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  • Google Glass Assisted Spine Instrumentation Using a Novel Video Streaming System: A New Usage of Wearable Computing In the Operating Room

    Final Number:
    1254

    Authors:
    Jang W Yoon MD. MS. BS.; Stephen M. Pirris MD

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: Image guidance for spine instrumentation has provided spine surgeons with improved accuracy and safety. Currently, navigation images are displayed on a separate screen away from the surgical field on the monitors. During spine instrumentation, surgeons have to take their attention away from surgical field and look at the navigational display then look back at the field to make sure the screw is following the planned trajectory. Multiple head turns between the navigation screen and the surgical field not only cause delays during implant placement but also cause the surgeon’s hand to deviate away from the intended area, causing the screw to take a different trajectory than intended.

    Methods: Using a novel video streaming system, neuronavigation images from StealthStation are captured and transferred wirelessly via a password-encrypted network to Google Glass during spine instrumentation. Following IRB approval, ten patients undergoing spine instrumentation using 3-D image guidance at Mayo Clinic Florida were consented and included in the study. At the end of the procedure, the investigators completed a survey related to the system to gather surgeons’ opinion of its efficacy.

    Results: Spine instrumentation using this novel video streaming system was successfully performed in ten patients as a pilot study for feasibility. There is a learning curve associated with use of wearable devices to assist in spine instrumentation. An enlarged display and higher processing speed of the wearable device can significantly improve the utilization of this technology.

    Conclusions: Previously reported usage of Google Glass in the operating room has been simple recording of the procedure and live streaming of these videos via Google Hangout to remote location. We report for the first time utilization of novel streaming systems to assist surgeons in spine instrumentation. This technology may improve and make spine instrumentation using image guidance more efficient and seamless.

    Patient Care: By utilizing this novel video streaming system, the surgeons will be able to view medical images on heads-up displays while performing complex surgical steps. Instead of looking up at the monitors to view medical images such as MRI, CT or neuro-navigation images, the surgeons will be able to bring up medical images via voice activation into their views. This will eliminate unnecessary head motions that may delay surgery or cause surgical mishaps. Integration of this technology may be a critical component in building the next generation surgical microscopes.

    Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the important role that the wearable computing device will play in building the next generation surgical microscopes, 2) Discuss in small groups how wearable computing device can be applied in neurosurgery, 3) Identify areas of neurosurgery that can be improved from using wearable computing device

    References: 1. Abowd GD, Mynatt ED. Charting past, present, and future research in ubiquitous computing. ACM Transactions on Computer-Human Interaction (TOCHI). 03/01/2000 2000;7(1):29-58. 2. Gazanfar Rahmathulla, Eric W. Nottmeier, Stephen M. Pirris, H. Gordon Deen, Mark A. Pichelmann. Intraoperative image-guided spinal navigation: technical pitfalls and their avoidance. http://dx.doi.org/10.3171/2014.1.FOCUS13516. 2014-03-01 2014. 3. Takeshita H, Kihara K, Yoshida S, et al. Clinical application of a modern high-definition head-mounted display in sonography. J Ultrasound Med. Vol 33. United States: 2014 by the American Institute of Ultrasound in Medicine.; 2014:1499-1504. 4. Ormerod DF, Ross B, Naluai-Cecchini A. Use of an augmented reality display of patient monitoring data to enhance anesthesiologists' response to abnormal clinical events. Stud Health Technol Inform. 2003;94:248-250. 5. Liu D, Jenkins SA, Sanderson PM. Clinical Implementation of a Head-Mounted Display of Patient Vital Signs. Paper presented at: Wearable Computers, 2009. ISWC '09. International Symposium on; 4-7 Sept. 2009, 2009. 6. Versel N. Does Google Glass Have a Place in the Operating Room? - US News. 2014; http://health.usnews.com/health-news/hospital-of-tomorrow/articles/2014/06/03/does-google-glass-have-a-place-in-the-operating-room. 7. Google Glass Delivers New Insight During Surgery. 2014; http://www.ucsf.edu/news/2013/10/109526/surgeon-improves-safety-efficiency-operating-room-google-glass. 8. Google Glass enters operating room at Stanford. CNET. 2014; http://www.cnet.com/news/google-glass-enters-operating-room-at-stanford/. 9. O'Connor A. Google Glass Enters the Operating Room. 2014; http://well.blogs.nytimes.com/2014/06/01/google-glass-enters-the-operating-room/. 10. @fox4kc. Google Glass goes into KC metro operating room. 2014; http://fox4kc.com/2014/08/11/google-glass-goes-into-kc-metro-operating-room/. 11. Google Glass hits the operating room. 2014; http://www.tennessean.com/story/money/industries/health-care/2014/07/05/google-glass-hits-operating-room/12228547/. 12. Doximity. Google Glass makes doctors better surgeons, Stanford study shows. 2014; http://news.doximity.com/entries/1507718. 13. Google plans Glass for Work program, report says. CNET. 2014; http://www.cnet.com/news/google-plans-glass-for-work-program-report-says/. 14. Nosta J. Inside The Operating Room With Google Glass. 2014; http://www.forbes.com/sites/johnnosta/2013/06/21/google-glass-in-the-operating-room/. 15. Leijen Mv. A surgeon with Google Glass could look right through you - Emirates 24/7. 2015; http://www.emirates247.com/news/a-surgeon-with-google-glass-could-look-right-through-you-2015-01-01-1.575136. 16. What does one minute of operating room time cost? J Clin Anesth. June 2010 2010;22(4):233–236.

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