[caption id="attachment_13931" align="aligncenter" width="600"] Google Glass lets surgeon see details indicated by 'hands' of remote expert.[/caption] Researchers investigating the potential of augmented-reality systems to improve surgical techniques have announced the use of Google Glass in surgery. Using a high-definition, interactive video-conferencing system, a University of Alabama at Birmingham research team performed a shoulder-replacement surgery Sept. 12. During the procedure, orthopedic surgeon Brent Ponce wore Google Glass to put a camera in a position that would give video-conference users exactly the same view of the patient as the surgeon. On the other end of the connection was Phani Dantuluri – an orthopedic surgeon who specializes in shoulder and elbow surgery and who consulted on the surgery virtually without leaving his home base in Atlanta. Google Glass served as the heads-up display/video connection for a University of Alabama-Birmingham (UAB)-developed video-conference system called VIPAAR (Virtual Interactive Presence in Augmented Reality) that is designed to provide high-definition, real-time, two-way interactive video conferencing for telemedicine. This beta test is designed to demonstrate how useful wearable computers are in telemedicine, but the same setup is likely to show up more frequently in datacenters than surgical suites: UAB spun the technology off to a company called VIPAAR to sell the system commercially. The company is pitching it primarily for field-service, technical service and other non-surgical situations in which the greater technical skills of a more experienced operator at the home office could benefit a less-experienced person in the field. "Today, you can't imagine having a phone without the capability to take picture, or a video," the announcement quoted VIPAAR CEO Drew Deaton as saying. "I can't imagine, five years from now, not being able to use a smart phone to connect to an expert to solve my problem. And have that person reach in and show me how to solve that problem." Ponce wore the Google Glass for its test as a surgical tool, using its camera to pick up the surgeon's own point of view and send it to Atlanta, where Dantuluri watched on a computer monitor and responded using a microphone, camera and motion sensors to let Ponce see what Dantuluri was talking about, as well as hear him. As the two spoke, ghostly images of Dantuluri's hands appeared in Ponce's heads-up display, allowing the Atlanta surgeon to point out details or demonstrate techniques directly rather than simply describing them. The result was far closer to the experience of collaborating with another surgeon present rather than speaking to one in typical telemedicine situations, Ponce said. Even the ghost hands were more useful than strange. "It’s real-time, real-life, right there, as opposed to a Skype or video conference call, which allows for dialogue back and forth but is not really interactive," Ponce said. The system – the presence of Google Glass notwithstanding – is a huge advance over previous techniques of "telemedicine," which boiled down to a phone call between a surgeon who'd done a procedure hundreds of times and one who done very few, according to Barton Guthrie, a UAB surgeon who launched the effort to develop VIPAAR a decade ago. "The paradigm of the telephone consultation is, 'Do the best you can and send the patient to me when stable,'" Guthrie said. "The paradigm with VIPAAR’s technology is 'Get me to the patient. Let’s get my expertise and experience to the physician on the front line.'" Ponce and Dantuluri reported being pleased with the effectiveness of the VIPAAR system with Google Glass added, though they suggested improvements would be required in the quality of the integration between VIPAAR and Google Glass, which is still in beta testing as part of the overall system.   Image: Univ. Alabama-Birmingham/VIPAAR