3D video systems have been around for a while in 2 options: through robots equipped with 3D video or independent, standalone systems where the viewer wears glasses to see the 3D images. However, the lack of resolution with previous 3D systems often left surgeons wanting more. “When we first started using 3D endoscopes, I just sent them back because the resolution was inferior,” says Dr. Bederson. “The decrease in resolution was more limiting than the increase in depth perception.”

Typically used in video microscopes with heads-up displays, 4K-3D technology promises more accurate surgery by providing high-resolution 3D imaging of the structure of tissue, blood vessels and other parts of the anatomy. On the 4K-3D system Dr. Bederson uses, the images can be displayed on both the eyepiece of the microscope and an ultra-high-definition video monitor. Dr. Bederson notes that not only does the technology boast detailed views of the surgical field, but it also has the ability to integrate with other standalone technologies, overlaying data from surgical navigation systems, CT scans, MRI scans and even virtual reality technology on the image of the surgical field to guide surgeons and help them avoid delicate anatomical structures.

Rafael Grossmann, MD, FACS, a general surgeon and healthcare innovator in Bangor, Maine, notes that while 3D imaging may help some surgeons and can “look real” on the screen, it’s still hard to define what, if any, benefits it provides in terms of outcomes or surgical accuracy.

Though Dr. Bederson says that he uses the 4K-3D microscope for complex procedures such as removal of deep-seated brain tumors or treating aneurysms, the technology could also be used for routine cervical and lumbar spine cases, like discectomies. Dr. Bederson notes the technology is still a “very high-tech, expensive platform,” but with more manufacturers looking at how to incorporate 4K-3D images into surgical specialties, he sees it becoming more commonplace.

“The expense is on the microscope side,” he explains. “4K-3D comes down to a camera and a flat screen. If you take out the video aspect of things, you could reduce the price significantly. I have a feeling once the technology is used routinely, it will facilitate increased safety for all sorts of cases.”

While you may be looking at getting a new 4K, 3D or even 8K video system in the future, you should also prepare for adding augmented reality to your ORs, says Rafael Grossmann, MD, FACS, a surgeon and healthcare futurist in Bangor, Maine. He says the use of virtual, mixed and augmented reality is going to challenge the current healthcare model within the next couple of years and let surgeons simulate surgical scenarios before and even during procedures.

“Augmented or mixed reality will revolutionize how we perform surgery,” says Dr. Grossmann. “We will be able to interact with images in a more powerful way than we do now.”

There are already some manufacturers making a move into this new landscape. In one augmented reality system used by Joshua Bederson, MD, neurosurgeon and professor and chairman of neurosurgery at Mount Sinai Health System in New York City, surgeons can upload pre-op MRI or CT scans into the system and use the technology to view 3D images of patient-specific anatomy. Dr. Bederson notes that this lets the surgeon identify critical structures to avoid, accurately highlight anatomical targets and even program image-guidance systems to map out the best surgical approach. Being able to overlay the images directly onto the patient can allow for more precise surgery.

Though still not widespread, expect augmented reality to appear in an OR near you within the next few years, says Dr. Grossmann. “From training to diagnostic to treatment, you will see this type of technology being used routinely,” he says.

— Kendal Gapinski