As medical technology improves precision, efficiency, and patient outcomes, smart glasses provide an innovative solution for real-time data visualization and hands-free communication during surgery. (1) These wearable devices, equipped with high-definition cameras and wireless connectivity, enable surgeons to instantaneously access crucial patient information, imaging results, and procedural guidelines. (2) This reduces the need for surgeons to divert their attention to external monitors, optimizing workflow and minimizing cognitive load. (3)
In vascular surgery and other complex fields, projecting anatomical details and procedural insights directly into the surgeon’s field of view enhances decision-making and precision. Smart glasses facilitate real-time intraoperative guidance and enable remote consultations, allowing experts to provide input without being physically present. (4) This expands access to specialized expertise and promotes collaborative care. Additionally, smart glasses significantly improve surgical training by offering immersive, first-person perspectives to medical students, residents, and nurses, thereby fostering a deeper understanding of intricate techniques. (5, 6) They can also be integrated into simulation-based learning environments, creating interactive training modules tailored to diverse surgical scenarios, thus reinforcing competency-based education. (7)
To leverage these benefits, we established an online training programme to share our expertise in managing vascular conditions across institutions. The primary objective is to enhance residents' training in vascular and general surgery by enabling real-time interaction with the operating surgeon. Beyond technical instruction, this initiative strengthens inter-institutional collaborations and facilitates fellowships. Over time, these interactions will assist in the seamless integration of trainees into national and international surgical networks.
Despite their promise, the adoption of smart glasses in the operating theatre presents challenges, including concerns regarding ergonomics, data security, and compatibility with hospital information systems. Furthermore, ensuring the accuracy and timeliness of displayed information is essential to preventing intraoperative errors. This article examines the applications, advantages, and challenges of using smart glasses for real-time surgical procedures. assistance, emphasizing their impact on surgical education and patient care.
Methodology
The program was collaboratively organized by the Department of Vascular Surgery at University Hospitals Leuven, Belgium, and the Service of Vascular Surgery at Ensemble Hospitalier de la Côte, Morges, Switzerland.
Participants included vascular surgeons, residents, medical students, nurses, and paramedics. Patients undergoing elective vascular and endovascular procedures were included after providing informed consent for participation and image usage.
The program was developed in July 2023 and launched a few months later. Two to three sessions per year were planned, each lasting between 90 and 120 minutes. Sessions utilized smart glasses equipped with high-definition video streaming capabilities (figure 1). The head-mounted camera transmits a high-definition image of the operating field (figure 2). Real-time interaction was facilitated using Rods & Cones (Amsterdam, The Netherlands) tools, allowing remote participants to engage directly with the surgical team (figure3). Fluoroscopic images can also be shared by linking the C-arm to the Rods & Cons system (figure4). Preoperative imaging and patient data were reviewed before each intervention to ensure an efficient session flow. To maximize educational value, the two institutions coordinated their sessions, selecting cases strategically to avoid redundancy.
Figure 1: The Rods and Cons smart glasses: 1: Moveable head-mounted display and camera; 2: Headphones and battery
Figure 2: Intraoperative image from the vascular surgeon’s head-mounted camera
Figure 3: The team can select different views from the operating theatre.
Figure 4: Intraoperative fluoroscopic images and live video feeds from the operating room, enhancing real-time decision-making.
Discussion
Our program was designed to establish an innovative approach to vascular surgical education while facilitating the exchange of experiences between European centers. The curriculum encompasses essential procedures for fellows, integrating both basic and advanced interventions. Unlike traditional webinars or conferences, which often highlight only select moments of a procedure, our live-streamed sessions provide an unedited view of the entire operation. Even seemingly routine steps, such as wound closure and hemostasis, are included to ensure comprehensive understanding.
A key strength of this initiative is the interactive and informal learning environment, which contrasts with more structured educational platforms where participants may hesitate to ask questions. The strong rapport between institutions fosters active engagement among both junior and senior vascular specialists.
There is potential to expand participation to additional centers in Switzerland, Belgium, and the Netherlands. However, including more than four institutions may hinder interactivity and complicate session management. Another notable benefit of the program is the exposure to diverse surgical approaches, which prevents the rigid application of institutional protocols. By observing multiple strategies for similar pathologies, fellows develop critical thinking skills that will aid them in independent practice.
Limitations
Challenges in implementing smart glasses technology include variations in internet connectivity, ergonomic concerns, and participant engagement levels. Additionally, integration with hospital information systems and data security remain key considerations.
Organising live surgical sessions requires significant logistical coordination, as operating teams must dedicate time despite already demanding schedules. Nevertheless, this structured training aligns with the Swiss Institute for Medical Education requirements, ensuring official recognition and validation of the training hours.
Conclusion
Smart glasses in surgical education offer a transformative approach to training vascular surgery residents. This technology enhances surgical proficiency and institutional collaboration by enabling real-time interaction, remote consultation, and immersive learning experiences. While challenges remain, continued development and integration of smart glasses into surgical training programs can potentially redefine the future of medical education.
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