Endoscopic navigation system with extended field of view using augmented reality technology

Background: While endoscopic skull base surgery (ESBS) has emerged as an alternative surgical option, the limited field of view of the endoscope may lead to the surgeon's fatigue and discomfort. Methods: The developed navigation system includes extended augmented reality (AR), which can provide an extended viewport to a conventional endoscopic view by overlaying 3D anatomical models generated from preoperative medical images onto endoscope images. To enhance the accuracy of the developed system, we adopted state-of-the-art endoscopic calibration and tracking techniques based on an optical tracking system. Results: The mean spatial errors of AR was ~1 mm, which falls in the acceptable range of accuracy for ESBS. For the simulated surgical tasks with the developed system, the number and duration of error events were decreased. Conclusions: The results show that the human subject can perform the task more precisely and safely with the developed AR-based navigation system than with the conventional endoscopic system.