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Biomedicine

A Better View for Advanced Surgery

Head-mounted virtual reality gives doctors a better view during minimally invasive surgery.

The advent of “minimally invasive” surgery, performed with slender instruments through tiny incisions, has meant less trauma and faster healing for patients. But the technique requires surgeons to watch a video or ultrasound screen while operating to see what’s going on underneath the skin-an awkward proposition for the surgeon. A head-mounted virtual-reality apparatus, developed at the University of North Carolina and now in clinical trials, could offer doctors a more natural view and allow for faster, safer operations.

The trial-the first conducted with such a device-will involve 24 women undergoing breast tissue biopsies. A surgeon dons headgear incorporating glasses-like displays and two cameras mounted in front of her eyes. A computer merges ultrasound information flowing from a probe held to the patient’s skin with video taken by the cameras, showing the operation site. This combination gives the surgeon a view into the body that corresponds with her natural perspective. What’s more, the system tracks every twist and turn of the surgeon’s head using ceiling-mounted cameras. Software adjusts for these movements to keep the ultrasound and video components of the surgeon’s view in sync.

Harvard Medical School’s Ferenc Jolesz, director of image-guided therapy at Boston’s Brigham and Women’s Hospital, says the North Carolina device “may lead to fundamental change in surgical visualization.” The technology does, however, have competition. Siemens is developing a similar device and is now seeking an appropriate clinical trial.

The North Carolina device might take a decade to reach operating rooms, says computer scientist Henry Fuchs, who led the team that developed it. So far, a surgeon working with Fuchs has performed four operations; Fuchs hopes that others will be completed this year. After that, he aims to seek an industrial partner to further develop the technology.

Eventually, head-mounted devices could be used for more challenging procedures like liver biopsies, which would become less awkward for surgeons-and safer for patients.

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