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Full-HD Image Injection Provides a Complete Picture of the Surgical Site Directly in the Microscope Eyepieces

The human skull is an especially delicate area for surgery. To differentiate healthy tissue from tumor cells, or treat an aneurysm for example, the surgeon needs a complete picture of the surgical area. Supplementary information provided by Image Guided Surgery (IGS) or neuro navigation systems, endoscope, and in some cases fluorescence, can support the surgeon’s visualization, insight and intra-surgical orientation. This supplementary visual information is often only viewable on a separate screen, but with image injection technology from Leica it can be overlaid in full high definition (HD) directly into the eyepieces of a surgical microscope.

Neurosurgeons perform most of their procedures while looking through a microscope. Having to raise the head in order to consult images on a navigation screen thus implies a rupture in the workflow.  To facilitate a smooth workflow and allow the surgeon to stay focused on the surgical field and patient, the HD image injection technology, CaptiView, injects all image data directly in the eyepieces of a M530 microscope either correlated or non-correlated. The surgeon does not have to reorient between the microscope and the screen, but can remain fully concentrated on the patient during the whole procedure.

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First aneurysm surgery with CaptiView image injection

CaptiView image injection was used for the first time in an aneurysm surgery at the Mount Sinai Health System, New York in combination with a M530 OH6 microscope, and the Brainlab Curve system with Cranial 3.1 neuronavigation software. The case was reported by abcNews in an article entitled “What a Brain Surgeon’s Virtual Reality Tool and Pokemon Go Have in Common”. In the video, the surgeon compares injection of neuronavigation data into the microscope eyepieces with projecting GPS data onto a windscreen of a car, supporting the driver to navigate more easily.

A complete picture of the surgical area

Image data injected by an image injection system such as the CaptiView module may include pre-operative MRI and CT scans displayed via IGS systems as well as real-time intraoperative data like endoscopic or vascular fluorescence images. Injected images from IGS systems and endoscope can be viewed in the right, left, or both eyepieces. Real-time FL800 vascular fluorescence can additionally be viewed in the right eyepiece. “To achieve the best possible patient outcome surgeons need a complete picture of the surgical area. Providing supplementary pre- and intraoperative data into the oculars, CaptiView aids the surgeon in making precise, informed treatment decisions”, explains David Smith, Product Manager at Leica.

Enabling a navigation system for the brain

Image Guided Surgery systems, also known as neuronavigation systems, display pre-operative patient data and track the position of instruments in relation to this data and to the brain structures. This data is displayed on a screen and with CaptiView additionally injected into the microscope eyepieces. The surgeon benefits from a continuous, real-time view which can help them to orient themselves during surgery and thus support precise decisions. Read more on neuronavigation in our Leica Science Lab article “Navigation Through the brain”.

New benchmarks for image quality

When it comes to image quality, the CaptiView image injection system sets new benchmarks: Images are displayed in full-HD with a resolution of 1920 x 1080 pixels which is 2.6x higher than with previous image injection devices from Leica. Bright LED backlight and LCD support a 500:1 contrast resulting in consistently bright, crisp overlays with distinct margins even on bright objects.

Enhancing intra-surgical support and teaching

Taking into account the importance of training and teaching, CaptiView image injection provides the same high-quality images for surgeon and assistant(s) alike. To share a view of the live surgical image with injected supplementary information enables the assistant to follow each delicate movement during surgery.

Moreover, the surgeon can display the microscope and injected images in full HD quality for the whole OR team, thus increasing understanding and intra-surgical support. For post-operative reviews and presentations, the injected images overlaid onto the surgical field can be recorded via the documentation system as video or still images.

Interruption-free procedure

As the CaptiView image injection module is completely integrated with M530 surgical microscopes the solution is easy to use and supports a smooth, uninterrupted workflow. Images are easily activated by either the microscope handle or a footswitch. The surgeon can inject all supplementary information from endoscope, IGS, and fluorescence, plus microscope settings without having to look up from the microscope. A streamlined workflow without interruptions helps the surgeon to remain focused on achieving the optimal patient outcome.