Wearables and the Surgical Revolution

By Ankit SinghReviewed by Susha Cheriyedath, M.Sc.May 7 2024

The field of surgery is currently undergoing a remarkable transformation spearheaded by the seamless integration of wearable technology. These innovative devices, which can be worn by both surgeons and patients, are revolutionizing surgical procedures in many ways. They provide many benefits that can significantly improve precision, efficiency, and patient outcomes.

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This article delves into the realm of wearable devices, discussing their working principles, applications in surgery, recent developments, and challenges in their widespread adoption.

From Pedometers to Smart Sensors

The evolution of wearable technology in medicine has been truly remarkable. What started as basic tools like pedometers and heart rate monitors in the early 2000s have now evolved into sophisticated devices capable of gathering and processing a vast amount of data. These advanced wearables have diverse sensors that track vital signs, body movements, and brain activity. This evolution has been fueled by the following key advancements:

• Miniaturization: Technological breakthroughs have allowed for the creation of incredibly tiny sensors that can be easily integrated into compact wearable devices.
• Wireless communication: Wearables can now transmit data wirelessly, enabling seamless integration with existing hospital infrastructure.
• Data processing advancements: Powerful microprocessors embedded within wearables enable real-time data analysis.

The principles behind this technology lie in the synergy of these advancements. Miniaturized sensors collect data with high precision, while powerful microprocessors allow for real-time analysis. Thereafter, the processed data is easily transmitted to PACS (picture archiving and communication system) for quick image storage and retrieval.¹

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Wearable Tech Transforming the Operation Room

Wearable technology has become an integral part of the operating room, significantly impacting the pre-operative, intra-operative, and post-operative stages.

In the pre-operative stage, wearables are used to optimize the patient's condition before surgery. Smartwatches and mobile apps can deliver prehabilitation programs that track physical activity, sleep patterns, and medication adherence, providing valuable insights to guide patient’s overall health.

Early detection of potential issues through continuous monitoring can prevent late complications and improve patient safety. Wearables can monitor various physiological parameters, allowing for early intervention in case of anomalies. Studies have shown that these programs can lead to improved post-surgical recovery.²

During surgery, these devices worn by surgeons can track their movements, providing online feedback on ergonomics and instrument handling. This feedback promotes optimal surgical technique, minimizing potential errors.

A recent study published in the Journal of Neurosurgery examined the feasibility of using wearables to monitor neurosurgeons' physical stress due to static posture, which can cause fatigue and musculoskeletal disorders. The collected data can help surgeons become more aware of their posture and prevent any further complications.³

In addition, surgeons can utilize heads-up displays (HUDs) to immediately access critical information like patient data and imaging scans, which provides quick assistance and guidance and also maintains sterility. This leads to improved surgical accuracy and efficiency in many complex surgeries.⁴

In the post-operative stages, wearables are crucial in monitoring a patient's recovery. Devices can follow pain levels and mobility, detecting complications and facilitating a smoother transition back to daily life. Wearable technology has been found to effectively measure patient outcomes after surgery, including physical activity levels, sleep quality, and pain scores.⁵

A Shift in Surgical Care

The integration of wearable technology into medical operating procedures has significantly transformed surgical care for both healthcare providers and patients.

Wearable devices offer real-time data and analysis that helps surgeons make informed decisions, leading to more precise and controlled procedures. These devices can also increase ease and comfort for surgeons by streamlining workflows and minimizing the need for physical tasks and interruptions.¹

These advanced devices also enable remote monitoring, allowing patients to receive continuous care from the comfort of their homes while reducing the need for frequent hospital visits. This not only improves patient convenience but also helps in optimizing healthcare resource utilization.⁶

Moreover, wearables can be used to capture surgical procedures, providing valuable training materials for future surgeons. Recordings from smart glasses or other wearable cameras can be used to create immersive training simulations that enhance surgical skill development. Additionally, these devices can facilitate collaboration among healthcare professionals by enabling the sharing of data and expertise across different locations.⁷

Navigating the Roadblocks

Wearable devices are revolutionizing operating room procedures and surgical care. However, certain challenges need to be addressed before their widespread adoption. One of the primary concerns is data privacy and security. As wearable devices collect sensitive health information, there is a risk of unauthorized access or data breaches, which could compromise patient confidentiality and trust in healthcare systems. Healthcare institutions must implement comprehensive data protection protocols to safeguard sensitive patient information.⁸

The interoperability of wearable devices with existing healthcare information technology (IT) infrastructure is another area of concern. With different device manufacturers and data formats, ensuring seamless integration and compatibility can be complex. Standardization efforts are underway to address this issue, but achieving universal interoperability remains a work in progress.⁸

Moreover, the initial investment in wearable technology can be significant, which can hinder its widespread adoption in resource-constrained settings. Therefore, it is essential to address cost barriers and explore cost-effective solutions to ensure equitable access to this transformative technology. Additionally, wearables are still under development, and their accuracy and reliability require further improvement and validation. Further efforts are, therefore, necessary to refine sensor technology and ensure the highest level of data accuracy for clinical applications.

Wearables Get Smarter: Latest Developments

Recent advancements in wearable technology are constantly pushing the boundaries of what is possible in surgery. Haptic feedback gloves, for instance, provide surgeons with a sense of touch during minimally invasive procedures. This technology can potentially revolutionize laparoscopic and robotic surgery by offering surgeons improved dexterity and control.⁹

Augmented reality (AR) and virtual reality (VR) smart glasses are another ground-breaking technology that projects real-time anatomical information and critical data like ultrasound or magnetic resonance imaging (MRI) directly onto the patient’s body, leading to improved attentiveness, visualization, and navigation during surgery. Studies have shown that AR glasses can improve outcomes and reduce procedure times in various surgical specialties.¹⁰

Artificial intelligence (AI) algorithms are also being integrated with wearables to analyze data in real time. This integration provides intelligent support and predicts potential complications on the go. It holds immense potential for personalized surgical care and proactive risk management. A recent study published in Current Anesthesiology Reports demonstrated the feasibility of AI-powered wearables for predicting postoperative complications with high accuracy.⁵

In addition to these technological advancements, there have been efforts to improve the design of wearable devices to enhance user experience and comfort. Flexible and biocompatible materials are being used to create wearable sensors that conform to the body's contours without causing discomfort or skin irritation. Additionally, efforts are being made to extend the battery life of wearable devices and improve their durability for long-term use in medical settings.¹¹

Future Prospects and Conclusion

The future of wearable technology in surgery is promising, with a range of possibilities that can transform the way surgeries are performed. As the technology matures, wearables will become more common in operating rooms, with their benefits recognized and utilized across diverse surgical specialties. The cost-effectiveness of wearables will also improve, making them more accessible to the masses.

Wearables will likely continue to evolve, incorporating even more sophisticated sensors and functionalities. Advances in sensor technology and miniaturization will pave the way for even more powerful and versatile wearables.

Personalized medicine is also set to receive a boost from wearables. These devices will be central in tailoring surgical approaches to individual patient needs and genetic profiles. Pre-operative data collected through wearables, combined with advanced AI algorithms, will enable the development of highly tailored surgical plans for optimal outcomes.

In conclusion, wearable technology is revolutionizing the landscape of surgical procedures. By providing real-time data, enhancing visualization, and offering personalized insights, wearables are changing the way surgery is performed, enabling a more precise, efficient, and patient-centric practice. As technology advances, the relationship between surgeons and wearables will undoubtedly shape the future of surgical care, leading to improved outcomes and a higher quality of life for patients.

References and Further Reading

1. Mirica, K. A. (2024). Unlocking the Potential of Wearable Sensors in Healthcare and Beyond. ACS Sensors, 9(2), 533–534. https://doi.org/10.1021/acssensors.4c00325
2. Syversen, A., Dosis, A., Jayne, D., & Zhang, Z. (2024). Wearable Sensors as a Preoperative Assessment Tool: A Review. Sensors, 24(2), 482. https://doi.org/10.3390/s24020482
3. Alejandro Zulbaran-Rojas et. al. (2024) Objective assessment of postural ergonomics in neurosurgery: integrating wearable technology in the operating room. JNS SPINE. https://doi.org/10.3171/2024.1.SPINE231001
4. Ahmad, H. S., & Yoon, J. W. (2022). Intra-operative wearable visualization in spine surgery: past, present, and future. Journal of Spine Surgery, 8(1), 132–138. https://doi.org/10.21037/jss-21-95
5. Ardon, A., Chadha, R. & George, J. Post-discharge Care and Monitoring: What’s new, What’s Controversial. Curr Anesthesiol Rep (2024). https://doi.org/10.1007/s40140-024-00627-y
6. Soon, S., Svavarsdottir, H., Downey, C., & Jayne, D. G. (2020). Wearable devices for remote vital signs monitoring in the outpatient setting: an overview of the field. BMJ Innovations, 6(2), 55–71. https://doi.org/10.1136/bmjinnov-2019-000354
7. McKnight, R.R., Pean, C.A., Buck, J.S. et al. (2020). Virtual Reality and Augmented Reality—Translating Surgical Training into Surgical Technique. Curr Rev Musculoskelet Med 13, 663–674. https://doi.org/10.1007/s12178-020-09667-3
8. Thapa, C., & Camtepe, S. (2021). Precision health data: Requirements, challenges and existing techniques for data security and privacy. Computers in Biology and Medicine, 129, 104130. https://doi.org/10.1016/j.compbiomed.2020.104130
9. Ozioko, O., & Dahiya, R. (2021). Smart Tactile Gloves for Haptic Interaction, Communication, and Rehabilitation. Advanced Intelligent Systems, 2100091. https://doi.org/10.1002/aisy.202100091
10.  Desselle, M. R., Brown, R. A., James, A. R., Midwinter, M. J., Powell, S. K., & Woodruff, M. A. (2020). Augmented and Virtual Reality in Surgery. Computing in Science & Engineering, 22(3), 18–26. https://doi.org/10.1109/mcse.2020.2972822
11.  Nan, X., Wang, X., Kang, T., Zhang, J., Dong, L., Dong, J., Xia, P., & Wei, D. (2022). Review of Flexible Wearable Sensor Devices for Biomedical Application. Micromachines, 13(9), 1395. https://doi.org/10.3390/mi13091395

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