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Derek Kwun-Hong Ho; Using smartphone-delivered stereoscopic vision in microsurgery: a feasibility study. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2233.
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Many surgical specialties are increasingly looking towards robot-assisted surgeries to improve patient outcome. Surgeons who conduct robot-assisted operations require three-dimensional (3D) surgical view in real-time. The widely used Da Vinci Robotic Surgical System uses a stereoscopic camera to capture the surgical view, which is transmitted in real-time to the dual screens in front of the surgeon’s eyes. Ophthalmic robots such as the IRISS may reveal new venues of novel vitreoretinal treatments, such as cannulating retinal vessels or even gene delivery to targeted retinal cells. This study investigates the feasibility of smartphone-delivered stereoscopic vision for microsurgical use.
A stereo-camera, connected to a laptop via USB, was used to capture the stereoscopic view from a binocular surgical microscope. Wi-Fi connection was used to live-stream (or ‘mirror’) the laptop display onto the smartphone screen wirelessly. Finally, a Virtual Reality (VR) headset, which acts as a stereoscope, was used to house the smartphone. The headset wearer can then fuse these slightly dissimilar images to achieve stereoscopic perception.(Fig 1, 2)
Using such smartphone-delivered 3D vision, the author performed a simulated cataract extraction operation successfully, despite a time lag of 0.354s±0.038. To the author’s knowledge, this is the first time a simulated ophthalmic operation was performed via smartphone-delivered stereoscopic vision. The time lag gave a sense of dissociation between the observed and actual instrument movements. Wearing a VR headset also impeded peripheral vision, which restricted situational awareness and made simple tasks such as changing instruments more challenging.
Microscopic output in 3D with minimal time lag can be readily achievable with smartphones and VR headsets. Uncoupling the surgeon from the operating microscope is required to achieve tele-presence, an essential step in tele-robotics. Where operating theatre space is a concern, head-mounted displays may be more convenient than 3D televisions. This 3D live-casting technique can be used in teaching and mentoring/coaching settings, where microsurgeries can be live-streamed stereoscopically onto smartphones via the local Wi-Fi network. When connected to the internet, microsurgeries can be broadcasted live and viewers worldwide can see the surgeon’s view simply using their smartphones and VR headsets.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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