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Singapore’s NUHS kicks off holomedicine research

Singapore neurosurgeons are testing the use of Microsoft’s HoloLens 2 mixed reality headset to locate brain tumours with higher precision and improve patient safety

Singapore’s National University Health System (NUHS) has been testing the use of Microsoft’s HoloLens 2 mixed reality headset to help doctors identify the location of tumours during brain surgeries in a research programme.

Under the first phase of the programme, a team of neurosurgeons from National University Hospital (NUH), which is part of NUHS, have started using holographic visors to project a 3D hologram of a patient’s brain scan into space and superimpose it onto the patient’s head during surgery.

The hologram is generated from the patient’s brain CT (computerised tomography) scan using 3D medical software from apoQlar, a German holomedicine technology provider. When the hologram is set in place on a patient’s head, surgeons are able to view the 3D holographic images of the brain from different angles.

The surgeons can also pull up information and alter the images in the visor using hand gestures and speech commands, allowing them to interact with and control the holographic image that is superimposed onto the patient.

NUHS said the holomedicine research programme will drive the development of next-generation clinical applications and improve patient safety. This would also augment clinical processes and enhance both undergraduate and postgraduate education.

While the use of holographic technology in operating theatres is still nascent, NUHS hopes to apply it in multiple fields of surgery, including keyhole and eye surgeries.

“Holographic technology may radically transform the way we practice medicine. Early adoption will place NUHS at the forefront of medical mixed reality research and position us as a pioneer in the clinical use of this technology,” said Ngiam Kee Yuan, NUHS’s group chief technology officer who is overseeing the research and development of the holomedicine programme.

Yeo Tseng Tsai, head and senior consultant at NUH’s neurosurgery division, added: “With this holographic technology, you are able to see inside the brain. You will be able to see the blood vessels and most importantly identify the tumour quickly and precisely, as well as to know which angle and the exact location to make the incision.

“For over 30 years now, we have been using a handheld navigation system to navigate and identify the location of the tumour. In comparison, this new mixed reality system is more intuitive as we can now see inside the patient’s head without the need to look up and refer to a computer screen while performing a procedure.”

By making it faster to locate tumours with higher precision, NUHS said the technology was expected to improve patient care and safety. And with the mixed reality headset weighing around 500 grams, it could replace bulky operating theatre equipment and even reduce the exposure to radiation in procedures such as spine operations, where X-rays are currently used to guide the insertion of metallic implants.

NUHS said the HoloLens 2 device could also be used by patients to help them better understand the procedures they are to undergo. This can be achieved by projecting a 3D image of a patient’s scan to better illustrate the steps of their procedure.

Moving forward, NUHS is looking to integrate holomedicine technology with existing hospital systems, develop procedures to onboard users and enhance the hospital’s infrastructure to support the system.

During a media briefing, Yeo said the technology’s accuracy would need to be validated against existing neural navigation systems, which requires brain surgeons to use a pointer and a screen to locate a tumour, before it can be approved by heath authorities for wider use.

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