"It has tremendous education potential," the MUHC's chief of rhinology Mark Tewfik says of the Targeted Guided Surgery system. "It allows new surgeons to understand the anatomy better." Pierre Obendrauf / Montreal Gazette
In a North American first, the McGill University Health Centre has been selected to use a novel augmented-reality technology in the operating room — a tool that should all but eliminate the risk of surgical errors while helping to train future surgeons.
The Targeted Guided Surgery system, developed by Scopis Medical in Germany, won approval in January from Health Canada and the U.S. Food and Drug Administration, and surgeons at the MUHC have been using it for sinus surgery since late March.
Ultimately, surgeons will be able to rely on augmented reality for much trickier spine surgery, open brain operations, as well as to remove tumours caused by head and neck cancers, said Marc Tewfik, the MUHC’s chief of rhinology.
“I think this is the next step in the future of endoscopic surgery,” Tewfik said, alluding to existing technology that allows surgeons to insert camera scopes into patients to perform minimally invasive operations.
During endoscopy, surgeons look at a computer screen that shows live images of the inside of the body. These images help the surgeon to know where to cut and where to suture. Augmented reality takes this one step further, superimposing computer-generated cues onto the live images, providing surgeons with even more precise pathways.
Scopis chose the Glen site superhospital as the first North American facility to use the system because the MUHC is an internationally recognized centre of excellence in sinus surgery. It’s feather in the cap for the beleaguered hospital network that has been hit by tens of millions of dollars in budget cutbacks.
The Scopis system usually sells for about $200,000, but the MUHC purchased it at cost for just $20,000.
“It has tremendous education potential,” Tewfik said of the system. “It allows new surgeons to understand the anatomy better. Just by virtue of planning the surgery, drawing out the different structures, drawing out where they have to put their instruments, it gives them a little bit more of a 3D understanding of the anatomy of patients, and that’s really important for this kind of surgery.”
Tze Choong Charn, a surgeon from Singapore who is fulfilling a fellowship at the MUHC, is training to use the new system.
“It’s very impressive,” Tze said. “It makes the surgery safer and faster.”
He likened existing endoscopic technology to “flying blind” compared with augmented reality.
Although the surgical error rate with sinus surgery is one in 10,000 cases, when a complication does arise, it’s “catastrophic,” he added. A surgeon can inadvertently damage a patient’s optic nerve.
With augmented reality, Tze expects the already-low error rate to drop even lower. During an operation, not only will surgeons see a patient’s sinuses, but colour-coded hoops are superimposed on the screen images to show a surgeon exactly where to operate.
Chantay Rose is scheduled to undergo surgery soon at the MUHC using the new system. Rose, who is 21, tore her left tear duct during a ski accident in 2015.
Rose said she already had full confidence in Tewfik, who will be performing the operation, but she’s even more reassured because he’ll be relying on augmented reality.
“It’s going to mean even greater pinpoint accuracy,” she said. “I think it’s cool.”
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