Augmented Reality Helps Russian Surgeons Remove Shrapnel Without Additional Incisions
Surgeons in St. Petersburg have performed Russia's first operation using augmented reality to remove shrapnel from a patient's lower leg. The technology enabled a more precise procedure, eliminated the need for unnecessary incisions, and reduced the risk of complications.
Removing shrapnel is one of the more technically demanding procedures in surgery. Surgeons must locate foreign objects among muscles, blood vessels, and nerve structures while avoiding damage to healthy tissue. At the same time, every fragment must be removed because any remaining shrapnel can lead to serious complications later. To address that challenge, clinicians at St. Petersburg City Hospital No. 9 and the S.M. Kirov Military Medical Academy used augmented reality technology to guide the removal of shrapnel from a patient's leg.
Originally developed for virtual gaming applications, augmented reality is now finding a role in the operating room. Before surgery, the patient underwent a computed tomography scan, which enabled specialists to create a precise three-dimensional model of the injured lower leg. Software then calculated the safest access path to each fragment.
During the procedure, a digital navigation system overlaid the virtual model directly onto the surgical field. The three-dimensional visualization allowed surgeons to see each fragment in relation to arteries, veins, and major nerves as though they could look beneath the skin without making additional incisions.
A Digital Assistant for Surgeons
This type of navigation is particularly valuable in complex injuries where a foreign object is located deep inside the body, has an irregular shape, or lies close to critical anatomical structures.
The primary goal of technologies like this is to make surgery safer. The more accurately a surgeon knows the location of a fragment, the less healthy tissue must be dissected to reach it. That translates into reduced blood loss, a lower risk of vascular and nerve injury, shorter procedures, and faster patient recovery.
The benefits become especially significant in patients with multiple shrapnel wounds, where even a small error can have serious consequences. Patients should not be concerned, however, because the digital system does not make clinical decisions on its own. Every critical decision remains the responsibility of the surgeon.
The Virtual Operating Room
According to the press service of the St. Petersburg Health Committee, digital technologies are steadily becoming part of routine surgical practice, enabling physicians to perform even complex procedures while minimizing trauma to patients.
Clinical practice indicates that Russia continues to expand its capabilities in digital surgery. This latest procedure represents a logical continuation of work that has been underway for several years.
Technology Development
In 2023, specialists from the S.M. Kirov Military Medical Academy, working together with Peter the Great St. Petersburg Polytechnic University, Medgital, and several medical organizations, introduced an augmented reality system for removing foreign bodies. The first patients were successfully treated using the new approach that same year.
Also in 2023, Samara State Medical University registered an updated version of its AUTOPLAN surgical navigation system, which is used in neurosurgery, traumatology, and other medical specialties. By that time, the platform had already supported more than 1,500 surgical procedures.
In 2025, a clinical team in Orenburg combined augmented reality with fluorescence-guided navigation during complex liver surgery. The approach enabled surgeons to identify blood vessels with greater precision while preserving healthy tissue. Then, in the summer of 2026, surgeons in St. Petersburg became the first in Russia to use augmented reality to remove a lung tumor. A preoperative three-dimensional model of the organ helped preserve a larger volume of healthy lung tissue.
Export Prospects
The potential applications of this technology extend well beyond a single surgical procedure. Augmented reality systems could be deployed in trauma centers, oncology clinics, neurosurgery, vascular surgery, and other specialties where physicians require highly precise intraoperative navigation.
Such systems could prove particularly attractive in countries that are actively expanding access to advanced medical care. Russian developers have already announced plans to bring these solutions to international markets, noting that they can compete with foreign alternatives through their compact design and lower cost.
