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Extended Reality Technologies for Preoperative Planning in DIEP Flap Breast Reconstruction: A Systematic Review

Berk B. Ozmen, Ali Foroutan, Joseph Quick, Robert Siska, Graham Schwarz
Cleveland Clinic Department of Plastic Surgery
2024-02-01

Presenter: Berk B. Ozmen

Affidavit:
Yes.

Director Name: Graham Schwarz

Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)

BACKGROUND: Preoperative imaging for DIEP flap breast reconstruction commonly utilizes CT angiography (CTA). However, CTA is limited to 2D visualization. Extended Reality (XR) is a state-of-the-art novel technology umbrella term including Virtual Reality (VR), Mixed Reality (MR) and Augmented Reality (AR). These technologies may allow immersive 3D visualization of the patient anatomy for pre-operative planning and for intra-operative visualization. The purpose of this study is to conduct a systematic review to investigate the state of the literature on XR technologies for use in DIEP flap surgery.

METHODS: We conducted a systematic review following the PRISMA 2020 guidelines, reviewing literature on Extended Reality and DIEP flap breast reconstruction procedure. We searched for relevant literature with search specific keywords on databases including PubMed, Elsevier Scopus, and Google Scholar. Only original research articles with real-world clinical patient data are included.

RESULTS: A total of 13 original research articles were included. Most papers on this topic were published between 2023-2024 (46.2%), with the first paper being published in 2009. Overall, 7 (53.8%) of articles discussed AR while 6 (46.2%) of articles discussed VR. There were no relevant publications discussing MR. The most used technologies for DIEP flap planning were Microsoft HoloLens, with 3 (30.8%) counts and VirSSPA with 3 (30.8%) counts. The median number of patients included in the studies was 12, with a range of 2 to 70 patients.

CONCLUSION: This study demonstrates growing interest in using XR technologies for preoperative planning and intraoperative guidance in DIEP flap breast reconstruction.

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