Augmented reality: Surgery through the lens of Smart-Glasses

The health care industry is loving Augmented Reality (AR), and technological innovations continue to proliferate across all areas of Med Tech, obscuring the lines between the digital and real-world environment. Smart-Glasses are one of the many exciting examples of this – wearable devices with a head-mounted monitor that enables an augmented reality, which provides surgeons with 3D information to support them in procedures. Smart-Glasses make life easier for medical practitioners, and with their capability allowing surgeons to prevent errors through a more precise completion of complex procedures, it is without a doubt that AR is set to be the future of the OR.

As of late, many healthcare providers have been expanding their use of AR devices, and with America’s first-ever AR, Smart-Glasses assisted knee replacement having been performed at the end of 2020 it is seemingly an apt time to address this market and look at some of the main companies making in-roads within this technological breakthrough.

With the AR market forecast to reach $340.16 Billion by 2028, and a CAGR of 43.8%, and the Surgical Smart-Glasses Market also set to reach $303,934.14 thousand by 2028, it is without a doubt that the merge between wearable technology and Orthopaedic surgeries will be an engine of growth in the Med Device sector in coming years.

Smart-Glasses have the potential to play a crucial role in Orthopaedic surgery, and AR can be applied to a wide scale of procedures such as tumour resection, fracture fixation, arthroscopy, and component alignment in total joint arthroplasty. Working as a Marketing Executive within this field I come across an array of exciting companies every day – I want to share with you some players operating in the Surgical Smart-Glasses market that you should be aware of in 2021, each with their own unique and state-of-the-art technologies.

The world’s first Smart-Glasses were created by Google. First released as the Google Glass Explorer Edition in 2013, the device emerged as a head-mounted technology that employs a wireless interface to provide users with a comfortable augmented reality experience in a range of areas. In recent years, the Google Glass has been utilised more in surgical settings, across many therapy areas, with the hands-free voice and motion command making the product particularly attractive to clinicians. Providing surgeons with a streamlined workflow in a setting where it is crucial to constantly monitor patients and maintain sterile conditions in the operating room, as well as Google Glass’s underlying tracking system and hands-free voice and motion command, their concept of wearable computing technology has set the pace for the practice of Smart Glasses in surgical settings.

However, although the multifaceted capabilities of Google Glass offer the potential to greatly impact the surgical field; health care providers remain uncertain about which tasks can benefit most from Google Glass intervention, and I feel it is appropriate that I discuss some other cutting-edge devices that I see offering more significant advancements in Orthopaedic surgeries.

US-based Vuzix, are set to become a notable leader in this field having successfully assisted Medacta’s NextAR, surgical platforms with their Vuzix Blade Upgraded Smart Glasses. These platforms use a preoperative scan, and surgeons equipped with the Vuzix glasses can access biomechanical visualisations using AR in real-time, without having to divert their eyes from the procedure to use a computer screen. This is highly beneficial in improving concentration and accuracy.

Vuzix’s pioneering technology was initially used alongside Medacta’s platform to complete Dr. Jonathan Vigdorchik’s first Smart-Glasses based total knee replacements in the US in late 2020, on two patients suffering from severe arthritis. The glasses provide a digital display of the patient’s leg with a 3D model superimposed showing a diagram of each planned incision, ensuring cuts are accurate to the millimeter. On top of this, being a lightweight, and completely wireless product, the Vuzix Blade Smart-Glasses offer surgeons maximum comfort during procedures, and the ability to work around PPE & headbands in surgical settings for extended operations with complete freedom of movement. Following the success of the initial knee replacement procedure in the US, Medacta now seeks to use Vuzix’s Smart-Glasses to drive new applications for AR usage in shoulder, hip, and spinal surgeries and are expanding to 54 countries to support incoming business requests for Smart-Glasses based continuity solutions.

Another well-backed medical device company with vast amounts of potential is Taiwan Main Orthopaedic Biotechnology who alongside Taiwanese scientists, has developed their own Smart-Glasses device, the Surglasses FORESEE-X. This cutting-edge technology applies AR into surgeries, striving to meet the needs of surgeons, physicians, and patients.

This company developed their Smart-Glasses in response to the lack of precision during operations which arose from the need for surgeons to constantly look up at a screen during surgeries to confirm the patient’s X-ray images. Traditionally, procedures would also expose both patients and surgeons to radiation, and so using these glasses allows the radiation exposure time to be minimised. This device also provides a high-end and easy-to-use technology, which can connect to different standard devices such as ultrasounds and endoscopes. The combination of allowing all kinds of data to be collected, and the wireless connection to the image processing box means the Foresee-X glasses are not only beneficial from the point of view of the surgeon, but also for the patient. The above-listed factors all combine to allow clinicians to conduct minimally invasive procedures which means a much faster recovery time for the patient.

The future also looks bright for WeStunitis with their PicoLinker Smart-Glasses, which can also improve accuracy, reduce radiation exposure time, total insertion time – and most importantly enables surgeons to stay focused, keeping their eyes fixed on the operation field. The PicoLinker glasses were used in a pilot study last year in Japan, where a pair of surgeons used the glasses on 20 patients who were enrolled to undergo spinal surgery. Procedures done with the fluoroscopic monitor in the Smart-Glasses were significantly efficient in treating patients, with the device additionally helping to create more space in the operating room as additional surgical equipment, assistants, and numerous monitors – which the Smart-Glasses can successfully replace.

On top of their ability to reduce unnecessary overcrowding in operation theaters, I think the sleek and wearable design of the PicoLinker provides them with a competitive edge, allowing surgeons more comfort and dexterity. Unlike Google Glass, PicoLinker has a video box that can be connected wirelessly, and the glasses have no CPU or camera meaning it is extremely lightweight, and due to its 10+ hour lifespan, battery life is rarely a problem. Additionally, The glasses are connected to a video source via a wire cable, meaning there is no image delay. On the other hand, Google Glass images are transferred via the internet, and therefore a disadvantage of the Google device is that there is a certain degree of latency inevitable in the process – something which the PicoLinker device successfully avoids.

Finally, MedithinQ is a South Korean start-up, providing wireless Smart-Glasses, with equally exciting plans to offer a dynamic solution to surgeons with their 2020 release, ScopEYE WIRED, and ScopEYE Wireless devices. Offering extraordinary vision during surgery, their device offers a cutting-edge wireless Smart-Glasses solution that enables physicians to work freely from a wired monitor on the Imaging Navigation System. They claim that in using their device, physicians will barely notice the latency between the image seen on the lenses and actual motions on the surgical site.

What particularly impressed me about MediThinQ is that their core technology is backed by over a decade of expertise, through the founder’s experience in his previous venture company which specialised in wireless transceiver systems. MedThinQ’s glasses allow surgical ergonomics to be optimised, allowing real-time intraoperative projection of data to the clinician’s eyes, such as CT, X-Ray, and MRI scans. With their technical innovation, their goal is to revolutionise surgical visualisation – providing solutions to improve operative efficiency by focusing specifically on supporting surgical techniques, while many of their competitor’s devices can be used across a variety of industries.

To conclude, it is without a doubt that Augmented reality is beginning to infiltrate the healthcare sector and is a technology that will dramatically change the future of surgery. I am intrigued to witness this paradigm shift and watch each of these companies contribute to the wider use of Smart-Glasses in Orthopaedic surgery, through pioneering technologies that will allow them to gain a foothold in a progressively more competitive market. Wearable technology offers an array of benefits to the Orthopaedics sector, but significantly their increased efficiencies will promote a higher level of accuracy and safety in surgeries, reducing risks to the clinicians and most importantly the patient.