...while tomorrow's surgeons will rely on virtual reality

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The Independent Online
British surgeons will lead the world by using virtual reality (VR) systems to repair damaged arteries, a technique that could be available to thousands of people within two years.

The new operation is potentially less hazardous than the standard operation, and VR could also help doctors score themselves for accuracy and speed in performing surgery, the British Association for the Advancement of Science in Leeds heard yesterday.

Professor Peter Bell of the University of Leicester revealed that within eight months he hopes the first test will go ahead at Leicester Royal Infirmary with a human volunteer. It will use keyhole surgery with VR techniques to repair a weakened section of the aorta's wall.

The aorta is the main blood vessel leading from the heart, and a weakness - or aneurysm - can be fatal if it bursts. Roughly 10,000 people are reckoned to die every year from aneurysms.

Surgeons can already repair aortic aneurysms using keyhole surgery, in which a probe is inserted into the femoral artery, in the groin, and pushed up towards the heart. At the aneurysm site, a tube of metal - known as a "stent" - is left to support the aorta's wall and reduce the stress on it.

But the process is difficult and risky. The aorta has a web of branches, and inserting the probe into the wrong branch could be deadly. Thus, it has to be tracked using X-rays throughout the operation.

"The surgeons and theatre staff have to wear lead-lined clothes, and a lot of people are getting exposed to radiation over a long period," said Professor Bell. "It isn't good." Roughly 3,000 aortic repairs are carried out every year in Britain.

The new VR systems, being developed together with University College London, would take results from a computerised tomography (CT) scan to build up a picture of the path of the aorta within the body, and of the location of the aneurysm.

The results of the scan are then fed into a computer, which produces a "virtual patient" which the surgeon views while operating via 3-D goggles or on a TV monitor.

The tip of the probe carrying the stent is fitted with induction coils, which give out a magnetic field so that it can be tracked up the aorta. By combining this data with the CT scans, the computer can show the surgeon precisely where the stent is.

The operation is ideal for this sort of "fly-by-wire" surgery, said Professor Bell, because the patient does not move, and the aorta does not move, unlike organs such as the heart or bowel.