Most surgeries are performed without navigation due to the impediments of cost and setup time. Now, an augmented reality surgical navigation system that has received FDA 510(k) approval for precision guided intraoperative spine surgery marks a big step towards making precision surgical guidance widely available and economically feasible.

VisAR, an augmented reality surgical navigation system from Novarad Corporation (Provo, UT, USA), transforms a patient's imaging data into a 3-dimensional hologram which is visible through an optical visor and superimposed onto the patient with submillimeter accuracy. This allows the surgeon to focus directly on the surgical objective without looking away at a separate monitor. Novarad has partnered with Microsoft (Redmond, WA, USA) to utilize off-the-shelf augmented reality headset technology which allows for lowered cost and the ability to leverage expected hardware advancements.

VisAR is an end-to-end solution with pre-surgical planning, virtual annotations, segmentation and bi-directional image connectivity. It features integrated 2D and 3D immersive navigation views with continuous hologram-to-patient registration. VisAR technology utilizes image visible CT fiducial markers for automatic registration. The operating room setup time is less than two minutes. Surgical accuracy is sub 2 mm for pedicle screw placement in both open and minimally invasive surgical (MIS) procedures.

The untethered wirelessly connected Microsoft HoloLens 2 visor worn by the physician results in the smallest OR footprint of any system on the market. No other navigation equipment is required. VisAR is built on the Novarad imaging technology solution stack that provides interoperability, HIPAA compliance, image management, and deep security. VisAR is currently available in the US, with usage being anticipated in other countries in the coming months.

"This is transformational technology that provides the precision of a robot, the portability of a stethoscope and the versatility of human powered intelligence," said Dr. Wendell Gibby, Novarad CEO and co-creator of VisAR. "Like a surgical GPS, VisAR provides a roadmap to guide the surgeon to the pathology of interest."

"My first impression of the technology, when you actually got to put it on and see real patient images come up was, 'this is amazing. This is groundbreaking, revolutionary technology.' It's hard to explain," added Michael Karsy, MD PHD, neurosurgeon from the University of Utah. 

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