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Relato de caso

Use of Google Glass in cheiloplasty: the surgeon’s perspective

Bruno de Oliveira Barbosa; Guilherme Henrique de Castro Teixeira; Danilo Monteiro Vieira; Ana Flávia Saraceni; Guilherme Gurgel do Amaral Teles

DOI: https://doi.org/10.5935/scd1984-8773.20201242573

Received on: 16/04/2020
Approved on: 13/11/2020

Financial support: None
Conflict of interest: None

Study conducted at the Institute of Plastic Surgery Santa Cruz, Dr. José Marcos Mélega, São Paulo (SP), Brazil


Abstract

Wearable technology has come to change the way people see and experience the world. Google Glass is one of these technologies created by Google Inc., Mountain View, California. This device has many uses, including in the medical field. One of these uses is the possibility of providing viewers with the surgeon's view during surgery. Surgeries with a small operative field, like cleft lip surgery, or cheiloplasty, should benefit from Google Glass. In our institution, we recorded the first cleft lip surgery using Google Glass to give our impression of the Glass.


Keywords: Education, Medical; Innovation; Technology


INTRODUCTION

Technology is increasingly present in our lives, and in the medical field, it is no different. At every moment, we face new devices in the clinical routine and in the surgical room that change the way we interact with the world.

Better known as “wearable” technology, Google glass is one of these technologies, and is already used in the medical field.1-4 Created by Google Inc. California Mountain View, this device provides the possibility of seeing the surgeon during the surgery in real-time or recording the procedure for later review. Davis and Rosenfield made the first description of this technology’s use in a surgical procedure in 2013,5,6 and their team demonstrates the difficulties and perspectives of this technology Figure 1 .

Surgeries with a small surgical field, such as cheiloplasty, benefit from the use of Google glass. Also, in teaching units, the difficulty in monitoring the surgery steps by residents and interns present in the room and outside the surgical field, due to the reduced visual field and the need to stop the surgery at each step, dramatically increases the time of the procedure.

Our institution recorded the first cleft lip surgery with Google glass to give our impression of this technology in reduced visual field surgeries Figure 2.

 

OBJECTIVE

This study aims to assess the use of a new technology in cheiloplasty, with a small surgical field, and use the technology for the improvement and learning of the team Figure 3.

 

METHODS

We chose a patient with an incomplete pre-incisive foramen fissure after obtaining informed consent with a recording authorization term. The absence of fast internet for streaming video limited the use of glasses only for recording. The patient was placed in Rose position and a Millard cheiloplasty was performed. After the surgery, we showed the video to residents.

 

RESULTS

The image was clear and made it possible to see the procedure and structures without any doubt. At first, its use may be strange for the surgeon, but over time it becomes habitual.

The procedure was conducted with the resident team for learning. The presence of the team during the surgery was essential. However, after the procedure with the recorded video, the surgical steps could be discussed and demonstrated with a detailed view, which generated fixation and understanding of the technique.

 

DISCUSSION

There are many benefits to using “wearable” technology like Google glass.7 The functionality that allows communication between doctors and the exchange of experiences or consultation during the surgical procedure is beneficial. However, the absence of fast internet is a limiting factor in countries like Brazil. Communication problems are a prevalent cause of errors in surgery, and this technology can reduce these errors.

The primary applicability for this technology that we see at the moment is in the surgical teaching, as in cheiloplasty, which has a limited surgical field, and the surgeon can share in real-time the procedure steps. As far as we know, this was the first cheiloplasty performed with Google glass, and we were able to take the opportunity to review the surgical field with the entire team.

However, ethical issues and the lack of fast internet streaming video can be some limitations. Other features, such as remote supervision and even consultation for minor procedures, could also be used.

 

CONCLUSION

The use of Google glass in surgeries with a reduced visual field is very feasible, and residents can enjoy and share first-person learning from the attending physician. However, the full potential of this technology has yet to be discovered. The possibility of performing surgical procedures and teaching or discussing from a first-person view is excellent for surgeries with a small field or procedures performed in educational institutions. In the current moment of social isolation that we live in, it is an option to continue teaching.

 

AUTHORS 'CONTRIBUTION:

Bruno de Oliveira Barbosa | 0000-0002-6399-6322 Statistical analysis; approval of the final version of the manuscript; study design and planning; preparation and writing of the manuscript; data collection, analysis, and interpretation; active participation in research orientation; intellectual participation in propaedeutic and/or therapeutic conduct of studied cases; critical literature review; critical revision of the manuscript.

Guilherme Henrique de Castro Teixeira | 0000-0001-7881-8222 Study design and planning; active participation in research orientation; intellectual participation in propaedeutic and/or therapeutic conduct of studied cases.

Danilo Monteiro Vieira | 0000-0003-1954-8706 Study design and planning.

Ana Flávia Saraceni | 0000-0001-9906-9398 Study design and planning.

Guilherme Gurgel do Amaral Teles | 0000-0003-2488-4536 Statistical analysis; approval of the final version of the manuscript; study design and planning; preparation and writing of the manuscript; data collection, analysis, and interpretation; active participation in research orientation; intellectual participation in propaedeutic and/or therapeutic conduct of studied cases; critical literature review; critical revision of the manuscript.

 

REFERENCES

1. Muensterer OJ, Lacher M, Zoeller C, Bronstein M, Kübler J. Google Glass in pediatric surgery: an exploratory study. Int J Surg. 2014;12(4):281-9.

2. Niamtu J III. Google Glass: dermatologic and cosmetic surgery applications. Dermatol Surg. 2014;40:1150-2.

3. Kantor J. First look: Google Glass in dermatology, Mohs surgery, and surgical reconstruction. JAMA Dermatol. 2014;150(11):1191.

4. Lindeque BG, Ponce BA, Menendez ME, Oladeji LO, Fryberger CT, Dantuluri PK. Emerging technology in surgical education: Combining real-time augmented reality and wearable computing devices. Orthopedics. 2014;37(11):751-7.

5. Rosenfield LK. Google Glass and the surgeon. San Mateo County Physician 2013;2:13-4.

6. Davis CR, Rosenfield LK. Looking at plastic surgery through Google Glass: Part 1. systematic review of Google Glass evidence and the first plastic surgical procedures. Plast Reconstr Surg. 2015;135(3):918-28.

7. Davis CR, Rosenfield, LK. Discussion: Google Glass in the operating room the plastic surgeon's perspective. Plast Reconstr Surg. 2016;138(1):303-4.


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