British Journal of Neurosurgery, December 2014; 28(6): 819–820 © 2014 The Neurosurgical Foundation ISSN: 0268-8697 print / ISSN 1360-046X online DOI: 10.3109/02688697.2014.931348
TECHNICAL NOTE
Alternative cost-effective method to record 3D intra-operative images: A technical note Damiano Giuseppe Barone1,2, Vin Shen Ban2, Ramez W Kirollos2, Rikin A. Trivedi2, Diederik O. Bulters2,3, Guilherme Carvalhal Ribas4 & Thomas Santarius2 1Department of Neurosurgery, The Walton Centre, Liverpool, UK, 2Department of Neurosurgery, Addenbrooke’s
Hospital, Cambridge, UK, 3Department of Neurosurgery, Southampton General Hospital, Southampton, UK, and 4Department of Neurosurgery, University of Sao Paulo, Sao Paulo, Brazil
Abstract The educational value of stereoscopic imaging in neurosurgical training has increasingly been appreciated and its use increased during the last decade. We describe a technique that we developed to acquire and reproduce intra-operative stereoscopic images.
In this technical note, we describe one of the techniques for recording still 3D images in the operating theatre as well as in the neuro-anatomical laboratory used in Cambridge (UK) and San Paulo (Brazil).
Materials and methods
Keywords: 3D camera; medical education; neuroanatomy; neurosurgical training; stereoscopy
The Leica IC3D Digital Camera (Leica Microsystems, Welzar, Germany), originally was developed for use with desktop laboratory microscopes. The IC3D has a dual 3.3 Megapixel sensors providing a resolution of 2088 ⫻ 1550 pixels. More technical details regarding the camera can be found on the developer website (http://www.leica-microsystems.com/). We found it to be compatible with the Leica surgical microscopes (Leica M520 MS2 ⫹ ULY500), and with suitable adapters we have also used it with other brands of microscopes (Zeiss Pentero microscopes). The IC3D digital camera mechanically connects with the microscope eyepiece, sitting between the eyepiece and the objective lens (Fig. 1). IC3D is connected and powered through IEEE 1394a High Speed Serial Bus (also known as FireWire 400) to a desktop computer with the Planar SD2020 (Planar Systems Inc., Beaverton, Oregon, USA) monitor (Fig. 2). The Leica Stereo Viewer v1.2 (Leica Microsystems, Welzar, Germany) is used for operating the camera, although other digital Twain camera software can be used. The IC3D camera is connected to the microscope before this is balanced and draped. At this point, the IC3D can be connected to the computer and tested without affecting the operating theatre workflow. Focusing is a crucial step in the whole procedure. The addition of the IC3D in-between the objective lens and main eyepiece affects the focus of the image seen through the latter. When the image is focused through the IC3D onto the computer screen, the image is out
Introduction Techniques for the production and re-production of 3D images have been refined in the last two decades, and awareness of the value of 3D imaging applied to medical education has increasingly been appreciated.1 In neurosurgery stereoscopy has been used very successfully to demonstrate microsurgical anatomy by Dr Albert Rhoton and co-workers. Ribas et al in 20012 and Shimizu et al in 2006,3 explained the importance of 3D neuroanatomical imaging as a teaching tool in neurosurgical training and comprehensively described original techniques for their production. However, the use of 3D imaging in neurosurgical training is not as widespread as it could be, partially due to the complexity of some techniques described in the past, the long preparation time in the pre- and post-operative phases and their interference with the operation, making it impractical in busy neurosurgical theatres. Companies producing microscopes and endoscopes have developed integrated 3D technology making 3D recording and editing less complex, but these are still very expensive.
Correspondence: Damiano G Barone, MD, MRCS, Department of Neurosurgery, The Walton Centre, Liverpool, L9 7LJ, UK. E-mail: [email protected] Received for publication 12 October 2013; accepted 31 May 2014
819
820 D. G. Barone et al.
Fig. 1. Leica IC3D Camera (red arrow) mounted on the Zeiss Pentero microscope using a bespoke adapter.
of focus through the eyepiece when set to 0 dioptres, necessitating calibration of the eyepieces to the surgeons’ individual sights. Once the microscope and the IC3D camera have been focused, everything else is done entirely through the computer, including capturing images. A 2D image can be viewed on the computer screen in real time allowing for adjustments of the system’s visual field and after image acquisition the image can be reviewed in 3D.
Discussion We have used this technique in a wide range of elective, scheduled, and emergency micro-neurosurgical operations over a period of 6 years. The recordings were used for postoperative discussion of the technical details of the operation as well as for creating a case library. The library now contains over 50 cranial and spinal cases, routinely used for in-house teaching and outside presentations. The acquired 3D images can be presented in two ways depending on the size of the audience. For a small audience (around 4–6 people), for example in the operating theatre or in the neuro-anatomical laboratory, we use the Planar SD2020 computer monitor with passive 3D glasses. For larger audiences, we use a custom-made dual projection system Duality X3 (Inition Ltd., London, UK) with passive 3D glasses. We received excellent feedbacks from audience up to 150 viewers. The technique for the acquisition of 3D images of microsurgical operations described in this paper causes minimal interference with the operating room or microsurgical
Fig. 2. Setting of the 3D recording system in theatre.
laboratory workflow and is relatively inexpensive (under $15 000). The major limitation of this system is its low bandwidth of data transfer, which does not allow for watching the procedures in real time or recording videos. The use of 3D imaging opens new opportunities for learning and teaching larger audiences, inside and outside the operating theatre, either during or after the operation and the possibility of sharing experience over the internet. Declaration of interest: The authors report no declarations of interest. The authors alone are responsible for the content and writing of the paper.
References 1. Justus I, Jones J-HP, Daniel L, Martil W. Using a high-definition stereoscopic video system to teach microscopic surgery. Proc of SPIE-IS & T Electronic Imaging 2007;6490:1–7. 2. Ribas GC, Bento RF, Rodrigues AJ. Anaglyphic three-dimensional stereoscopic printing: revival of an old method for anatomical and surgical teaching and reporting. J Neurosurg 2001;95:1057–66. 3. Shimizu S, Tanaka R, Rhoton AL, Jr., et al. Anatomic dissection and classic three-dimensional documentation: a unit of education for neurosurgical anatomy revisited. Neurosurgery 2006;58: E1000. discussion E.
Copyright of British Journal of Neurosurgery is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
TECHNICAL NOTE
Alternative cost-effective method to record 3D intra-operative images: A technical note Damiano Giuseppe Barone1,2, Vin Shen Ban2, Ramez W Kirollos2, Rikin A. Trivedi2, Diederik O. Bulters2,3, Guilherme Carvalhal Ribas4 & Thomas Santarius2 1Department of Neurosurgery, The Walton Centre, Liverpool, UK, 2Department of Neurosurgery, Addenbrooke’s
Hospital, Cambridge, UK, 3Department of Neurosurgery, Southampton General Hospital, Southampton, UK, and 4Department of Neurosurgery, University of Sao Paulo, Sao Paulo, Brazil
Abstract The educational value of stereoscopic imaging in neurosurgical training has increasingly been appreciated and its use increased during the last decade. We describe a technique that we developed to acquire and reproduce intra-operative stereoscopic images.
In this technical note, we describe one of the techniques for recording still 3D images in the operating theatre as well as in the neuro-anatomical laboratory used in Cambridge (UK) and San Paulo (Brazil).
Materials and methods
Keywords: 3D camera; medical education; neuroanatomy; neurosurgical training; stereoscopy
The Leica IC3D Digital Camera (Leica Microsystems, Welzar, Germany), originally was developed for use with desktop laboratory microscopes. The IC3D has a dual 3.3 Megapixel sensors providing a resolution of 2088 ⫻ 1550 pixels. More technical details regarding the camera can be found on the developer website (http://www.leica-microsystems.com/). We found it to be compatible with the Leica surgical microscopes (Leica M520 MS2 ⫹ ULY500), and with suitable adapters we have also used it with other brands of microscopes (Zeiss Pentero microscopes). The IC3D digital camera mechanically connects with the microscope eyepiece, sitting between the eyepiece and the objective lens (Fig. 1). IC3D is connected and powered through IEEE 1394a High Speed Serial Bus (also known as FireWire 400) to a desktop computer with the Planar SD2020 (Planar Systems Inc., Beaverton, Oregon, USA) monitor (Fig. 2). The Leica Stereo Viewer v1.2 (Leica Microsystems, Welzar, Germany) is used for operating the camera, although other digital Twain camera software can be used. The IC3D camera is connected to the microscope before this is balanced and draped. At this point, the IC3D can be connected to the computer and tested without affecting the operating theatre workflow. Focusing is a crucial step in the whole procedure. The addition of the IC3D in-between the objective lens and main eyepiece affects the focus of the image seen through the latter. When the image is focused through the IC3D onto the computer screen, the image is out
Introduction Techniques for the production and re-production of 3D images have been refined in the last two decades, and awareness of the value of 3D imaging applied to medical education has increasingly been appreciated.1 In neurosurgery stereoscopy has been used very successfully to demonstrate microsurgical anatomy by Dr Albert Rhoton and co-workers. Ribas et al in 20012 and Shimizu et al in 2006,3 explained the importance of 3D neuroanatomical imaging as a teaching tool in neurosurgical training and comprehensively described original techniques for their production. However, the use of 3D imaging in neurosurgical training is not as widespread as it could be, partially due to the complexity of some techniques described in the past, the long preparation time in the pre- and post-operative phases and their interference with the operation, making it impractical in busy neurosurgical theatres. Companies producing microscopes and endoscopes have developed integrated 3D technology making 3D recording and editing less complex, but these are still very expensive.
Correspondence: Damiano G Barone, MD, MRCS, Department of Neurosurgery, The Walton Centre, Liverpool, L9 7LJ, UK. E-mail: [email protected] Received for publication 12 October 2013; accepted 31 May 2014
819
820 D. G. Barone et al.
Fig. 1. Leica IC3D Camera (red arrow) mounted on the Zeiss Pentero microscope using a bespoke adapter.
of focus through the eyepiece when set to 0 dioptres, necessitating calibration of the eyepieces to the surgeons’ individual sights. Once the microscope and the IC3D camera have been focused, everything else is done entirely through the computer, including capturing images. A 2D image can be viewed on the computer screen in real time allowing for adjustments of the system’s visual field and after image acquisition the image can be reviewed in 3D.
Discussion We have used this technique in a wide range of elective, scheduled, and emergency micro-neurosurgical operations over a period of 6 years. The recordings were used for postoperative discussion of the technical details of the operation as well as for creating a case library. The library now contains over 50 cranial and spinal cases, routinely used for in-house teaching and outside presentations. The acquired 3D images can be presented in two ways depending on the size of the audience. For a small audience (around 4–6 people), for example in the operating theatre or in the neuro-anatomical laboratory, we use the Planar SD2020 computer monitor with passive 3D glasses. For larger audiences, we use a custom-made dual projection system Duality X3 (Inition Ltd., London, UK) with passive 3D glasses. We received excellent feedbacks from audience up to 150 viewers. The technique for the acquisition of 3D images of microsurgical operations described in this paper causes minimal interference with the operating room or microsurgical
Fig. 2. Setting of the 3D recording system in theatre.
laboratory workflow and is relatively inexpensive (under $15 000). The major limitation of this system is its low bandwidth of data transfer, which does not allow for watching the procedures in real time or recording videos. The use of 3D imaging opens new opportunities for learning and teaching larger audiences, inside and outside the operating theatre, either during or after the operation and the possibility of sharing experience over the internet. Declaration of interest: The authors report no declarations of interest. The authors alone are responsible for the content and writing of the paper.
References 1. Justus I, Jones J-HP, Daniel L, Martil W. Using a high-definition stereoscopic video system to teach microscopic surgery. Proc of SPIE-IS & T Electronic Imaging 2007;6490:1–7. 2. Ribas GC, Bento RF, Rodrigues AJ. Anaglyphic three-dimensional stereoscopic printing: revival of an old method for anatomical and surgical teaching and reporting. J Neurosurg 2001;95:1057–66. 3. Shimizu S, Tanaka R, Rhoton AL, Jr., et al. Anatomic dissection and classic three-dimensional documentation: a unit of education for neurosurgical anatomy revisited. Neurosurgery 2006;58: E1000. discussion E.
Copyright of British Journal of Neurosurgery is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
