3D goggles may soon help surgeons see better

(Reuters Health) – In a first, heart surgeons in Poland used 3D goggles to help them see inside a patient’s chest as they opened up a narrowed heart valve, according to a report in the European Heart Journal.

Although the imaging machines surgeons typically use to peer into the body collect data in three dimensions, the images are displayed on two-dimensional screens. That means surgeons doing minimally invasive procedures have no depth perception and need to periodically tap internal surfaces to get oriented.

With the ability to see in three dimensions, the surgeon using the new technique was able to orient himself without having to tap instruments against the heart, the authors note.

“We developed the method of real-time streaming of (ultrasound) data into head-mounted mixed-reality holographic display allowing for touchless control and data sharing within the cath-lab,” the research team led by Jaroslaw Kasprzak, a cardiologist at Bieganski Hospital and chair in the department of cardiology at the Medical University of Lodz writes. “The method was tested for the first time in a human during (a procedure to widen the mitral valve).”

During that procedure, a deflated balloon is placed inside the narrowed valve and then inflated to widen the opening so blood will flow more freely, explained Dr. Omar Ali, director of the cardiac catheterization lab at Detroit Medical Center’s Heart Hospital in Michigan. Ali was not involved with the new research.

“I do minimally-invasive structural heart procedures, such as fixing the valves in the heart,” Ali said. “We usually rely on 3D ultrasound images of the heart that are projected onto a flat screen.”

The new technology takes the 3D image collected by the ultrasound machine and sends it to the 3D goggles so that the surgeon is able to actually see in 3D rather than looking at a 2D image projected on a flat screen.

The technique described in the new report “helps the surgeon navigate,” Ali said. “And this novel technique will potentially help to provide better treatment.”

Until now, the 3D technique has been used to teach medical students anatomy, Ali said. “Traditionally cadavers were used,” he added. “Now they aren’t needed because you can navigate through the body virtually.”

While the new report is promising, the technique will need to be studied in randomized trials, Ali said. And if it fulfills its promise, surgeons will need to learn how to use it, he added.

Dr. Raveen Bazaz agrees that the new technology might improve patient care.

“3D holographic displays such as the one mentioned have the potential to allow operators to utilize this valuable information and modify techniques in real time, permitting dynamic guidance during an ongoing procedure,” Bazaz, a cardiac electrophysiologist with the Heart and Vascular Institute at the University of Pittsburgh Medical Center said in an email. “The synthesis of computation and real-time imaging hold promise to permit more optimal outcomes than attainable in the past.”

SOURCE: European Heart Journal, online April 12, 2019.


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