New lens on the operating room

Healthcare is getting an upgrade, thanks to an innovative trial partnership at Mediclinic Kloof that empowers experts to look in on the operating theatre – from anywhere in the world.  

First there were smartphones, then smartwatches and TVs. Now, an exciting new technology called Rods&Cones allows surgeons to collaborate with experts anywhere in the world via “smart glasses” that connect to the internet. The system will revolutionise how medical students learn surgery and is being trialled in South Africa through a partnership with Mediclinic Kloof, renowned gastroenterologist Dr Chris Ziady, and medical device manufacturer Boston Scientific. It has the potential to let surgeons have an expert in the field assist them in theatre from anywhere in the country – or the world.  

What Is Rods&Cones?   

“It’s a set of glasses that looks like the 3D glasses you wear to the movies,” explains René Rossouw, Executive Area Manager for Endoscopy at Boston Scientific in South Africa. Built into the nose bridge between the lenses is a camera. On the right-hand side of the frame, there’s another camera with a zoom lens and a light; on the other side, a small screen in front of the lenses allows the surgeon wearing the glasses to view a display. The glasses also have a built-in microphone and speaker so the surgeon can speak to the long-distance expert hands-free. The expert, who can be anywhere in the world, only needs a computer and a strong internet connection. “Dr Ziady helps out some of the tertiary institutions and we thought this is a way to help him help others – he can sit at home and assist the physicians while they’re doing the procedure,” says Rossouw.  

How the technology works  

The glasses come with a cellphone that connects via a cable. This device powers the glasses and connects to WiFi, explains Rossouw. When a surgeon is ready to call the remote expert, they put on the glasses and look at a QR code – displayed, say, on the wall of the operating theatre – that has been registered to a specific expert, for example, Dr Ziady. The glasses lens will scan the code automatically, which calls the expert on their computer, Skype-style, without the surgeon having to touch anything physically. The expert can now sit at their own computer and whatever the surgeon is looking at in theatre will display on their screen. There’s also a mirror function that allows the expert to view the video output of a machine, such as a videoscope processor.  

5 reasons Rods&Cones is better than a regular video camera  

1. No hands. The technology is entirely hands-free and takes up no additional space in theatre. 

2. Stays in sync. Using the glasses guarantees that both surgeon and remote expert are looking at the same thing.   

3. Remote control. The expert on the other end of the call controls the display. All the surgeon has to do is look in the right direction – the expert can then zoom in or out and switch the light on and off remotely.   

4. Visual aids. The small screen attached to the glasses allows the expert to share their own screen as you would on a Zoom call. They can then take a screenshot and annotate the picture, “like in Microsoft Paint,” explains Rossouw – for example, circling a tumour so the surgeon can see its exact location.   

5. Easy communication. The two doctors can speak to each other as if they were in the same room – the way a rugby television match official (TMO) speaks to the on-field ref.  

Future of medical education  

Dr Ziady has been involved in Boston Scientific’s virtual training programmes for years and has long been a champion of using technology to take the “classroom to the students”. Since retiring from private practice at the end of 2019, training has been an even bigger focus. He believes the Rods&Cones system could bring a new dimension to teaching young doctors. “Many units have a facility for observation from a distance but this would allow students to see both sides of what’s happening and have access to a mentor,” he says. Boston Scientific sees this technology being applied to education. “The way we view this is that it’s a teaching tool – a way for, say, Dr Ziady to sit safely at home and assist his students,” says Rossouw.  

Expert on call  

Virtual classrooms aside, the technology opens up possibilities for collaboration between specialists down the line. “We’re exploring the possibility of remote proctorship,” Dr Ziady says. “So if people performing a specific procedure encounter a difficult case, they could dial in and access an expert on the other side to help them through the procedure. They would be learning and the patient would benefit as well.” 

Coming soon  

Testing of the Rods&Cones system in South Africa has been delayed as a result of the pandemic, but the team is positive that testing will resume soon.