When smart glasses were introduced in 2012, research teams around the globe tried figuring out how to bring critical information to the surgeon in a reliable way to enhance the surgeon’s own experience, but also to share it with others.
Early challenges, like battery life, design and cost, created barriers, were outweighed by the potential benefits. To figure out how smart glasses have evolved and what the technology means to surgical teams today, Surgical Products connected the co-founders of Vital Enterprises, CEO Ash Eldritch and CMO Dr. Oliver Aalami, vascular and endovascular surgeon and clinical assistant professor of surgery at Stanford University.
What opportunities do smart glasses present for surgeons when it comes to accessing information at the point of care during surgery?
Aalami: To start off with, surgeons wear eyewear for every case…whether it is for splash protection, magnification, light source, or even radiation protection. It is not a big leap to make this eyewear smart!
Operating rooms are filled with monitors. The original monitors were to keep track of pertinent vital signs such as blood pressure, respiratory rate, oxygen saturation, etc. These are still present and having access to these is important particularly when performing procedures where the surgeon is providing the anesthesia. This would be the case whenever conscious sedation is provided (bedside procedures in the icu / every cardiac catheterization / every angiogram / colonoscopies, etc.). An even more interesting phenomenon has been the dramatic rise in minimally invasive surgery in nearly all surgical subspecialties. These procedures are increasingly becoming image guided, requiring video towers to view and perform the surgery. This, in my opinion, is by the far the greatest opportunity to disrupt the current practice. The key will be to come up with a solution that meets current needs well plus adds so much more value that surgeons will wear the smart glasses for every case.

Vital Enterprises CMO Dr. Oliver Aalami wearing the smart glasses from Vital Enterprises.
Eldritch: Putting information right into the field of view of the surgeon at the point of care means that the surgeon no longer needs to look away from the patient and the surgical site in order to reference key information such as vital signs, fluoroscopy and endoscopy video feeds, x-rays, CT/MRI scans and so on. This allows us to improve both general situational awareness, as Oliver discussed, as well as hand-eye coordination for types of procedures that require very high hand precision and referencing imagery, in particular neurosurgery around the brain and spine. Smartglasses will eventually also enable augmenting the surgeon’s view with digital aids overlaid directly on the patient, e.g. mapping an MRI directly onto the patient’s body.
Another powerful use for the smartglasses is for telementoring — enabling remote expert surgeons to see through a local surgeon’s eyes and remotely assist in unexpected or extraordinary procedures, which would be particularly valuable in rural and developing areas.
What are the common questions surgeons have when discussing wearables?
Alami: There is very little knowledge about wearables. Biggest concerns would be battery life, compatibility with prescription glasses, weight, challenges with the user interface (head gestures vs. verbal commands). The key again is to make sure whatever solution is offered covers the basics of current eyewear very well and adds more value with other features.
Eldritch: Of the many surgeons I’ve presented this to, most are very positive about the opportunities smartglasses present. Questions are often around asking for additional capabilities, but also whether the glasses are reliable enough, accurate enough, etc.
What challenges persist with the technology behind smart glasses or their application?
Alami: Battery life, initial set up/configuration whenever one is donned – is it turned on, am I connected to the right network, did the software crash. The ideal solution would be glasses that come out of a charger-type case fully charged every time with minimal to no configuration required. Instead of adding work, it should add pleasure to the experience.
Eldritch: Oliver outlined the technical and user experience challenges with the early versions of smartglasses. Between advances in the hardware and our own experience designing elegant user interactions with this very novel form factor, these challenges are being overcome.
What technology is in place to secure patient information that can be seen with the glasses?
Alami: Most importantly these glasses are not connected to the world wide web. The data most often goes straight from the monitoring device or video output in the room to the glasses. We are not connected to any Google services as even the Google glass devices are rooted.
Eldritch: HIPAA compliance enforces encryption of all patient data both “in flight” and “at rest” — i.e. when being transferred and stored. We provide device-level authentication. We can also operate entirely within the confines of a hospital’s network “firewall”.
This blog originally appeared in Surgical Products.