Having a pair of X-ray vision eyes to see through a patient's body, directly identifying lesions and assisting in pinpointing issues is a dream for many doctors. Hualien Tzu Chi Hospital has collaborated with SURGLASSES to conduct research on advanced minimally invasive spine surgery. This involves utilizing Augmented Reality (AR) technology, allowing surgeons to visually display hidden nerves and blood vessels beneath the skin and muscles during surgery. This innovative approach aims to reduce the risk of damaging surrounding nerves and blood vessels during spinal surgery. Dr. Yeh Kuang-Ting, Deputy Director of the Orthopedics Department at Hualien Tzu Chi Hospital, emphasized the importance of not only minimizing invasiveness but also enhancing safety in surgical procedures. The results of this groundbreaking research will be showcased at the "Taiwan Medical Technology Exhibition" from December 1st to 4th. Medical professionals and the public interested in this advancement are welcome to experience it firsthand at the Nangang Exhibition Center during the exhibition.
Using orthopedic spine surgery as an example, after the introduction of minimally invasive techniques, advantages such as smaller incisions and less bleeding can reduce the size of the wound, enhance surgical safety, and decrease postoperative pain and recovery time. However, clinical studies have found that during the process of implanting screws, it is still challenging to avoid damaging some nerves and blood vessels. Professor Zeng Guofan from the Tzu Chi University Simulation Medical Center in Hualien stated that each segment of the spine has nerve connections, and there are arteries and veins entering and leaving both inside and outside the spine to supply blood. There are also finer blood vessels in the surrounding area. Therefore, the common large incision and dissection in traditional spine surgery often lead to muscle and fascial damage, as well as postoperative unexplained pain at the surgical site. Even with minimally invasive or endoscopic techniques, entering the surgical area may still inadvertently damage nerves or blood vessels. If, during the surgery, efforts are made to control bleeding by cauterizing nearby vessels outside the spine, it may lead to postoperative blockage of the spinal cord blood supply route, potentially causing localized mini-strokes or other unexpected sequelae after surgery.
Dr. Yeh Kuang-Ting, an orthopedic surgeon at Tzu Chi Hospital in Hualien, stated that in traditional surgery, it is necessary to undergo a certain amount of dissection before safely placing screws in the spinal canal. Therefore, utilizing Augmented Reality (AR) and Mixed Reality (MR) technology in spine surgery allows for preoperative simulation of the 3D overlay of anatomical blood vessels and nerves. This technique enables surgeons to enter the correct position without performing extensive dissection. With the assistance of AR glasses, surgeons can visualize the 3D positions of nerves and blood vessels, allowing for minimally invasive surgery while avoiding the neural and vascular pathways. This approach effectively reduces the risk of postoperative sequelae in spinal surgery.
The biotech company has been investing in Augmented Reality (AR) smart surgical glasses for many years. Currently, they have obtained a Class II Medical Device License from Taiwan's Food and Drug Administration (TFDA) and are the only AR smart glasses guidance system approved for clinical use in Taiwan. Augmented Reality involves using cameras and image analysis to calculate the three-dimensional position, allowing virtual objects to be displayed on the screen and interact with the real world. CEO Wang Min-liang explained that while AR glasses utilize AR-related technology, they use advanced software development and AR transparent eyeglass display lenses to present virtual objects. This makes them more suitable for applications in high-precision medical fields. In collaboration with Hualien Tzu Chi Hospital, the company has developed interactive technology that allows instruments to accurately project real internal structures with an error margin of less than 1mm, directly displaying 3D spinal anatomy and fitting precisely onto the patient's actual spine.
The AR technology has been successfully applied in clinical practice, notably assisting in the reconstruction of the pelvis for a severe pelvic fracture patient involved in the 0402 Taroko Express train derailment incident. Deputy Director Yeh Kuang-Ting stated that recent developments in AR-assisted minimally invasive surgery have progressed further at the Tzu Chi University Anatomy Simulation Medical Center. While focusing on innovative research in spinal surgery, they have discovered new applications of AR smart glasses in clinical settings. The collaboration between the two entities will continue to deepen in the future.
In this event, there were ample resources provided, and within the simulation operating room at Tzu Chi University, spinal surgery was simulated using cadavers. Augmented Reality (AR) glasses were employed to display a 3D representation of nerves and blood vessels. From pre-operative to intra-operative stages, it seemed as though the surgeons had gained a pair of X-ray vision, enabling them to see nerves and blood vessels. This technological integration proves beneficial for both clinical practice and teaching. The selfless contribution of cadavers combined with advanced technology allows for precise calculation and simulation of each surgical step, focusing on crucial details throughout the process. In the future, not only spinal injury patients but also physicians from various specialties and patients in diverse medical conditions will benefit from this union of compassionate anatomical donations and cutting-edge technology.
Hualien Tzu Chi Hospital's Director of the Teaching Department, Xie Ming-Zhen, expressed that the collaboration between Hualien Tzu Chi Hospital and Tzu Chi University, with the silent mentors' selfless dedication, provides ample resources for academic and technological development. In the simulation operating room at Tzu Chi University, silent mentors were utilized for simulating spinal surgeries, combined with Augmented Reality (AR) glasses to display a 3D representation of nerves and blood vessels. From pre-operative to intra-operative stages, it seemed as though the physicians had gained a pair of X-ray vision, enabling them to see nerves and blood vessels. This integration proves beneficial for both clinical practice and teaching. The silent mentors' altruistic donation of their bodies combined with advanced technology allows for precise calculation and simulation of each surgical step, focusing on crucial details throughout the process. In the future, this advancement will not only benefit spinal injury patients but also physicians from various specialties and patients in diverse medical conditions.
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