DAS – Design for Augmented Surgery
2024 – ongoing
Regional project, Bando “Aggregazioni R&S – Salute”, Regione Autonoma della Valle d’Aosta
The DAS project proposes advanced technologies at the forefront of international scientific innovation in cranio-maxillofacial precision surgery. By employing the “Augmented Human” paradigm, it aims to integrate enabling technologies such as Extended Reality (XR), Artificial Intelligence (AI), and True-Real Time Interaction (TRI). These technologies, which merge with human capabilities to enhance life quality and abilities, demonstrate significant benefits across various application fields. The project’s “Augmented Surgery” model introduces these tools to the surgical field, which has yet to benefit from them, potentially making a substantial impact on the scientific community. This would help bridge the cultural gap and promote economic and social growth, considering the advantages relative to emerging socio-demographic scenarios.
The DAS project aims to develop an “Augmented Surgery” framework that leverages XR, AI, and TRI to create a cooperative environment between engineers and surgeons throughout the surgical process, from preoperative planning to postoperative review. The development of an XR-based Augmented Human solution, combined with AI and TRI communication technologies, also introduces a new concept of a “hybrid” surgical device. This device combines a “digitally augmented” part projected onto the surgical field with a physical “mini-invasive” part, fixed to the anatomical region of interest, allowing for precise and effective surgical interventions.
In particular, for surgeries involving extensive anatomical regions and significant osteotomies (two to five bone segments), a series of “mini-invasive” surgical tools, interconnected in an “augmented” manner, can be used to manipulate osteotomies easily as a single unit. This approach ensures a more targeted and effective design process for surgical devices, focusing on patient and surgeon needs in a human-centered logic, particularly for Cranio-Maxillo-Facial Surgery, through three phases:
- Augmented Pre-Planning: This phase supports preoperative planning by developing an immersive and interactive platform that allows collaborative and synergistic cooperation between the engineer and the surgeon. Planning activities include defining a 3D preoperative plan, resection plans, implants, and fixation activities.
- Augmented Room Surgery: This phase supports the surgical act by developing an “augmented” solution that guides the surgeon during the operation based on preoperative clinical specifications. It introduces a “hybrid” surgical device concept with a “digitally augmented” part projected onto the surgical field and a physical “mini-invasive” part fixed to the anatomical region. This digital part allows “last-minute” modifications to the surgical device, ensuring precision and adaptability during surgery.
- Augmented Knowledge/Learning Management: This phase aims to transfer the expert surgeon’s experience more broadly, with high interactivity and immersiveness essential for surgical practice learning. It involves developing an augmented platform for viewing and reviewing the surgical act, supporting continuous improvement strategies through AI.
The creation of an “augmented” ecosystem for preoperative planning would enable more effective and interactive involvement of the surgeon in the device design process and the engineer in the “surgical process” through immersive visualization tools, multi-device, and multi-protocol compatibility. This would reduce potential misunderstandings between surgeon and engineer, leading to more effective and efficient solutions tailored to the pathology, patient, and surgeon needs. Overall, personalized precision surgery would improve tissue protection, limit surgical field extension, reduce bone segment repositioning detachment, and facilitate faster and easier patient recovery with social and psychological benefits. For surgeons, it would enhance visualization, ergonomics, reduce stress and fatigue, and improve precision during surgery, benefiting outcomes such as mandibular reconstruction using the fibula free flap technique.