Visualising the Future of Orthopaedic Surgery: A Novel Application of Wireless Smart Glasses to Visualise Intraoperative Imaging

Abstract

Smart glasses can provide a heads-up display of advanced imaging intraoperatively. In recent years, growing attention has been drawn to the use of smart glasses as an assistive technology to improve both efficiency and ergonomics in a surgical setting. Previous studies have reported improved surgical accuracy, efficiency, and ergonomics with its usage, but its effectiveness as a form of intraoperative heads-up display remains elusive in the context of orthopaedics. This study provides a novel account of a wireless set-up of the Moverio BT-35E Smart Glasses (Suwa, Japan: Epson Inc.), incorporated in a complex orthopaedic procedure.Hind-foot nailing was performed on a patient with a complex open ankle fracture and multiple comorbidities. Smart glasses were worn by the primary surgeon throughout the procedure to provide heads-up visualisation of the intraoperative fluoroscopy.In our surgical case, the surgeon experienced improved ergonomics and reduced disruption to focus with the use of smart glasses. The wireless set-up provided excellent signal transmission throughout the duration of the procedure.The wireless set-up of smart glasses is a potential solution for common occupational risks imposed on orthopaedic surgeons. Smart glasses minimise musculoskeletal strain from switching of vision from monitor to patient, whilst the wireless set-up allows for efficient use of space in an operating theatre and may potentially limit radiation exposure. Lastly, ergonomic benefits may increase the efficiency of movement for the surgeon, decreasing operative duration, and in turn minimising the risk of surgical complications for patients.

Towards Wearable Augmented Reality in Healthcare: A Comparative Survey and Analysis of Head-Mounted Displays

“…Although the majority of the smart glasses used in the selected studies were Google Glass, eight exceptions were considered. Harris et al [10] chose ODG R-7 AR glasses with installed NuLoupes for their demonstration; Munusamy et al [11], Kim et al [12], and Sommer et al [13] used Vuzix smart glasses in their research studies; Maruyama et al [14] selected the Moverio BT-200 (Seiko Epson Corporation); Park et al [15] and Jang et al [16] selected the Moverio BT-35E smart glasses (Suwa, Japan: Epson Inc.); and the VR X-Ray glasses developed by Skilitics and Virtual Medical Coaching, New Zealand, were selected by Kato et al [17].…”

“…It is important to note that the vast majority of the studies examined the potential use of Google Glass as an intraoperative intervention (9/15, 60%) [10,11,[13][14][15][18][19][20][21], as well as its potential use in preoperative/teaching (4/15, 26.7%) [12,16,17,22] and postoperative (1/15, 6.6%) [8] settings (Figure 2). Another analyzed study [23], which did not cover any of these three applications, was associated with Google Glass applications in the medical industry, as well as its useful contribution to physicians.…”

“…The authors selected international studies related to medical applications of Google Glass Figure 3 shows the countries that conducted the research. The studies selected were conducted in the USA [10,13,18,22], South Korea [12,16,20], Japan [14,17], Germany [21], Italy [8], the UK [15], Spain [19], Turkey [23], Malaysia [11], and Tanzania [13].…”

“…During spine surgeries, a smart glasses system with an integrated camera and microphone was used to transmit in-3 patients of scoliosis correction Vuzix Smart Glasses Spine Surgery Regarding operative settings, Google Glass was used in various surgical specialities, including urological surgery [19,21], spinal surgery [13,20], oncological surgery [24], orthopaedic surgery [15], and neurological surgery [11,14,18] (Table 1). This technology was also applied in preoperative settings, namely dermatology visits [22] and nursing skills training [12].…”