Mixed reality surgery world tour comes to South Africa

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Professor Stephen Roche, a South African surgeon from Groote Schuur Hospital and ‎professor of orthopaedics at the University of Cape Town, is one of 15 surgeons from 13 countries worldwide who have undertaken mixed reality orthopaedic operations, as part of a 24-hour online event.

Professors Stephen Roche and Thomas Grégory virtually collaborating during the surgery.
Professors Stephen Roche and Thomas Grégory virtually collaborating during the surgery.

Microsoft says after years of research, it has finally brought augmented reality (AR) into the operating theatre through the holographically-navigated shoulder surgery, enabled by Microsoft’s mixed-reality HoloLens 2 headsets.

During Roche’s live-streamed, mixed reality world tour, which took place last night, he is seen using HoloLens 2 to “see inside” patients before and during the surgery.

HoloLens allows surgeons to take computed tomography (CT) scans that have previously been completed and overlay 3D digital models of them onto a patient’s body part during reconstructive surgery.

Using CT imaging, 3D representations of the affected anatomy are generated and directly projected into the surgical field overlaying the real anatomy during the operation.

With this, surgeons can see the patient’s 3D anatomy, while the AR navigation software guides critical steps of the surgery. For example, the exact insertion point and trajectory of a screw is shown directly on the patient’s anatomy.

Roche participated in three of the 13 surgeries, leading the surgery in SA and assisting in two surgeries conducted in France and Germany.

All 13 mixed reality surgeries were led by professor Thomas Grégory of the Avicenne AP-HP Hospital, France. In December 2017, Grégory performed the first mixed reality surgery.

From France, the surgery toured a number of countries, including South Africa, France, India, UAE, Ukraine, Germany, Belgium, Morocco, Brazil, Bolivia, Mexico, the US and the UK.

The event’s international component enabled healthcare practitioners from different countries and cultures to share the diversity and richness of their respective practices.

“Interactions during the meetings and recording the surgery make you feel the other surgeons are in the room with you,” says Roche.

“Using this new technology and discussing surgery of the shoulder with world-recognised surgeons has allowed closer relations with the international shoulder community, especially as our normal interactions in international meetings have been cancelled during the pandemic. We are all trying to solve some of the problems of shoulder replacements from different perspectives, and this allows us to share our knowledge in real-time.”

Equipped with the HoloLens 2, the surgeons in each country were able to visualise and operate via hologram; share their real-time view of the surgery, benefitting from remote peers’ expertise on different clinical cases; and train their peers remotely, enriching their surgical practices.

According to Microsoft, this technique has been used to help surgeons successfully move blood vessels from one part of the body to another to help open wounds heal. Patients have included a 41-year-old man whose leg was injured in a car crash, an 85-year-old woman who fractured her fibula and a person who developed an infection that required surgery.

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