# EVD Surgical Guidance with Retro-Reflective Tool Tracking and Spatial Reconstruction using Head-Mounted Augmented Reality Device

arXiv: https://arxiv.org/abs/2306.15490 · HTML: https://mlsanity.com/paper/2306.15490/

## Key facts

- Cited by 6 papers in the map (data through 14 Oct 2026).
- Builds on 2 of its 55 references that are in the map.
- First posted on arXiv 27 Jun 2023.

## Builds on (most cited first, 2 of 2)

- [HoloLens 2 Research Mode as a Tool for Computer Vision Research](https://mlsanity.com/paper/2008.11239/) (2020)
- [STTAR: Surgical Tool Tracking using off-the-shelf Augmented Reality Head-Mounted Displays](https://mlsanity.com/paper/2208.08880/) (2022)

## Built on by (most cited first, 6 of 6)

- [EasyREG: Easy Depth-Based Markerless Registration and Tracking using Augmented Reality Device for Surgical Guidance](https://mlsanity.com/paper/2504.09498/) (2025)
- [Markerless Augmented Reality Registration for Surgical Guidance: A Multi-Anatomy Clinical Accuracy Study](https://mlsanity.com/paper/2511.02086/) (2025)
- [Segment Any Medical Model Extended](https://mlsanity.com/paper/2403.18114/) (2024)
- [SurgNavAR: An Augmented Reality Surgical Navigation Framework for Optical See-Through Head Mounted Displays](https://mlsanity.com/paper/2603.29990/) (2026)
- [AR Surgical Navigation with Surface Tracing: Comparing In-Situ Visualization with Tool-Tracking Guidance for Neurosurgical Applications](https://mlsanity.com/paper/2508.10554/) (2025)
- [ARport: An Augmented Reality System for Markerless Image-Guided Port Placement in Robotic Surgery](https://mlsanity.com/paper/2602.14153/) (2026)

## Abstract (arXiv)

Augmented Reality (AR) has been used to facilitate surgical guidance during External Ventricular Drain (EVD) surgery, reducing the risks of misplacement in manual operations. During this procedure, the key challenge is accurately estimating the spatial relationship between pre-operative images and actual patient anatomy in AR environment. This research proposes a novel framework utilizing Time of Flight (ToF) depth sensors integrated in commercially available AR Head Mounted Devices (HMD) for precise EVD surgical guidance. As previous studies have proven depth errors for ToF sensors, we first assessed their properties on AR-HMDs. Subsequently, a depth error model and patient-specific parameter identification method are introduced for accurate surface information. A tracking pipeline combining retro-reflective markers and point clouds is then proposed for accurate head tracking. The head surface is reconstructed using depth data for spatial registration, avoiding fixing tracking targets rigidly on the patient's skull. Firstly, 7.580± 1.488 mm depth value error was revealed on human skin, indicating the significance of depth correction. Our results showed that the error was reduced by over 85% using proposed depth correction method on head phantoms in different materials. Meanwhile, the head surface reconstructed with corrected depth data achieved sub-millimetre accuracy. An experiment on sheep head revealed 0.79 mm reconstruction error. Furthermore, a user study was conducted for the performance in simulated EVD surgery, where five surgeons performed nine k-wire injections on a head phantom with virtual guidance. Results of this study revealed 2.09 ± 0.16 mm translational accuracy and 2.97± 0.91 degree orientational accuracy.