Caduceus S — AR Navigation
Navigation you never look away from
Caduceus S is an augmented reality navigation system for spinal surgery. It projects the navigation image into the surgeon's own line of sight, so the plan, the instrument and the anatomy stay in one view, without a monitor across the room.
FDA 510(k) cleared: K220554 (opens in a new tab), K242271 (opens in a new tab) · TFDA Class II license MOHW-MD-No. 008401
What it is
Augmented reality, brought into the surgical field
Caduceus S is an image-guided navigation system for percutaneous spine procedures. A transparent near-eye headset lets the surgeon look at the patient and at the navigation images at the same time.
What the system does
- Headset display — the headset displays 2D stereotaxic screens and a 3D anatomy model
- Instrument tracking — optical tracking shows the location of tracked surgical instruments relative to the patient's acquired scan
- Posterior pedicle screw placement — the navigation image is available throughout percutaneous spine procedures
- Planning — pedicle screw implant size planning and navigation on rigid bone structures
AR navigation in action
Why augmented reality for spinal surgery?
Augmented reality merges the imaging with the real surgical environment rather than putting it on a screen beside it. Six features of the system are described below.
A live case, seen the way the surgeon sees it
This footage shows a procedure in a real operating room.
Image in front of the surgeon
Conventional navigation shows the image on a screen on the far side of the room. With Caduceus S the image is displayed in front of the surgeon.
Registration from the C-arm images
Registration is done from the C-arm images themselves.
Imaging in the field of view
The headset projects the navigation images into the surgeon's field of view.
Tracked instruments
Shows the location of tracked surgical instruments relative to the patient's acquired scan.
Headset display
2D stereotaxic screens and a 3D anatomy model.
CT or C-arm images
Navigation from images acquired preoperatively by CT or intraoperatively by C-arm.
Features
In the operating room
The navigation image is displayed where the surgeon is looking.
Intuitive imaging, in the surgeon's own line of sight
The navigation image is displayed directly in the surgeon's field of view, so position can be checked without looking at an external monitor.
The headset and a tracked instrument
A surgeon and an assistant work with a tracked instrument, the headset in use.
Colleagues looking on
A surgeon wearing the headset holds a tracked instrument while colleagues look on.
The team in the operating room
A surgical team works around a draped patient in an operating room, two members wearing Caduceus S headsets.
Caduceus S is cleared by the US FDA under 510(k) (K220554, K242271) and licensed as a Class II medical device by Taiwan's TFDA and the Thai FDA, and is manufactured under an ISO 13485:2016 quality management system. See every clearance and license in full
Percutaneous procedures
Navigation on CT or C-arm images
Caduceus S supports image-guided navigation of medical image data acquired preoperatively by CT or intraoperatively by C-arm, in percutaneous spine procedures.
Instrument tracking
The system shows the location of tracked surgical instruments relative to the patient's acquired scan.
A team with a tracked instrument
Members of a surgical team work together with a tracked instrument in an operating room.
A surgeon wearing the headset
A surgeon in profile wearing the Caduceus S headset in an operating room.
Imaging modules
Navigation on the imaging in the room
Caduceus S supports image-guided navigation of medical image data acquired preoperatively by CT or intraoperatively by C-arm. Three modules match the imaging device in the room: a 2D C-arm, a 3D C-arm or an intraoperative CT.
| Aspect | 2D C-arm module | 3D C-arm module | Intraoperative CT module |
|---|---|---|---|
| Imaging source | A standard 2D C-arm | A 3D C-arm | An O-arm intraoperative CT |
| Registration | Performed from the C-arm images themselves | Automatic, once the 3D scan is complete | Automatic, once the CT scan is complete |
| Equipment | Supports multiple C-arm brands | Various registration tools; DICOM loaded into the navigation workstation | O-arm, with no extra connections or configuration |
All three columns are Caduceus S modules, not separate products. Which one is used depends on the imaging device in the operating room.
2D C-arm module
Registration is performed from the C-arm images themselves.
3D C-arm module
The reconstructed volume, the planned trajectory and the instrument position sit on one screen.
Registration
Various registration tools are supported, and DICOM images load straight into the navigation workstation.
Intraoperative CT module
The intraoperative CT module pairs Caduceus S with an O-arm. The scan is taken in theater, on the patient as they are positioned, and the navigation runs on that scan. X-ray images can be brought into the navigation alongside the CT.
For multi-level cases involving four or more levels, the 3D C-arm module takes the 3D scan, registers it automatically and drives navigation from it.
Deployment settings
A hospital and an outpatient center need different things
Caduceus S is one system with more than one shape. A hospital with 3D imaging or an intraoperative CT can navigate from a volume; an outpatient surgery center with a single 2D C-arm can run the same AR-guided procedure without buying one.
Hospitals
For hospitals the system adds a 3D C-arm module and an intraoperative CT module — O-arm or a hybrid OR. It builds the 3D image during the case and projects it onto the surgical area through AR, and the surgeon can pick between three perspectives as the procedure demands.
Both modules attach to imaging equipment the hospital already owns, so the move to AR navigation is a change of workflow rather than a capital purchase. Which module runs is the hospital's choice, depending on the imaging available.
The individual imaging modules — 2D C-arm, 3D C-arm and intraoperative CT — are described in the Imaging Modules section.
Outpatient and ambulatory surgery centers
The case for OSCs and ASCs is largely financial. Caduceus S navigates from a standard 2D C-arm, so a center can offer AR-guided spinal surgery without investing in 3D imaging. No intraoperative CT is needed, and no second imaging device to find room for.
It adapts to the room rather than the other way round — large theater or small procedure room — and the same system navigates from either imaging setup, so the choice stays with the surgeon and the patient in front of them.
In either setting the clinical work is the same: the system is FDA 510(k) cleared for posterior pedicle screw placement.
Caduceus S — laptop version
Portable AR navigation
The same navigation, running on a laptop. Deployable across operating rooms and portable between theaters.
One module, no cart
The laptop version supports one navigation module per software installation, chosen at purchase: the C-arm module, the 3D C-arm module, or the I-CT module as an option. Everything else — the AR projection and the positioning functions — is what the full system does.
- Compact and mobile — no bulky equipment
- Spine implant and MIS procedures — the same two families of case the cart-based system is used for
Regulatory status
Clearances, licenses and availability
Caduceus S (marketed as Caduceus S AR) is FDA 510(k) cleared (K220554, K242271) and licensed as a Class II medical device by Taiwan's TFDA and the Thai FDA. It is not CE marked and is not available for sale or use in the European Union. Availability differs by country; please contact us about your country.
Augmented reality navigation
See it in your own operating room
Tell us what imaging you already have — a 2D C-arm, a 3D C-arm, an intraoperative CT — and the procedures you run most often, and we will show you the configuration that fits. Online, or on site with the system in front of you. If you are near our US office in Naples, Florida, we can bring the demo to you.