Mixed reality in shoulder surgery at the Victor Hugo clinic


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

It is developed by Dr Philippe Collin, former President of the French Society of Shoulder Surgery, and one of the orthopaedic surgeons who developed it with two other colleagues, French and American, and within a team of international specialists. Dr Philippe Collin has performed a mixed reality shoulder prosthesis implantation with intraoperative 3D visulas. The challenge is to develop this practice by becoming the first Parisian clinic to offer complete robotic guidance very quickly. 

The technology consists of two phases: the creation of a preoperative plan prior to the operation, on a computer using the BLUEPRINT™ preoperative planning software, designed by the French startup IMASCAP (Wright Medical N.V. Group). In a completely virtual way, the practitioner implants a prosthesis (reconstructed in three dimensions) in the patient's shoulder; a joint that is particularly difficult to access. This optimises the procedure, making it all the more precise, as well as the positioning of the implant. Then, in the operating theatre, the surgeon puts on mixed reality glasses (HoloLens, Microsoft) and operates by simultaneously visualising the patient's shoulder and a three-dimensional holographic representation of the shoulder associated with the preoperative plan. The 3D data of the preoperative plan is projected as a hologram in the surgeon's glasses: this is the first time that the planning software is directly associated with mixed reality glasses. By gesture and speech, the surgeon displays, rotates and analyses the holographic representation of the joint directly in front of the surgical field, and observes the holographic images from all angles. Being able to compare the 3D holographic shoulder and the operated shoulder in real time allows the surgeon to be guided, for a result of unequalled precision. 

Research is continuing with a view to, in the short term, envisaging intraoperative guidance, in real time, of the surgical procedure inside the joint. The ambition is to extend this technology to all orthopaedic and traumatological surgery.