The authors sought to evaluate the impact of virtual reality (VR) applications for preoperative planning and rehearsal on the total procedure time of microsurgical clipping of middle cerebral artery (MCA) ruptured and unruptured aneurysms compared with standard surgical planning.

A retrospective review of 21 patients from 2016 to 2019 was conducted to determine the impact on the procedure time of MCA aneurysm clipping after implementing VR for preoperative planning and rehearsal. The control group consisted of patients whose procedures were planned with standard CTA and DSA scans (n = 11). The VR group consisted of patients whose procedures were planned with a patient-specific 360° VR (360VR) model (n = 10). The 360VR model was rendered using CTA and DSA data when available. Each patient was analyzed and scored with a case complexity (CC) 5-point grading scale accounting for aneurysm size, incorporation of M₂ branches, and aspect ratio, with 1 being the least complex and 5 being the most complex. The mean procedure times were compared between the VR group and the control group, as were the mean CC score between the groups. Comorbidities and aneurysm conduction (ruptured vs unruptured) were also taken into consideration for the comparison.

The mean CC scores for the control group and VR group were 2.45 ± 1.13 and 2.30 ± 0.48, respectively. CC was not significantly different between the two groups (p = 0.69). The mean procedure time was significantly lower for the VR group compared with the control group (247.80 minutes vs 328.27 minutes; p = 0.0115), particularly for the patients with a CC score of 2 (95% CI, p = 0.0064). A Charlson Comorbidity Index score was also calculated for each group, but no statistical significance was found (VR group, 2.8 vs control group, 1.8, p = 0.14).

In this study, usage of 360VR models for planning the craniotomy and rehearsing with various clip sizes and configurations resulted in an 80-minute decrease in procedure time. These findings have suggested the potential of VR technology in improving surgical efficiency for aneurysm clipping procedures regardless of complexity, while making the procedure faster and safer.

作者试图评估与标准手术计划相比，虚拟现实 (VR) 应用程序在术前计划和排练对大脑中动脉 (MCA) 破裂和未破裂动脉瘤显微外科夹闭总手术时间的影响。

对 2016 年至 2019 年的 21 名患者进行回顾性研究，以确定实施 VR 进行术前计划和排练后对 MCA 动脉瘤夹闭手术时间的影响。对照组由计划使用标准 CTA 和 DSA 扫描的患者组成（n = 11）。VR 组由患者组成，这些患者的手术计划采用患者特定的 360° VR (360VR) 模型（n = 10）。360VR 模型在可用时使用 CTA 和 DSA 数据进行渲染。对每位患者进行分析并使用病例复杂性 (CC) 5 分评分量表进行评分，其中考虑了动脉瘤大小，包括 M ₂分支和纵横比，1 是最不复杂的，5 是最复杂的。比较 VR 组和对照组的平均手术时间，以及各组之间的平均 CC 评分。合并症和动脉瘤传导（破裂与未破裂）也被考虑用于比较。

对照组和 VR 组的平均 CC 分数分别为 2.45 ± 1.13 和 2.30 ± 0.48。两组之间的 CC 没有显着差异（p = 0.69）。与对照组相比，VR 组的平均手术时间显着缩短（247.80 分钟 vs 328.27 分钟；p = 0.0115），尤其是 CC 评分为 2 的患者（95% CI，p = 0.0064）。还计算了每组的 Charlson 合并症指数评分，但未发现统计学显着性（VR 组，2.8 与对照组，1.8，p = 0.14）。

在这项研究中，使用 360VR 模型来规划开颅手术和排练各种夹子尺寸和配置，导致手术时间减少了 80 分钟。这些发现表明，无论复杂程度如何，VR 技术都具有提高动脉瘤夹闭手术效率的潜力，同时使手术更快、更安全。