Ureteroscopy is the standard of care for diagnosing and treating kidney stones and tumors. However, current ureteroscopes have a limited field of view, requiring significant experience to adequately navigate the renal collecting system. This is evidenced by the fact that inexperienced surgeons have higher rates of missed stones. One-third of patients with residual stones require re-operation within 20 months. In order to aid surgeons to fully explore the kidney, this study presents the Navigated Augmented Reality Visualization for Ureteroscopic Surgery (NAVIUS) system. NAVIUS assists surgeons by providing 3D maps of the target anatomy, real-time scope positions, and preoperative imaging overlays. To enable real-time navigation and visualization, we integrate an electromagnetic tracker-based navigation pipeline with augmented reality visualizations. NAVIUS connects to 3D Slicer and Unity with OpenIGTLink, and uses HoloLens 2 as a holographic interface. We evaluate NAVIUS through a user study where surgeons conducted ureteroscopy on kidney phantoms with and without visual guidance. With our proposed system, we observed that surgeons explored more areas within the collecting system with NAVIUS (average 23.73% increase), and NASA-TLX metrics were improved (up to 27.27%). NAVIUS acts as a step towards better surgical outcomes and surgeons' experience. The codebase for the system will be available at: https://github.com/vu-maple-lab/NAVIUS.

翻译：输尿管镜检查是诊断和治疗肾结石与肿瘤的标准方法。然而，当前输尿管镜的视野有限，需要丰富的经验才能充分导航肾集合系统。经验不足的外科医生结石遗漏率较高即证明了这一点。三分之一的残留结石患者需要在20个月内再次手术。为辅助外科医生全面探查肾脏，本研究提出了用于输尿管镜手术的导航增强现实可视化（NAVIUS）系统。NAVIUS通过提供目标解剖结构的三维图谱、实时镜体位置以及术前影像叠加来辅助外科医生。为实现实时导航与可视化，我们将基于电磁跟踪器的导航流程与增强现实可视化技术相集成。NAVIUS通过OpenIGTLink连接3D Slicer和Unity，并采用HoloLens 2作为全息交互界面。我们通过用户研究评估NAVIUS，让外科医生在有/无视觉引导条件下对肾脏模型进行输尿管镜检查。使用本系统后，我们观察到外科医生借助NAVIUS探查了集合系统内更多区域（平均增加23.73%），NASA-TLX指标亦有所改善（最高提升27.27%）。NAVIUS是改善手术效果与外科医生体验的重要一步。系统代码库将发布于：https://github.com/vu-maple-lab/NAVIUS。