If a tumor is located too close to important blood vessels, its surgical removal may prove to be dangerous or even impossible. 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.

In the VIVATOP research project, scientists from the Universities of Bremen (Bremen, Germany) and Oldenburg (Oldenburg, Germany) 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 joint project aimed to develop innovative and interactive 3D technologies for clinical use. 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. The prototypes from the VIVATOP project have passed clinical trials.

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.

“With the help of the 3D models, we can capture the complex vascular and organ anatomy much faster,” added Professor Dirk Weyhe, a visceral surgeon from Pius Hospital Oldenburg. “CTs and MRIs require a composition from two levels.”

“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,” emphasized Professor Rainer Malaka, Managing Director of the Technology Center Informatics and Information Technology (TZI) at the University of Bremen. 

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