Inside the iSurgery operation
By Fabian Bimmer
When my boss, Joachim Herrmann, told me that I had to cover liver surgery using an iPad, I had no idea how an iPad could be helpful during an operation. I knew that iPhones, iPads and tablets were becoming more important in being useful in all sorts of activities in our daily life – but for surgeries?
We use these new toys in different ways: GPS for cars, during sporting activities, music, mail and for other ways to communicate. Some of my colleagues use tablet computers to present their portfolios and to operate their cameras. Swiss camera maker Alpa uses an iPhone as a viewfinder for their tilt and shift cameras. But I couldn’t imagine how an iPad would be helpful during an operation to remove two tumors from a liver.
Also, I knew nothing at all about livers or any surgery before this assignment.
To get a feel for the atmosphere, the hospital, light conditions and the team, I went to meet Professor Karl Oldhafer, chief physician of general and visceral surgery at the Asklepios Clinique in Hamburg-Barmbek, two days before I had to go through with my project. Actually being present at a surgical procedure I felt slightly uncomfortable. As I arrived at the hospital, I was confronted with an invitation by Professor Oldhafer to participate in a surgery there immediately.
Never having seen this amount of blood, massive cuts and all the different instruments being used, I was a little bit frightened. Would I faint? Would I be horrified when they cut open the stomach with a long knife? The “test run” went well, I survived and I had an idea what to expect in two days.
After two more nights I woke early, had my usual pot of coffee and arrived pretty much on time at the Barmbek hospital to join Professor Oldhafer’s team in the changing room. The green clothing did fit well, but it wasn’t really my color and also not my type of uniform.
The preparation was similar to the one I saw on the previous day. Then the Professor entered the room with an iPad in his hands. It was covered in a plastic bag, like the zip lock bags I use at home in my freezer.
When he could see the liver he used the iPad to localize the two tumors in the liver. It was very exciting as it was one of the first operations to be carried out in this way within Germany.
The tablet uses augmented reality, which allows the liver to be filmed with an iPad and overlaid during an operation with virtual 3D models reconstructed from the real organ. Developed by Fraunhofer MEVIS in Bremen, this procedure helps locate critical structures such as tumors and vessels and is expected to improve the quality of transferring pre-operational resection plans into actual surgery, according to Bianka Hofmann from the institute.
I was really impressed with how many surgeons, doctors and nurses took part in one surgery and how everybody seemed to know their roles exactly. Even more impressive and fascinating was getting a picture of this tiny little white lump – the cancer – which could be so vicious and dangerous to the human body.
After three hours of hard work by the whole team, myself included, the operation finished successfully. A great job was done and I want to thank Professor Oldhafer and his team for their kind support and especially Bianka Hofmann from the Fraunhofer MEWIS institute for her help and patience. Last but not least a special thank you to Joachim in the Berlin office, who had the idea for this impressive story.