Professor Stephen Roche hoisted the South African flag high when he led a team from Groote Schuur Hospital early this month to use a Microsoft HoloLens2 – a holographic helmet – to perform a mixed reality shoulder replacement surgery.
The mixed reality technology is considered one of the best as it enables medical teams to plan and visualise surgeries. The marathon surgery was part of a global 24-hour event in which surgeons from 13 countries collaborated on 13 orthopaedic surgeries using holographic imagery.
Roche who is head of shoulder and elbow unit at the Groote Schuur Hospital said: “This technology allows for surgeons anywhere in the world to share expertise and collaborate virtually in real time. Not only does this lead to better patient outcomes but the applications of this technology in a context such as South Africa also go far beyond the operating theatre.”
Launched last year, the project is the brainchild of the French surgeon Professor Timothy Grégory. He invited Roche and his team from Groote Schuur Hospital to participate in the global 24-hour event with a view to showcasing the use of the HoloLens2 in orthopaedic surgery.
Roche said the event used the holographic helmet in a series of surgeries which took place in 13 locations around the world. Not only did Roche lead the South African surgery team but he also assisted in two other surgeries in Germany and France.
Roche said the Groote Schuur surgery required the collaboration of administrative, surgical and anaesthetic teams who ensured everything ran smoothly on the day.
Said Roche: “I am happy to say that the South African surgery was successful thanks to the expertise of our team who did everything from ensuring that the Wi-Fi worked to spending long hours learning how to manipulate the holographic images produced by the HoloLens2 helmet.”
Roche added that “an eminent honorary consultant at Groote Schuur, Professor Basil Vrettos, performed the actual surgery so that I was free to attend to the integration of the technology in the theatre to maximise the showcasing of the technology without compromising the patient.”
Roche believes that the foremost benefit of using such technology is indeed better surgical outcomes for patients. “Orthopaedic surgeons have for some time used computer-generated imagery of the anatomy of a patient to ensure precision, especially in the case of joint replacement surgery. Using extremely detailed holographic imagery, which can be updated and manipulated in theatre, is a very useful tool for a surgeon. For example, imagine being able to magnify or be able to walk around an actual image of a particular patient’s scapula, in real time, during a surgery,” explained Roche.
Surgeons not only have access to such holographic imagery both prior and during surgery, he added, they can also share it remotely, allowing for virtual collaboration from anywhere in the world.
“This promises great benefits for surgeries happening in remote areas or when surgeries need to be performed by doctors who are not necessarily specialists in that particular kind of surgery.”
Roche said even a surgeon based in a remote hospital may benefit from the technology. “Using mixed-reality technology, such a surgeon could call on the expert advice of a specialist on a different continent. It is almost like having that doctor standing beside you in the theatre.”
The use of the HoloLens2 as a teaching tool was not a new experience to Roche. He said they have long been using the mixed-reality technology long before the February marathon shoulder replacement surgery.
“We started doing Monday surgical sessions that allowed registrars and trainee surgeons to witness surgeries which they would otherwise not have access to, especially over the course of the last year due to many surgeries not taking place due to the pandemic and COVID-19 restrictions.”
Concluded Roche: “I think that in the future such technology will become widely used. Mixed-reality technology is already being used across a number of medical disciplines, from cardiothoracic and neurosurgery and now thanks to projects such as these, it is increasingly being used in the public health sector.”
He said the technology “offers the next generation of surgeons the opportunity to learn from and share knowledge with the best in their field in a way that transcends geography or national borders”.