A seemingly frivolous fad that came and went faster than a Hula-Hoop almost four decades ago is back to fill some serious needs of science and medicine.
Three-dimensional images that can be seen only by wearing special glasses flopped in the 1950s when applied to comic books and movies, but they are coming back as a teaching tool for medical students and doctors who need to learn the intricacies of the brain`s delicate anatomy before attempting surgery.
The technology is also helping researchers understand complexities of molecular structure and atmospheric turbulence. And it is poised for an entertainment comeback as an integral factor in virtual reality scenes.
But for the moment, surgery is the realm where 3-D imaging appears to be having the biggest impact.
Typical is a surgical suite at Loyola Medical Center in Maywood, where Dr. Thomas Origitano worked one recent morning to remove a patient`s brain tumor. As Origitano watched himself work through two microscopic lenses, onlookers wore polarized glasses as they gazed at a television screen where Origitano`s view was transmitted from cameras attached to each of his microscope`s lenses.
Dr. Blake Welling, a senior resident, watched the TV monitor as he assisted Origitano. Dr. Richard Harrison, a junior resident, watched the monitor as he described the technique to Helen Nikolas, a third-year medical student.
What 3-D images and their odd-looking glasses bring to medicine is a depth perception that cannot be achieved on a standard two-dimensional image. Dr. Ossama Al-Mefty, a Loyola surgeon who is a pioneer in removing hard-to-reach tumors just below the brain, brought 3-D video to Loyola to communicate his ground-breaking techniques to colleagues and students.
The tumors Al-Mefty treats are at the base of the skull, above the roof of the mouth, in about the center of a person`s head. He uses special tools, reaching the tumor through openings smaller than a half dollar.
Typically, vital nerves and blood vessels almost as small as a human hair may be embedded in the tumor covering, and damage to these structures can mean loss of function, permanent coma or death to the patient.
Showing colleagues and students the true picture of this anatomy was close to impossible without 3-D, said Al-Mefty. He now uses 3-D slides and videotapes to supplement lectures he gives describing sensitive techniques.
``With a 3-D videotape, I can show colleagues a procedure, and they see everything just as I saw it on the day of the operation,`` said Al-Mefty.
He is so enthusiastic about the teaching benefits of 3-D that Al-Mefty has arranged to get hologram images of some anatomic scenes so that viewers can examine them without the aid of glasses.
Although the main purpose of 3-D microsurgery is teaching, it can also improve the surgery. Physicians assisting the chief surgeon can do a better job when they can look at a TV monitor and see in depth exactly what the chief surgeon sees, said Dr. Franco DeMonte, a Loyola neurosurgeon who works with Al-Mefty.
``With depth perception, when the surgeon asks you to put an instrument in, you can put it right where it is needed,`` said DeMonte.
The 3-D electronics needed to make the system work were supplied to Al-Mefty by New Dimension Communications Inc., a small St. Louis firm that worked with Dr. M.G. Yasargil, a Swiss neurosurgeon with the University of Zurich, who conceived the idea as a way to satisfy the many surgeons who observed his techniques.
Robert Fabian, founder of the St. Louis company, said it took five years to develop the technology, which so far is only in use in a handful of university medical centers, including the University of Chicago as well as Loyola.
``It`s not yet an off-the-shelf commercial product,`` said Fabian. ``We don`t have salesmen out there making calls. But it is starting to spread to large medical centers that find it useful for teaching.``
The real medical breakthrough for 3-D imaging will come once someone learns how to get a good in-depth image for technology in which surgeons insert small tubes called endoscopes through tiny abdominal incisions to remove gall bladders and other organs that once required open surgery and long hospital recoveries.
The major drawback to endoscopic surgery now is that surgeons can see their instruments inside a patient`s body, but they lack depth perception.
``The big boom in 3-D will come when we have 3-D endoscopy,`` said Al-Mefty. ``That will really have an important impact on surgery itself, not just surgery education.``
Several people are working on 3-D endoscopy, including Fabian of St. Louis and Thomas DeFanti, co-director of the University of Illinois at Chicago`s electronics visualization laboratory.