UCL Division of Surgery and Interventional Science


Surgeon’s virtual ‘scrub-in’ using new technology filmed by Sky

27 April 2017

A skin cancer operation in Watford, directed by a plastic surgeon 15 miles away at the Royal Free Hospital using augmented reality technology, appeared on the Sky show ‘Swipe’ earlier this month. 

The Royal Free London is the first trust in the UK to use an augmented reality platform, called Proximie, that allows surgeons to direct operations taking place in other hospitals.

This new technology enables surgeons to relay precise instructions about a procedure to surgical colleagues at another location by marking procedural annotations and instructions on the screen of their tablet, desktop computer, laptop or mobile phone. This is known as augmented reality.

Augmented reality technology works by providing a live feed of a real-world environment. New information can then be overlaid on top of that image using computer-generated sensory input such as sound, video, graphics or GPS data.

It means that patients across the country need not travel to the Royal Free in order to benefit from the trust’s clinical expertise.

Edward, a patient at Watford General Hospital had a skin cancer operation, directed by consultant plastic surgeon, and clinical lead, Ash Mosahebi 15 miles away at the Royal Free Hospital in Hampstead. Using a special camera, Mr Mosahebi can draw on the screen to mark precisely where an incision should be made.

Proximie’s augmented reality platform allows surgeons to virtually “scrub in” to any operating room locally or globally. They can use it to guide, train and support other surgeons and clinical staff.  

Mr Mosahebi said: “We have one of the country’s best plastic surgery services here at the Royal Free and we are always looking at how new technology can improve the care we provide to patients.

“Proximie allows patients, wherever they are in the UK, to access the expertise here at the Royal Free and it allows us to guide, train and support surgeons in other locations. I hope that this technology could lead to a more efficient NHS – allowing patients to benefit from first-rate expertise wherever they are in country.”

Consultant vascular and general surgeon Fiona Myint and transplant surgeon Bimbi Fernando have also been involved in this project, along with the support of the Royal Free’s medical director, Stephen Powis.

Similarly, Proximie is being used by students at UCL as a teaching method. Using the platform, they can remotely view and interact directly with operating surgeons at The Royal Free, giving them access to procedures and operations that they may otherwise have only read about in a text book or via a simulated video. It has opened up opportunities for students to ask questions and annotate and visualize techniques.