Walter Reed Breaks New Ground With 3-D Vision System

By Kristin Ellis
Special to American Forces Press Service

April 3, 2007 – Virtual reality made its way into the operating room last week when an Army doctor performed the military's first three-dimensional minimally invasive surgery at Walter Reed Army Medical Center here. Armed with a state-of-the-art helmet, Col. (Dr.) Ernest Lockrow, director of the Telerobotics and Minimally Invasive Surgery Center, used the 3-D capabilities to perform a hysterectomy.

Minimally invasive surgery, also known as laparoscopy, uses tiny incisions to operate and typically involves a telescopic lens that is connected to a video camera. The operation last week was the first time the military has used the 3-D vision system to help visualize and guide the surgeon during a laparoscopic procedure. According to Lockrow, the typical laparoscopy procedure is done with a two-dimensional display. The images from the telescopic lens appear on a monitor, and surgeons use this to guide their way through the operation.

Some of the problems with teaching new surgeons in two-dimension technology are that they can easily miss something while practicing operations until their eyes adjust to the two-dimension view. This lack of depth perception can hamper the surgeon during an operation, Lockrow explained. With the new three-dimensional headset capability, surgeons can precisely get to where they need to be.

"What the three-dimensional procedure now gives is a camera for each eye, so the surgeon can now see just as he was operating in a general, open procedure," Lockrow said. "When you're used to operating in two dimensions and then you go to three dimensions, it just makes it so much easier. We actually had a fellow who has not done a lot of laparoscopic surgery and was able to easily grasp the laparoscopic procedure in three dimensions."

Lockrow is taking the technology a step further by exploring a new realm of telecommunications with the use of this device. Although there are issues associated with transmitting images across a network in terms of signal delay, it could be possible someday to have a doctor use a 3-D helmet in Germany to assist a doctor here who also is wearing the helmet, and vice versa, Lockrow said.

"In military aspects, that's really where we want to go; it's just a long road to get there," he added. Walter Reed now has the facilities that give surgical teams the capability to broadcast the surgery, Lockrow noted.

"We're actually able to take the new technologies and techniques, and we can now televise them to a network or to a classroom," he said. "Now, more than two people can watch a procedure; a whole classroom can watch."

The 3-D laparoscopy device is part of a bigger project involving robotic surgery and minimally invasive surgery in which the Army is trying to incorporate new technologies and make them available at health-care facilities throughout the military. Lockrow's team tested the helmets at the robotic training center lab at Uniform Services University.

A Navy surgeon, Cmdr. (Dr.) Christine Sears, assisted Lockrow in the operating room. An Air Force surgeon, Maj. (Dr.) Chad Hamilton, watched the procedure.

Sears said she's impressed with the new technology. "The 3-D visualization improves the ergonomics of laparoscopy - the image is directly in front of the surgeon at all times," she said. "Rather than looking at a screen which is stationary, the helmet moves with the surgeon's head, improving visualization."

Hamilton said continuing to bring state-of-the-art procedures and methods to military medicine will ensure servicemembers get the best available care. “Incorporation of such technology will allow (the military) to continue offering cutting-edge procedures our beneficiaries have come to expect and keep us in the vanguard of technology and medicine," Hamilton said.

Lockgrow agreed. "I think it's important that we keep exploring these new technologies, because this is great for military medicine," he said.

(Kristin Ellis is a Stripe staff writer at Walter Reed Army Medical Center.)

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