Improving Surgical Precision with Augmented Reality

SPONSORED The Veterans Health Administration (VHA) is the largest integrated healthcare system in the United States. It provides care at 1,255 health care facilities that serve more than 9 million veterans enrolled in the VA healthcare program. These facilities help the VHA carry out its mission to honor America’s veterans by providing them with exceptional healthcare that improves their health and well-being. 

With the goal of providing the best possible care to those who have served our country, the VHA strives to use leading-edge technology in its facilities, including the most advanced surgical solutions available today. And that’s the case with Project Convergence. Through this initiative, the VA partnered with Verizon, Medivis and Microsoft to provide veterans with the one of the first 5G medical campuses in the United States and sophisticated surgical visualization tools. 

The initiative, led by the VA’s National Center for Collaborative Healthcare Innovation, brings Verizon’s 5G technology together with an FDA-approved use case in Medivis’ surgical augmented reality clinical visualization software (SurgicalAR) and Microsoft’s HoloLens 2 headset and Azure cloud service. Together, these technologies promise to improve healthcare delivery at VA facilities and in the broader healthcare community.

Improving surgical precision with augmented reality

Medivis’ SurgicalAR platform is truly groundbreaking. It integrates augmented reality, artificial intelligence and computer vision to advance surgical planning. Leveraging the Microsoft HoloLens 2 AR headset, SurgicalAR enables physicians to visualize patient imaging holographically, allowing for superior precision and real-time decision making — in and out of the operating room.

SurgicalAR is realization of the vision of two physicians who founded Medivis, neurosurgeon Osamah Choudhry and radiologist Christopher Morley. The pair started laying the groundwork for SurgicalAR while they were senior residents at New York University (NYU) Medical Center. Today, Dr. Choudhry serves as chief executive officer of Medivis and Dr. Morley holds the post of chief operating officer.

From the outset, Dr. Choudhry and Dr. Morley recognized the need for 3D technology that could improve surgical precision by giving surgeons a more complete and immersive view of imaging, as opposed to today’s commonly used 2D imaging tools. As Dr. Choudhry notes in a presentation to the VA community, this need for 3D visualization technology became clear during his neurosurgical training years at NYU. 

The team had a delicate 10-hour surgery to peel a tumor away from a network of blood vessels at the base of a patient’s brain. Eight hours into the procedure, the surgical team was struggling to understand critical 3D anatomy as they scrolled through a series of 2D magnetic resonance imaging (MRI) slices and the lead surgeon tried to mentally re-create what he was seeing through the microscope.

“It was a very frustrating experience,” Dr. Choudhry says in the presentation. “We all kept thinking, ‘This imaging is such critical information. There has to be a better way of seeing and understanding this than through these 2D slices.’”

This experience raised an obvious question for Dr. Choudhry and his colleagues: Why use 2D imaging if we are solving a 3D problem? And that put Dr. Choudhry and Dr. Morley on the path to the development of SurgicalAR and the use of augmented reality and AI to create very exact 3D holographic images that can help surgeons do their jobs precisely and safely.

The technology under the hood

Medivis’ rapid rise to prominence in the world of surgical visualization has been fueled in part by powerful partnerships with world-class technology companies, including Dell Technologies, NVIDIA and others.

“The way we work is that we take our imaging and we reconstruct it using our software technology,” Dr. Choudhry explains in a Dell Technologies case study. “And because the reconstruction is very compute-intensive, we do it using a Dell Precision 7750 workstation with an NVIDIA Quadro RTX 5000 GPU. That system uses parallel processing capabilities that allow the holographic rendering to be created in real time.”  

Another big piece of the SurgicalAR solution is the Microsoft HoloLens 2 AR headset. HoloLens receives the data from the Dell Precision workstation and visualizes it in immersive 3D via the Verizon 5G network. 

Beyond the operating room, the SurgicalAR solution can be used to help doctors better plan and prepare for surgery by being able to view and orient themselves to the patient’s internal anatomy. It can also be used to provide an immersive learning environment for training doctors and other clinicians. This capability is particularly important to VA hospitals, which provide a training ground for more than 70 percent of U.S. doctors.

Initially, the SurgicalAR solution is slated for deployment at VA sites in Palo Alto, Portland, Puget Sound, Philadelphia and Orlando. But the bigger vision is to bring the solution, and the power of augmented surgical visualization, to VA facilities across the country.

“This is an incredibly exciting partnership,” Dr. Choudry says in the Dell Technologies case study. “It allows us to work with the VA healthcare system, which is the country’s largest healthcare system, and use this technology to help our nation’s veterans, who really deserve the best of technology in their care.”

To learn more about the SurgicalAR solution, check out the video “Augmented Reality for Safer Surgery” and read the Dell Technologies case study.

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