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Surgery. source: flickr.com/photos/ndguard

Picture for a moment that you are a surgeon: you have a patient in front of you who has several kidney stones that need to be removed, but you want to minimise tissue damage, pain and scarring. You make a very small incision of around 1cm, but before you can insert the tiny endoscopic camera into the kidney to actually see what you’re doing, you have to successfully find the organ and puncture it with a needle…

As you can imagine, blindly poking a needle around inside someone would be enough to worry anybody, even experienced surgeons!

This is where the iPad comes in.

The main problem that surgeons currently face during kidney puncture is determining the exact location of the organ. Traditional visualisation methods such as ultrasound and x-rays have their uses and can provide horizontal and longitudinal pictures of the kidney, but the image can only represent a single plane, and essential anatomical structures can be shown incompletely or missed altogether.

When using the iPad to help navigate inside the body, 3D virtual reality displays everything you need to see at the same time without the restrictions of other methods which could affect how well the surgery goes. By allowing surgeons to use both hands, rather than having one occupied with an ultrasound scanner, this new method has proven to be extremely helpful and has so far produced excellent results.

So, how does a 3D virtual reality environment work?

ipad surgery. Source: http://europeanurology.com

To produce the virtual surgery environment on the iPad’s screen, the doctors use a computed tomography (CT) scanner to create comprehensive 3D map of the inside of the patient’s body. During the scan, special markers are attached to the skin around the site of surgery to act as navigational aids. In the operation, the iPad is used as a camera to take images of the patient’s skin with the markers attached. These images are then sent via WiFi to a control-room computer which runs an algorithm to determine the position and orientation of the patient in relation to the iPad. The computer then overlays the captured picture with the CT images, which are sent back to the iPad and displayed on the screen, allowing virtual 3D insight into the patient.

Using virtual reality in surgery is certainly a fascinating idea, and enabling surgeons to see otherwise hidden interior structures is an incredible technological advance. Furthermore, in comparison to other imaging equipment, the iPad is more affordable, functional and simple to use. With Apple due to announce the release of the iPad 3 this spring, it is really exciting to see the implementation of this technology in a surgical setting; there really appear to be no limits to what it can do… Food for thought during your next game of Angry Birds!

References:

Rassweiler et al. Eur Urol 2012, 61:628-31 [PMID:22209052]