[Editor's Note: Felasfa Wodajo, senior editor at iMedicalApps, had the following article published in the Journal of Surgical Radiology.  The iMedicalApps article is based off an experiment we performed to study the functionality of the iPad in the operating room, briefly covered in a prior article we wrote.  This is Part 1 of a two part series, in Part II we will cover the method of using OsiriX and Dropbox to transferring images to the iPad.]

The iPad has received a significant amount of attention in the health care arena since its introduction last year. The attraction is fairly obvious; it is a portable, lightweight, powerful computing device with an intui-tive interface and a large library of built-in applications. In fact, major medical schools such as Stanford and University of California, Irvine have made decisions to provide iPads to all incoming medical students this year. While predicting the future of medical technology is always precarious, here are a few things we have learned in the months since the iPad was introduced.

A short time ago, we published at IMedicalApps.com a brief entry describing the potential use of the iPad in the operating room. What we found was that a simple xray cassette sterile bag, ubiquitous in the OR, holds an iPad comfortably. Once the iPad is inserted into the plastic bag by the circulating nurse, the top can be cut off, folded back and clamped with a hemostat (see image) allowing the iPad to be safely brought into the sterile field.

Notably, we found that the iPad touch screen works quite well through the plastic bag, even while wearing gloves. Somehow, the touch of the plastic bag itself against the glass screen registers as a valid touch. There was hardly any problem navigating between and inside apps, or with gestures such as pinch and zoom. This was somewhat of a surprise since, as many people have noticed, using an iPhone touch screen with gloves is difficult at best and impossible if one is double-gloved.

[Ed. This post is excerpted from the article published in the Journal of Surgical Radiology (link)]

What is the use of an iPad in the OR? The reasons may actually be myriad but, generally speaking, the same features which make the iPad great for surfing the web, such as looking at images and viewing video, nicely translate into the operating room. Thus far, the most obvious use for me has been as a convenient way to easily access previous patient imaging. Additional potential assets of utilizing the iPad in the OR include the ability to review relevant anatomy at the point of care and enhancement to resident teaching. It can also be useful in bypassing hospitals’ restrictive networks to access remote files and office electronic medical records (EMRs) using the cellular 3G networks.

Recently, there was a report of a Japanese surgeon using an imaging application on the iPad to plan surgery in the OR (Medgadget). Although it is not clear what application was being used, I suspect it was OsiriX (seen in the accompanying images). I am not aware of any currently available applications for the iOS platform currently available which integrate with surgical devices such as laparoscopes, arthroscopes or computer-aided navigation. It is fun though to speculate about a future iPad-like device which might use onboard gyroscopes to provide an “augmented reality” view of internal structures, so that tilting the device would show different portions of the body. This could even conceivably be integrated with views from internal cameras, navigation or robotically controlled surgical instruments.

We will have part two of our original article in the Journal of Surgical Radiology tomorrow.