Surgeons get new insight from Mixed Reality

Surgeons get new insight from Mixed Reality
The NHS HoloLens solution allows surgeons to view a 3D model of a patient's leg transposed in mixed reality onto the actual limb, to better plan surgeries.
Published: 19 June 2018 - 6:39 a.m.
By: Mark Sutton

Surgeons in the UK are using Mixed Reality and Microsoft HoloLens to help them perform reconstructive surgery.

A project developed by Imperial College and St Mary's Hospital in London is using HoloLens to provide plastic surgeons with a 3D mixed reality (MR) model of patient's limbs, which drastically improves the time and success rate of certain operations.

Dr Philip Pratt, a technologist and Research Fellow at the Faculty of Medicine, Department of Surgery & Cancer at Imperial College explained that the MR model helps address a problem faced by plastic surgeons when carrying out reconstructive surgery.

With some injuries, a patient requires not just a skin graft to cover an area, but an actual transplant of a chunk of flesh - referred to as a ‘flap' - complete with intact blood vessels. By taking the flap from another part of the body, usually the patient's leg, the surgeon is able to transplant it into a wound, and connect the new blood vessels, to ensure that it heals properly.

One of the challenges for surgeons is identifying a suitable flap and its essential blood vessels, and removing the tiny vessels still intact. Traditionally surgeons had relied on ultrasound scans to find the blood vessels, but the scans were not always reliable. Sometimes they might cut a patient open, and not be able to locate the vessels, or the vessels might be damaged by cutting in the wrong place.

Now, using a method suggested by a consultant radiologist at St Mary's Hospital, hospital staff are conducting CT scans of the patient's limb to map the blood vessels. Then a 3D vascular model is translated into a mixed reality model, which the surgeon can view using a HoloLens. The model is projected directly onto the limb in real life, meaning the surgeon is able to see the most promising blood vessels, and then precisely mark where they will cut on the patient's skin with a marker pen.

The greater degree of accuracy means that surgeons can find a suitable flap much more quickly, carrying out two operations in the time it normally takes to do one.

The process has been such a success that it is now being rolled out across the UK's National Health Service, and surgeons are inundating the technology team with requests for more Mixed Reality simulations.

Dr Pratt said that there are many more potential uses for the technology. Training is becoming a common usage for MR simulations, and MR can potentially open up medical data such as 2D scans to much deeper interaction and interpretation by medical professionals.

"We are just scratching the surface at present. I always find it incredible that we have got these machines in the hospital, MRI scanners and CT scanners, that give us incredibly detailed pictures of what is inside the body, but the way that clinicians and surgeons interact with that information is so antiquated at the moment, we could do so much better. The HoloLens, I think, opens your mind to what is possible in future."

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