Surgeons at the St Petersburg University Clinic preserve a patient’s kidney using mixed reality
Surgeons at the Pirogov Clinic of High Medical Technologies at St Petersburg University has performed a complicated operation to remove a kidney tumour. The team was headed by the Deputy Director for Urology, surgeon Nariman Gadzhiev. Mixed reality enabled the surgeons to preserve the kidney. This technology was developed using original Russian software.
The patient was admitted to the St Petersburg University Clinic with a small mass in the left kidney. The formation was located in the kidney tissue and did not protrude beyond the kidney. Such tumours are very difficult to find during surgery. To detect them, it is necessary to use intraoperative ultrasound or inject indocyanine green, i.e. a special substance that becomes visible when exposed to infrared light and makes it possible to perform the operation more accurately. However, as surgeon Nariman Gadzhiev said, these methods do not always help to solve the problem.
Mixed reality is a new technological solution based on the combination of augmented reality (AR) and virtual reality (VR). This makes it possible to create virtual projections of objects in the real physical world.
The surgeons decided to use the technology of mixed reality, i.e. glasses with the Russian software HLOIA. It develops individual models of the internal anatomy of a person based on diagnostic data obtained using computed and magnetic resonance imaging.
At the first stage, the patient is given a computed tomography with contrast. The tomography is loaded into a special viewer programme to be segmented. It colours various structures in different colours, i.e. the kidney, the tumour, and the vessels. This data is then uploaded to the HLOIA service to be transmitted to the application that is installed in the mixed reality glasses.
‘In the operating room, a surgeon puts on glasses. From the glasses, the finished model, i.e. a virtual organ complex, is projected to any point in physical space, in our case, to the kidney. As a result, the surgeon receives complete information about the location of the vessels, ureter, tumour, and renal artery,’ Nariman Gadzhiev explained.
Mixed reality ensures that the surgeon can remove the formation, preserve the organ, and avoid possible complications inherent in such operations, such as bleeding.
According to the experts, the method also helps the surgeon to better prepare for the operation and reduce the time to make decisions. During the operation, the surgeon can refer to the model of the organ complex as reference information. To this end, they do not need to leave the instruments, are not distracted and can additionally study the patient’s images. Mixed reality provides a full picture at once.
The project on the use of the HLOIA service in surgery is being developed jointly with Professor Igor Semeniakin, Bauman Moscow Technical University, and Innopolis University.
The surgeons are confident that the use of virtual technologies in the field of healthcare can change the understanding of and existing procedure for providing surgical care around the world.