When Dr Claus Eckardt makes delicate incisions on an eye, he doesn't look down into a microscope like those preferred by many of his ophthalmologist colleagues. Wearing 3D glasses, he looks at a flat-panel display beside his patient. The new-style surgical imaging system which his hospital has bought also includes data overlays that were originally developed for military aviation.
Eckardt is director of Frankfurt-Hoechst Hospital's eye clinic and has advocated for computer-guided eye surgery at several medical congresses and is working on a paper to be published in the journal Retina. Eye surgeons typically prefer an ophthalmic operating microscope, rather than the kind of 2D imaging systems which have become common in keyhole surgery for other organs of the body like the bladder.
Described by the manufacturer as a "stereoscopic high-definition visualization system" that enables eye surgeons to operate in a "heads up" manner, Eckardt's equipment - a cross between a microscope and 3D camera - costs nearly 70,000 euros (about 83,000 dollars). Deeply in the red, the hospital was able to obtain it thanks to funds from a friends' association. "I've never operated with so much assurance," remarked Eckardt, who's been performing surgery exclusively with the system for months now. He said the image of the eye wasn't just more vivid, but also larger and brighter, and praised not having to sit hunched for hours over a microscope.
His only criticism: The image's resolution is lower - "so far." To assess the new technique's performance, Eckardt had medical students and nurses arrange pins or thread sequins, both under a microscope and wearing the 3D glasses. Half of the 20 test persons found the glasses to be faster, and nearly all of them said the work posture was more comfortable. The new system overlays the image with guidance about where to make incisions.
The first heads-up displays, developed for military pilots, projected data into their field of vision so that they could look straight ahead rather than down at their instruments. Some automakers and computer game designers now also use such displays. The Federal Association of German Ophthalmic Surgeons (BDOC) sees promise for the technique in the field of medicine.
"It's a track we should continue to follow," said BDOC executive board member Dr Andreas Mohr. But he cautioned against expecting "a quantum leap in quality," pointing out that the quality of surgery in 2D wasn't bad either. Whether or not the technique catches on depends on many factors, Mohr said. What does it cost? Is it a good fit with other surgical equipment? How big is the difference? Not limited to ophthalmology, 3D surgery "can be used in any field requiring a surgical microscope," said Robert Reali, vice president at California-based TrueVision 3D Surgical, which manufactures the new visualization system.
The company says it also sells the system to neurosurgeons, for spinal surgeries and to ear, nose and throat specialists. "3D applications are currently being developed for dentists, orthopaedists and plastic surgeons as well," Reali said. Urologists at the Asklepios Hospital in the eastern German city of Weissenfels are using the 3D eyeglasses to get a better view during minimally invasive surgery on bladders and kidneys.
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