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He was then able to superimpose the CT scan scapula reconstruction with manual adjustment onto the visible part of the bone ( Figure 2 and see video at ). The surgeon was also able to drag the 3-D reconstruction of the scapula, scaled 100%, right before his eyes, by simple gestures in front of the headset ( Figure 1) in approximately 3 minutes.
Hence, the surgeon was able to compare, stage by stage, what he was doing with what had to be done. As described above, the surgeon was able to access the patient’s medical data combined with the data of the operative technique, which were transmitted into his operating headset in real time during the intervention, e.g., patient scapula 3-D reconstruction extracted from her CT scan, the planning of the positioning of the glenoid and the whole operative technique developed in 3-D holograms according to the planned position. The prosthesis was implanted with the aid of this MR headset at Avicenne Hospital in Bobigny, France, on December 5, 2017. Here, we present the first use of such a system in a surgical environment and focus on the latest trends of the rapidly developing connection between MR and surgery. The promise of such technology in the surgical field is huge, as it allows the surgeon (i) to gain access to computer-based solutions in real time during the procedure while remaining totally sterile, (ii) to gain access to 3-D holograms related to the patient imaging or the surgical technique, and (iii) to remotely interact with colleagues located outside the theatre. Recently, Microsoft has developed a new concept of an MR headset (HoloLens), equipped with motors, that allows the hand user to interact with the headset by oral command or simple gesture. As virtual elements in the form of holograms align with the reality this is commonly referred to as mixed reality (MR) as it enhances reality. This can be done using augmented reality (AR), a technique that allows the superimposing of a digital image on top of the visual field, i.e., augmenting reality. The next step in the usage of 3D anatomical information is to go from planning to per-operative usage. Among many others, computer-based solutions such as 3-D anatomical reconstruction and computer-based procedures planning have shown clear benefits to patients (Beckmann et al. Surgical innovation aims to improve both patient outcome and safety.