When Dr. Brent Kimball looked down at his spinal surgery patient in an operating room on Jan. 28, he found himself with an ability very few have ever experienced: the equivalent of X-ray vision.
Kimball, a neurosurgeon at Sky Ridge Medical Center in Lone Tree, was wearing a special headset created to augment his vision and allow him to view the inner workings of his patient’s body.
The 68-year-old man’s spine was there, in 3D in front of Kimball’s eyes. And he hadn’t yet made a single cut.
“We can actually see where the spine is underneath the skin, the fat, the muscle tissue, the ligaments, we can see where the nerves are, we can see where everything is without even making an incision," Kimball said. "It allows the approach, the planning, to be very, very precise.”
Over the next three hours, Kimball worked to relieve the man’s lower back and leg pain, which was being caused by a slipped vertebrae. For the first time, Kimball was aided in the spinal surgery by this cutting-edge tool, which allowed him to be even more precise.
“Accuracy is really important,” he said. “There’s a lot of nerves nearby and they're very, very sensitive to even the smallest inaccuracies.”
The near-eye display headset, made by Augmedics, is custom fit for each user. Sky Ridge is the first hospital in the Denver metro area to have access to this tool, according to a news release from the hospital.
The technology being used, known as augmented reality, layers 3D, computer-generated images over the user’s real-world surroundings.
In the case of spinal surgeries, the augmented reality headset superimposes an image made by a CT scan of the patient’s body onto the patient, allowing the surgeon to see exactly where he needs to make an incision or place hardware. This is important because each patient’s spine and body are going to be slightly different. Knowing the exact layout of each patient’s anatomy provides a significant advantage.
“I feel like this technology allows me to take what I’ve mastered and amplify it in a way that the surgery is more precise, safer, faster, and there’s more confidence in it,” Kimball said.
Before this technology was available, spinal surgeons had several other options including the use of robotics, looking at a two-dimensional map of the body on a nearby screen during the surgery or taking continuous X-rays to reference throughout the procedure. So far for Kimball, he prefers the “xvision” headset over all these options.
“We’ve only done two surgeries, but this has already given me things that I haven't been able to fully appreciate or benefit from using the other technologies out there,” he said.
Instead of having to constantly look up at another screen throughout the surgery, he can keep his eyes on his patient the whole time.
“They’ve figured out a way to present (a lot of) information in a very intuitive way for the surgeon to just use it,” he said.
At the beginning of each surgery, the surgical team attaches a reference frame to one of the patient’s bones. Throughout the surgery, that reference frame is constantly calculating and communicating with the headset, keeping the image that the surgeon is seeing up-to-date, similar to how a satellite works. He can also see his tools and equipment through the software. When he places a screw, he can see exactly where it lies in the spine.
“There’s no lag,” he said.
As of Feb. 3, Kimball had used the headset in only one other surgery, for a scoliosis patient. He hopes to see other doctors in the hospital trained to use the technology as well in the future.
“The learning curve was very, very short,” he said.
The headset can be used for fusion surgeries, or procedures where the surgeon is placing hardware in the body to alleviate pain caused by injury or disease.
Kimball will decide when to use this tool in the future based on each patient's specific situation.
“The most exciting thing for me is I think it will lead to more reliable and ultimately more efficient and faster surgery,” Kimball said. “It’s going to allow us to have more confidence during surgery that everything is exactly where we want it to be and that means a lot.”
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