Intuition Aquarius (TeraRecon) Trick -Applying Virtual Reality to Operative Planning

I have used many different flavors of image post processing software including Osiris, Vitrea, and now Aquarius, aka TeraRecon. But I notice that outside of endovascular planning, people rarely use the virtual 3D reconstructed images (the pretty pictures) for anything other than posting images for publication in JVS, and even there I think we have reached saturation.

I have found 3D reconstruction to be especially useful for open surgical planning, and that is by doing two things. First, on viewing the 3DVR data, I reorient and center on the surgeon’s perspective, using left button to rotate the picture around the zero at the center of the screen, and the right mouse button to grab the whole image and recenter as necessary.

Window Leveling.001
Surgeon’s eye OR view

I then window-level in tissue density -this is done by pressing both the right and left mouse buttons, but you can choose this off the menu.

Window Leveling.002

I can plan the incisions and exposures from any angle -in this case, I can see the saphenous vein and its relative proximity to the CFA to perform an in site bypass to the AK POP. And I see the loci of the tributaries that I may need to ligate.

Window Leveling.004

This is a powerful tool that is often overlooked.

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