St. Joseph's medical breakthrough like 'laser-guided GPS' for surgery

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It’s a futuristic medical marvel happening in London.

St. Joseph’s Health Care London is the first hospital in Canada and one of only two in the world to pioneer precision surgery using hologram-like technology to guide surgical instruments.

Called a “mixed-reality guidance system,” the technology tracks surgical instruments in real time and guide surgeons with precision, said George Athwal, a surgeon at St. Joseph’s.

“It is really cool. When we do an operation, I can see an exact replica of the patient’s anatomy,” he said. “It is like a laser-guided GPS system.”

The technology works like this:

• A 3D representation of the patient’s anatomy – similar to a hologram – is overlaid on the patient’s body giving the surgeon the ability to see inside like an X-ray.
• The technology guides the surgery by monitoring the position of the instruments as the surgeon makes adjustments. The instruments are guided by “widgets” that can be seen through a special headset.

“Put simply, the system allows me to peer into and through the incision to the bones and other anatomical structures below. It knows exactly where my instruments are and can guide me where to make the most intricate adjustments to replicate the pre-surgical plan precisely,” Athwal said.

The Mayo Clinic in the United States is the only other centre to use this technology in the operating room.

Although used now for shoulder surgery, it has other surgical applications such as hip and knee replacement and spinal surgery.

“The technology is very adaptable,” said Athwal.

Athwal, a surgeon with St. Joe’s Roth McFarlane hand and upper limb centre, became a global pioneer in developing and using digital 3D imaging technologies as tools in shoulder replacement surgery three years ago.

Employing 3D technology and wearing a special headset, he used a digital rendering of the patient’s shoulder to plan the surgery before the operation.

That surgery also was the first in Canada, and the second globally, to use such technology and laid the foundation for this latest breakthrough.

This latest development is an evolution of that early pioneering work.

“What’s new and exciting is the giant leap in what we can now do with this technology to advance surgical precision,” Athwal said. “The 3D representations of the patient’s anatomy can, quite literally, point the way.”

He was involved in the development of this software and technology for the past 10 years along with a team of surgeons for Stryker, a medical and surgical equipment manufacturer in the U.S.

Athwal envisions this next generation of the system will be used for more complex shoulder replacement surgery such as those with the greatest amount of bone deformity and disease.

“For the most challenging cases, where implant positioning is critical to successful patient outcome, this technology is a game-changer,” he said.