Purdue University has performed the first successful study in which medics used augmented reality technology to perform surgery in lifelike simulated war zones. (Photo courtesy of Purdue University photo/Edgar Rojas Munoz)
As augmented reality telemonitoring becomes more common in operating rooms, in which doctors communicate and perform complex procedures under the guidance of experienced counterparts remotely, the technology may have unique value in the battlefield.
Researchers at Purdue University have completed a study in which medics successfully performed surgery in lifelike simulated war zones with the use of the System for Telementoring with Augmented Reality (STAR), an augmented reality system developed in 2015 by Purdue and Indiana University School of Medicine.
“We anticipate our system to be more beneficial in these settings than conventional telementoring systems,” Edgar Rojas-Muñoz, a recent Ph.D. graduate from the School of Industrial Engineering at Purdue University who assisted the study, told HCB News. “Our platform will allow the remote mentor to provide real-time guidance based on the visual feedback provided by the system, which can be critical in situations when errors arise.”
STAR consists of a headset in which first responders can transmit a recorded view of the operating site to the surgeon, who uses a large display touch screen to mark up the recording with drawings of how to complete the procedure. Augmented reality allows first responders to see the surgeon’s annotated instructions directly on their view of the operating field.
The platform is agnostic and can be used for most procedures, but the focus is primarily on applications of surgery. The researchers tested its capabilities with first responders and surgeons at the Naval Medical Center Portsmouth in Virginia. First responders were asked to use STAR to perform a cricothyroidotomy — a procedure for opening up blocked airways — on a patient simulator. Those with no or little experience in performing the procedure prior the study were able to do so successfully when receiving instructions from surgeons through STAR. Fasciotomies — releasing muscle tension by cutting through fascia — were also performed successfully with the technology.
Simulations took place indoors and outdoors to assess the challenges presented by smoke and sounds of gunshots, explosions and helicopters. Smoke is especially a challenge due to its preventing visual sensors from working. First responders with STAR performed cricothyroidotomies more successfully than those who relied solely on hearing the surgeon’s voice for each scenario. They were still able to perform the operation if smoke made visualization unreliable, with the technology automatically switching to audio-only telementoring.
Researchers hope to evaluate its performance in closer-to-real-life scenarios such as severe bleeding from actual patients. They claim that while the technology can work under extreme conditions, it requires more durable materials before it can be used in combat areas.
“We have been in touch with our collaborators to discuss possible improvements of our platform and how to test them,” said Rojas-Muñoz. “For instance, we have been working on integrating an artificial intelligence module to assist mentees in austere scenarios when the network communications get compromised. However, there are currently no set dates on when further evaluations can happen.”
STAR is protected by patents filed through the Purdue Research Foundation Office of Technology Commercialization.
The study was financially supported by the Office of the Assistant Secretary of Defense for Health Affairs and the National Science Foundation.
The findings were published in NPJ Digital Medicine.
