Shoulder surgery is benefiting from a worldwide technological innovation: mixed reality.

It has been developed by Dr Philippe Collin, former President of the French Society for Shoulder Surgery, one of the orthopaedic surgeons who perfected it together with two other colleagues, one French and one American, within a team of international specialists. Dr Philippe Collin has performed the implantation of a shoulder replacement in mixed reality, with 3D visualisation during the operation. The aim is to develop this practice and to become, very soon, the first Paris clinic to offer complete robotic guidance.

The technology involves two phases. First, a preoperative plan is prepared ahead of the operation, on a computer, using the BLUEPRINT™ preoperative planning software designed by the French start-up IMASCAP (Wright Medical N.V. group). Entirely virtually, the surgeon implants a prosthesis, reconstructed in three dimensions, in the patient's shoulder, a joint that is particularly difficult to access. This optimises the procedure, which becomes even more precise, as well as the positioning of the implant. Then, in the operating theatre, the surgeon puts on mixed reality glasses (Microsoft HoloLens) and operates while viewing at the same time the patient's shoulder and a three-dimensional holographic representation of that shoulder linked to the preoperative plan. The 3D data of the preoperative plan is projected like a hologram inside the surgeon's glasses: this is the first time that planning software has been directly connected to mixed reality glasses. Through gesture and voice, the surgeon displays, rotates and analyses the holographic representation of the joint right in front of the surgical field, and examines the holographic images from every angle. Being able to compare the 3D holographic shoulder and the operated shoulder in real time guides the surgeon and delivers unmatched precision.

Research is continuing, with the short-term aim of intraoperative, real-time guidance of the surgical gesture inside the joint. The ambition is to extend this technology to the whole of orthopaedic and trauma surgery.