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A&E and AR: How augmented reality is transforming surgery

AR headsets could cut surgery time by 20% — so why aren’t they in the operating room yet?

By Steph Bailey

Credit: Credit: Lightspace

From MRI scans to ultrasounds, imagery and technology have revolutionised medicine. But inside the operating room, surgeons still have a problem. 

To see images and data, medical professionals have to look at separate 2D screens, distracting them from the surgical procedure and forcing them to mentally translate images into 3D. 

“Most of the surgeries that we do are done through small openings, small incisions and quite a lot of the anatomy is obscured,” Adrian Elmi Terander, an associate professor of neurosurgery at Karolinska Institutet in Sweden, tells Sifted. “You’re looking at the monitor and looking back at your patient. You have this loss of attention which can be quite disturbing.”

An exciting solution is augmented reality (AR), which would allow for medical data and information to be superimposed directly onto a surgeon’s view of a patient. And it’s rapidly gaining steam, as healthtech AR is predicted to reach $76b globally by 2030

“Using augmented reality to focus on your surgery means you don’t have this loss of attention,” Terander says. “You don’t need to look at the two-dimensional radiological images and do the 3D translation in your brain.”

Saving time — and lots of money

One company building AR headsets for medical use is Latvian deeptech startup Lightspace, which also develops tools for immersive training and other high precision activities like auto manufacturing.

“AR technology is very helpful in a number of areas and we found one of them is healthcare,” says Ilmars Osmanis, Lightspace’s CEO. “You can really see the human body in medicine with immersed or 3D images of the tissues or bones for treatment.”

Osmanis says Lightspace’s AR headsets could potentially reduce procedure times by 20%, as well as reducing mistakes, injuries and the costs of displaying information using multiple systems and screens.

A Lightspace AR headset.

AR could have major consequences for pre and post-op too; Osmanis says it allows surgeons to plan procedures by pre-marking an image as well as capturing surgeries for review or training new doctors.

“One of the important advantages of augmented reality is using it in education, and shortening the time it takes for a junior surgeon to learn how to perform a more complex surgery,” says Terander.  

“One of the important advantages of augmented reality is using it in education, and shortening the time it takes for a junior surgeon to learn how to perform a more complex surgery.”

While the first AR-guided operation was performed in February 2020, with other solutions such as Microsoft’s HoloLens being available, Terander, who is a research partner of Lightspace, says the company is “quite pioneering” by building a multifocal display in its headset that can visualise images at a closer distance — which other market solutions lack.

Collaborating with neurosurgeons

Six years after launching in Latvia, Lightspace recently opened a lab in Cambridge Science Park to further its research and development efforts. 

To trial the headsets — initially developed for spine surgeries — Madara Kalnina-Kalnmale, Lightspace’s managing director, told Sifted the startup is set to work with Italy’s University of Pisa, Sweden’s Karolinska University Hospital and Eindhoven University of Technology. 

“September is very important for us,” she says. “We’ll start this collaboration with Karolinksa and from there, there’s already a group of neurosurgeons who are very interested in AR solutions.”

Credit: Lightspace

In addition to building accompanying software to its hardware, Lightspace says it’s looking into integrating AR solutions into existing surgical navigation systems and robotic systems.

“If you look at neurosurgery, a lot of procedures we perform are done using a microscope,” says Terander. “I think that in the future we’ll build magnification into these goggles.”

Roadblocks to mass adoption

Terander tells Sifted there are still hurdles to jump before we see the mass adoption of AR headsets in surgery. Most notable, he says, are accuracy and the high costs of new intricate technology.

“If you have three millimetres of inaccuracy, you can basically miss the target,” he says. “Within a couple of years, we’ll see more and more accurate systems. When that part works, then the evolution [to mass adoption] will come automatically.”

While he predicts headsets and goggles are “the future of AR,” he says “the head-mounted devices need to be smaller, they need to be lighter, they need to be easier to wear in sterile environments.”

“The head-mounted devices need to be smaller, they need to be lighter, they need to be easier to wear in sterile environments.”

Osmanis says mass adoption will be achieved when applications beyond medicine are also realised. Gaming is “a big enabler of our technology,” as is developing headsets suitable for children to use for education.

“You need to take care that you don’t hurt kids’ eyes and that’s the reason none of the existing headsets are really made for kids,” he says. “In our multifocal approach, you can create content for kids where the content actually moves forward and backwards like in a game.” By developing the technology for a mixture of applications, Osmanis says AR will advance quicker for use in medicine. 

Terander, though, remains hopeful for an AR-led future of medicine, and says we aren’t too far from distance consultation, or when a senior surgeon oversees a surgery remotely.

“I can sit in my living room, put on my goggles and see exactly where my residency is in the middle of the night and I can guide him or her to perform the surgery without being there,” he says. “This sounds a bit futuristic and far-fetched right now, but I think we’re going to be there much sooner than you can imagine.”

“I can sit in my living room, put on my goggles and see exactly where my residency is in the middle of the night and I can guide him or her to perform the surgery without being there.”

Because technology for medical use requires specific approvals, Osmanis hopes Lightspace’s headsets will be used in real life applications by 2023.

“I think it’ll be around two to five years before we have augmented reality systems that we can deploy in the OR,” says Terander.

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Lightspace AR headset enables precision near distance Digital Healthcare visualizations.

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