Using MR to ‘see through’ patient tissue in operations

A team at Imperial College London have demonstrated how mixed reality can be used in complex reconstructive lower limb surgery.

The team used a Microoft Hololens to overlay images of CT scans showing the position of bones and key blood vessels onto an actual patient’s leg. This essentially allows the surgeon to ‘see through’ the limb while performing the procedure.

The key benefit of leveraging the technology in this way is to allow surgeons to better locate and reconnect important blood vessels during the reconstructive surgery. This is something the team believe will lead to improved outcomes for patients.

The successful demonstrations make the team that first group to show that the technology can be effectively applied in this kind of complex and potentially risky surgical environment. This kind of reconstructive procedure usually involves taking skin from other parts of the patient’s body and using it to cover up tissue damage or open wounds caused be sever trauma, such as a car accident.

Increasing accuracy

One of the most important steps in lower limb reconstructive surgery is connecting the blood vessels of the new tissue being used to cover the wound to the site of the trauma. This is an essential step, as without it oxygenated blood cannot reach the new tissue and it will die.

Currently, surgeons use a handheld ultrasound scanner to try and identify blood vessels under the skin. This allows the surgeon to approximate where the vessels are and how they run through the tissue in question. The mixed reality solution proposed by the Imperial College London team could dramatically improve the speed and accuracy of this important aspect of the procedure.

The successful demonstration involved five different patients who all underwent CT scans to map the structure of the injured limb before undergoing surgery. The CT scan data can then be segmented into bone, muscle, fatty tissue and blood vessels, which is then used to create a 3D representation of the leg. This model is then fed into the HoloLens which then overlays it over the patient’s leg.

It is hoped that this approach could not only improve patient outcomes, but speed up the currently time-consuming process of data preparation in major trauma centres.

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