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Surgeon Live-Streams Procedure Using Google Glass and iPad

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With the help of Google Glass and an iPad, a surgeon in the US has live-streamed a procedure as he performed it in the operating room, thus turning a new page in the annals of telemedicine.


Rafael Grossmann, a general and trauma surgeon at Bangor-based Eastern Maine Medical Center (EMMC), used the "wearable computer" headset to send a live video stream while he carried out a simple endoscopic procedure called PEG (Percutaneous Endoscopic Gastrostomy) on a patient who needed a feeding tube fitted.


The live video, together with Grossmann's live commentary, were sent to and received by an iPad situated nearby, although there is no technical reason why it, or any other compatible receiving device, could not have been thousands of miles away. The point was to demonstrate that this key step in telemedicine is feasible.


However, Google Glass is more than just a recording device that can stream what it records onto the internet: the wearer can also use it to search the internet.


The wearable computer has a camera, a GPS, bluetooth, microphone and a small head-mounted display that sits unobtrusively in the corner of one lens of a pair of glasses. The computer can grab images and video, under control of the user's voice.


Grossman also live-streamed the procedure to a Google Glass Hang-out (HO) that he had set up between his Glass and his Google account beforehand. (This proves the potential use of having other people participating in the live streaming event).


He recorded himself giving a brief explanation before starting the procedure, and talked about the importance of not revealing any patient identifying information.


He had Google Glass switched on all the time, linked up with the HO. The live video images that he could see through his Glass appeared on the remotely located iPad.


He said he could use the set up to show not only the patient's abdomen, but also the endoscopic view, in what Grossman describes as a "very clever, simple and inexpensive way".


On his blog Grossman, one of 8,000 'explorers' that Google has chosen to test the device before general release, describes the historic achievement with obvious excitement:


"The whole thing was fairly quick and went very well. We used 'home-made' techniques, so the pictures and video are not optimal, but I think the point stands: Google Glass Streaming During Live Surgery...By a Glass Explorer Surgeon...IS POSSIBLE."


Grossman applied to be a Google Glass Explorer after consulting with the hospital's administration, reports Bangor Daily News.


Grossman performed the Google-Glass-assisted procedure on Thursday 20th June, just one day earlier than Spanish surgeon Pedro Guillén, head of the Traumatology Department at the Clínica Cemtro in Madrid.


In that operation, Guillén carried out a chondrocyte transplant on a 49-year-old man with a cartilage injury while being watched by 150 people all over the world, including Homero Rivas, director of Innovative Surgery at the Stanford University School of Medicine in the US.


Guillén told Europa Press that "the glasses didn't bother me at all, in fact, there were moments when I forgot I was wearing them".


He describes the set up as "very interactive", and allowed doctors who were observing in real time over the internet, to ask him questions as he performend the operation.


"It's a very good tool for training doctors and researchers, allowing them to enrich their knowledge by watching live operations," he added.


The obvious benefits of such an application are huge. Several doctors can watch a procedure at the same time anywhere in the world, instantly share opinions and information about the patient, and retrieve supportive material and extra data (such as clinical history) from an electronic health record "cloud".


But while the technology is attractive and exciting, there are still numerous challenges to overcome, especially around protecting patient privacy.


Grossman was careful in his demonstration to ensure that the footage was only accessible through his personal Google account. No personal information about the patient was sent or recorded, and the patient's face was not shown.


He says the patient gave fully documented informed consent to the Google-Glass-assisted procedure, which he carried out because, as he says on his blog:


"By performing and documenting this event, I wanted to show that this device and its platform, are certainly intuitive tools that have a great potential in Healthcare, and specifically for surgery, could allow better intra-operative consultations, surgical mentoring and potentiate remote medical education, in a very simple way."


Dr. James Raczek, chief medical officer at EMMC, told Bangor Daily News that while they applaud Grossman's work with Google Glass, further measures are needed before they can start looking at using the technology to assist doctors at the bedside.


"We think that this technology may have real benefits for patients but we have to find an answer to the privacy concerns," says Raczek.

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