Augmented Reality in the Operating Theater

Surgical navigation systems are increasingly being used as awareness grows regarding the wide range of associated benefits. These systems enable minimally invasive surgery, reduce pain and blood loss, and result in quicker patient recovery. All of these factors will continue to drive the global market for surgical navigation systems. In a new analysis, BCC Research predicts that this market will grow at a five-year compound annual growth rate (CAGR) of 10.6%.

Surgical navigation systems are primarily used to guide a surgeon’s movements during an operation. These systems display and track the real-time positions of instruments and anatomical structures. Navigation data incorporated with images of the patient are collected through an optical or electromagnetic tracking device, which helps a surgeon determine precise positioning of an instrument in relation to the patient’s organs.

GLOBAL MARKET SHARE FOR SURGICAL NAVIGATION SYSTEMS, BY TYPE, 2021

In 2016, imaging technology and display technology accounted for 52.8% and 29.5% of the global surgical navigation systems market, respectively. According to BCC Research’s analysis, the imaging technology sector is expected to grow at a five-year CAGR of 10.2% to reach $512.3 million in 2021. During the forecast period, BCC Research anticipates that this segment will be driven by an increasing need to perform medical imaging of anatomy before any simulation process can be started.

BCC Research predicts that the tracking technology sector of the global surgical navigation systems market will grow at a five-year CAGR of 10.4% to reach $172.7 million in 2021. During the forecast period, growth in this segment will be due to an expected increase in penetration of instrument tracking technologies. The display technology sector is forecast to grow at a five-year CAGR of 11.4% to reach $302.3 million in 2021. BCC Research believes that this sector will increase mainly as a result of the growing market for multiplanar displays, 3D displays, virtual and augmented reality, and heads-up display.

A system recently described in The Engineer exemplifies how each of these three technology segments of the global surgical navigation systems market—imaging, tracking, and display—are integral to the overall procedure. Philips has developed an augmented reality system designed to guide surgeons through delicate, minimally invasive spinal procedures. The system combines camera images of the exterior of the patient’s body with 3D X-rays of the inside of the body to create a detailed path for the spinal surgeon to follow. This could help to improve surgical tool navigation and implant accuracy, as well as reduce procedure times.

Spinal procedures have traditionally been performed by open surgery, in which a large incision is made and the muscles are moved aside to expose the vertebrae. But this invasive procedure results in a lengthy recovery period and a considerable amount of pain for the patient, according to Ronald Tabaksblat, business leader of image-guided therapy systems at Philips.

However, replacing open surgery with minimally invasive techniques is particularly difficult in the case of spinal procedures such as vertebrae fusion. In these operations, screws are inserted that must be positioned with submillimeter accuracy, said Tabaksblat. “A small error in one direction and you could hit an artery, causing major bleeding, while a small error in another direction means you could hit a nerve, causing nerve damage or even paralysis,” he said.

The system uses high-resolution optical cameras mounted on a flat-panel X-ray detector to image the surface of the patient. It then combines the external view captured by the cameras with the 3D internal view acquired by the X-ray system to create accurate real-time, augmented-reality images of the patient’s anatomy. “We can make 3D acquisitions of the vertebrae of the spine, and show where they lie in the body, and we can also register what happens above the skin,” said Tabaksblat. “So now if the surgeon holds an instrument above the skin, we can show them a virtual path along which the instrument should be inserted into the body.”

The system has undergone preclinical trials at Karolinska University Hospital in Stockholm, Sweden, and the Cincinnati Children’s Hospital Medical Center in the United States. In the trials, results of which were recently published in the journal Spine, the technology was shown to improve the overall accuracy of screw placement from 64% to 84%. The technology will now undergo clinical trials at ten hospitals around the world. These will determine whether the system can continue to improve the accuracy of spinal surgery when performed in a clinical setting. (The Engineer, January 17, 2017)

The global market for surgical navigation systems is expected to reach $987.3 million by 2021, up from $596.7 million in 2016, according to BCC Research’s study. Hospitals and diagnostic centers, which represent the largest market segment in terms of end users, should grow at a five-year CAGR of 10.4%. During the forecast period, the market is predicted to especially gain traction in home use or ambulance services, where a surgical navigational specialist is physically unavailable. This segment will show a five-year CAGR of 12.4%.

The segment comprising research and development centers is forecast to grow at a five-year CAGR of 7.2%. Continuous development in multiple image registration procedures, along with a wide range of tracking mechanisms for spatial locations in the body, will be key drivers.

“The overall market is expected to grow chiefly due to rising demand for laparoscopic and cardiac surgeries with minimally invasive methods,” says BCC Research analyst Aneesh Kumar. “The rising elderly populations in the Asia-Pacific region, North America, and Europe are also expected to drive the market.” BCC Research’s January 2017 study, Surgical Navigation Systems: Technologies and Global Markets, analyzes types of surgical navigation systems, applications, end users, and regional markets. Global market drivers and trends, with data from 2015, estimates for 2016, and projections of CAGRs through 2021, are provided.