Recent advances in technology are radically shifting the practice of medicine in eye care and other fields. One of the newest technologies in the medical field is augmented reality (AR). Popularized by smartphone apps, AR is the overlay of digital information on the real world through the lens of a camera. In medicine, AR is having a significant impact on surgeries. Many surgeons are using the technology to improve surgical procedures. Rather than smartphone cameras, though, surgeons use special AR glasses that display important information and images over the patient during an operation. The glasses allows a surgeon to stay focused on the patient and not have to turn away to consult a diagram or plan.
How AR Works in the Operating Room
AR glasses have clear lenses to allow surgeon to see the real world. Inside the glasses are sensors that generate a three-dimensional representation of the physical world. Current technology makes it possible to map up to a 120-degree field of view through infrared cameras that can calculate depth. The calculations run constantly so the field of view moves as the surgeon moves. Specialized sensors, including an accelerometer and a gyroscope, help calculate the position of the head in space. These sensors provide information about acceleration and angle of movement. This means the projected images are linked to both the physical world and the body of the surgeon wearing the glasses.
Creating such a detailed map of the physical world requires a great deal of processing power, and it is only recently that it was possible to compute using the glasses alone. Prior, the glasses would transmit data to a computer and then receive it back, which created a delay that limited the usefulness of AR in surgery. Now, the software and hardware are improved, which has increased adoption of the technology. AR glasses continue to grow more powerful; some advanced versions allow wearers to zoom in and manipulate images using hand movements.
Why AR May Be a Powerful Tool for Surgeons
What makes AR so powerful in the operating room is the ability to overlay personalized anatomical information on the patient’s body. Surgeons use several different visualization techniques to map anatomy, locate a problem or target their procedure. In a standard operation, these images are separate from the patient and may be displayed on screens in the operating suite to be referenced during the surgery. AR allows the display of such imaging directly over the patient’s body, so surgeons can make even more precise incisions.
Surgeons at Imperial College London (ICL) are using AR during reconstructive surgery on patients with critical leg injuries. The AR for the leg surgeries involves performing computed tomography angiography to create three-dimensional images of bones, soft tissue and vessels. These images are then projected as holographic images over the leg, so surgeons can see the internal anatomy before making the first incision. Surgeons have been able to operate more efficiently, thereby reducing patient time under anesthesia and achieving better patient outcomes. ICL surgeons note the AR technology is more reliable and more time-efficient than the current standard of audible Doppler ultrasound.
Barriers to the Implementation of AR in Surgical Procedures
While the future is promising for integrating AR into surgeries, there are some challenges to be addressed before the technology can be more widely adopted. One issue is the fact that hospitals will need to create a new workflow and hire skilled professionals to create the models displayed in AR. In addition, custom software is required, which could impose a cost burden. Furthermore, surgeons will need significant training before they can use the glasses safely and effectively. The training takes time and demands that other surgeons skilled in the practice are available to serve as instructors. Additionally, translating medical imaging into three-dimensional models takes time, so the technology is not yet useful in emergencies.
At the same time, AR has significant potential to make routine surgeries safer and faster. The ability to visualize clots, tumors, injuries or anatomical structures in real time directly on the patient would be enormously helpful to surgeons. Implementation may be easier in the future as the technology evolves and becomes more affordable and easier to deploy.
