A groundbreaking surgical procedure was successfully performed on a small island in the Mediterranean, marking a significant advancement in spinal surgery.
At Hospital Son Llàtzer in Mallorca, Spain, Dr. Juan Toribio, a pioneer in orthopedic surgery, collaborated with Dr. Wendell Gibby, co-inventor of VisAR augmented reality navigation. Together, they performed the first-ever immersive 3D spinal surgery using augmented reality guidance with combined silhouette and X-ray registration.
What sets this procedure apart is what was not required: there was neither a CT scanner nor a navigation tower in the operating theater. The surgery was carried out in a hospital equipped with standard imaging technology available, including a CT scanner in radiology, and a C-arm in the operating room.
While spinal navigation has existed for some time, it relies on expensive equipment such as CT scanners and navigation towers, which can cost upwards of $1 million. This financial barrier has limited access to advanced surgical techniques for many healthcare facilities. However, the procedure performed by Dr. Toribio and Dr. Gibby using VisAR demonstrates a disruptive innovation that can be implemented across hospitals of varying socioeconomic levels.
The VisAR system simply consists of an augmented reality headset worn by the surgeon—no extra computers, towers, monitors, or scanners needed. Prior to the surgery, images were acquired via the CT scanner in radiology, and the patient was then moved to the operating theater. The immersive 3D CT dataset was superimposed onto the patient with a single AP X-ray fluoroscopy shot and patient silhouette registration in immersive 3D augmented reality. This allowed for precise alignment of the patient’s real anatomy with the virtual anatomy displayed on the CT scan. With this innovative approach, Dr. Toribio and his associate Dr. Laura Perello were able to navigate four screws into the spine for fusion, as well as a disc insert.
Following the procedure, Dr. Toribio expressed his enthusiasm for the technology, stating, “After these two days in our hospital, we have been able to confirm that the level of technology you have developed is far superior to what we had imagined. You have to see it to understand it.” He continued, “The moment of greatest satisfaction was when we compared with the X-rays to make sure everything was all right. It was very good.”
A clinical trial has begun with Dr. Toribio, and additional cases are scheduled this month. These developments highlight the potential for augmented reality to transform surgery across many types of hospitals and surgical centers where legacy navigation is simply not cost-effective.
