Atlantic Health is pioneering use of ‘mixed reality’ visualization surgery in N.J.

Morristown, Overlook medical centers are among 1st hospitals in U.S. to use new surgical technology

Imagine technology that provides a virtual hologram that is projected adjacent to the patient during surgery, enabling the surgeon to synthesize online preoperative planning software with real-time data analysis during shoulder replacement surgery.

This groundbreaking technology, called “mixed reality,” enhances the highest level of precision and may in some cases shorten the length of surgery.

It is being used at Morristown Medical Center and Overlook Medical Center to enhance outcomes in shoulder, hand and upper extremity surgeries, officials from Atlantic Health System said.

Dr. James Wittig, the medical director, orthopedic oncology, at Atlantic Health System and chairman of the Department of Orthopedics at Morristown Medical Center, said the technology improves outcomes.

“At Atlantic Health System, we are committed to investigating and utilizing the latest technology for the benefit of our patients in order to provide them with the safest procedures and best outcomes,” he said. “Mixed reality provides a technologically advanced tool at the surgeon’s fingertips for simplifying complex surgeries and providing more precise, consistent and reliable results.”

More specifically, Morristown is using Stryker’s Blueprint Mixed Reality and Overlook is using the Microsoft HoloLens 2 mixed reality headset.

Stryker’s Blueprint Mixed Reality — which is used at Morristown Medical Center by Dr. Eric Black, a shoulder and elbow specialist — anchors virtual patient imaging objects into the real world and allows the surgeon to interact with the objects through a holographic headset before and during surgery.

Prior to its use at Morristown, only two other hospitals in the country were selected to use this technology — the Mayo Clinic in Rochester, Minnesota, and Massachusetts General Hospital in Boston. According to Stryker, the technology is still in limited release and in use at only 15 sites in the U.S.

This advanced technology can be used to assist in the placement of implants during shoulder replacement surgery, specifically in complex cases. It can also be used as an educational tool to teach other surgeons how to navigate complicated cases. Mixed reality allows surgeons to have immediate access to patient history, X-rays, 3D CT scans and implant choices throughout the operation. Fewer than a dozen U.S. surgeons are currently able to use the technology.

Complex shoulder replacements are Black’s specialty. He performs about 160 each year.

As a teaching tool, mixed reality has the potential to enable surgeons learning new procedures or implants to invite another surgeon to be a surgical mentor and provide them with guidance through the surgery. Mixed reality can be a powerful tool for education, clinical assessment and intraoperative navigation.

At Overlook Medical Center, Dr. John Erickson, a fellowship-trained orthopedic hand and upper extremity surgeon, is utilizing the Microsoft HoloLens 2 mixed reality device in preoperative planning and intraoperative execution for difficult shoulder and elbow cases, including shoulder replacements.

Due to his early adoption of the technology and expertise, Erickson was selected to be part of a small team of surgeons for a global Microsoft 24-hour Holographic Surgical Event in February 2021. As part of that event, Erickson worked remotely with a surgeon in Paris to help a Brazilian surgeon treat a collarbone fracture and perform a shoulder arthroscopy — all using the new technology. He continues to collaborate with surgeons worldwide to advance the use of mixed reality technology like the Microsoft HoloLens 2 in the field of orthopedic surgery.

This device allows surgeons to interact with immersive 3D models of anatomical parts to better prepare for procedures, which may result in shorter operating times, less blood loss and more precision.

Erickson is currently doing research with Rutgers New Jersey Medical School to answer some of these questions. It is always beneficial for surgeons to go through the surgery ahead of time so they know what to expect, as this may lead to better outcomes for their patients. The ability to share information and point-of-view insight also helps better train the next generation of surgeons and improves the skills and knowledge of operating room staff.