Collaborators on a project called BetterView will develop a SWIR microscope that will overcome challenges faced by conventional visible spectrum surgical microscopes, such as seeing through blood, cartilage, soft tissue, and biofilms. The aim is to illuminate blood, bacterial biofilms, cartilage, and soft tissue; display them spatially; and make them distinguishable from each other. Seven institutions will partner on the project, including Bielefeld University and Klinikum Bielefeld, one of the hospitals forming the University Hospital OWL. The research will be coordinated by medical technology company Munich Surgical Imaging and will have a budget of €4.1 million (~$4.52 million). To test the microscope, the researchers will use it in the treatment of cholesteatoma, an ailment of the middle ear, at the University Hospital OWL’s Department of Otorhinolaryngology, Head, and Neck Surgery at the Klinikum Bielefeld, which performs the most cholesteatoma operations nationwide. Development of the shortwave infrared (SWIR) microscope in the project called BetterView that aims to enable imaging through blood, cartilage, soft tissue, and biofilms. The instrument will be based on the Arriscope surgical microscope from Munich Surgical Imaging. The device is approved for all applications in ear, nose, and throat surgery. Courtesy of Munich Surgical Imaging. Traditional surgical microscopes are limited in their ability to aid during surgery. Because they deal almost exclusively with the visible spectrum, factors such as bleeding, bacteria, biofilms, soft tissue, and cartilage severely obstruct the view of the surgical site. To remedy this, physics professor Thomas Huser of Bielefeld University and his team will develop software for the microscope that will filter out light from outside the SWIR spectrum and create a three-dimensional image. “In addition, the software needs to produce color contrasts. Such colored markings make it easy to distinguish between, for example, nerves and soft tissue,” Huser said. The software must display the video image in real time for surgeons to work precisely and maintain awareness of conditions in the surgical field. The team expects to see a number of advantages from the SWIR microscope. Its ability to see through blood and distinguish bacterially infested tissue, bone nerves, and soft tissue is particularly important. “Already during the operation, this will enable surgeons to see where remaining bacterial colonization is still present in the middle ear,” said project coordinator Hans Kiening of Munich Surgical Imaging (MSI). “This allows them to completely remove infected areas that could otherwise lead to the development of a new cholesteatoma.” Patient safety is another expected benefit of the device. Increased visibility of the surgical site will lower the risk of damaging sensitive structures such as facial nerves or structures of the inner ear. The team will build the device using an MSI-provided high-resolution microscope currently used in surgery as a base. The Federal Ministry of Education and Research is providing funding to the BetterView joint project as part of the funding initiative “Photonic methods for detecting and combating microbial contamination.”