computed tomography angiograms to simulate the patient{\textquoteright}s anatomy on a virtual stereoscopic display. Members of the surgical teams reviewed the anatomical models to localize an interatrial communication that allowed blood to flow between the two hearts. The surgical plan to close the 1-mm interatrial communication was significantly modified based on the pre-procedural spatial awareness of the anatomy presented in the virtual visualization. The virtual stereoscopic display was critical for the surgical team to successfully separate the twins and provides a useful case study for the use of virtual reality technology in surgical planning. Both twins survived the operation and were subsequently discharged from the hospital. Conjoined twins separation procedure surgical planning virtual reality stereoscopic visualization National Institutes of Health https://doi.org/10.13039/100000002 1R01EB018205-01 National Science Foundation https://doi.org/10.13039/100000001 IIS-1251069 university of minnesota https://doi.org/10.13039/100007249 edited-state corrected-proof Declaration of conflicting interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the National Science Foundation (IIS-1251069), the National Institute of Health (1R01EB018205-01) and the Institute for Engineering in Medicine at the University of Minnesota. ORCID iD Bethany Juhnke https://orcid.org/0000-0003-0312-9961 ",

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Use of virtual reality for pre-surgical planning in separation of conjoined twins: A case report

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