SOCNORTH Pioneers Augmented Reality Tele-Mentoring (ARTM) Technology to Bring Surgical Expertise to the Battlefield

U.S. Special Operations Command North, supported by NORAD and U.S. Northern Command, is pioneering a new technology designed to project life-saving surgical expertise to the most austere, isolated environments on the globe.

The Augmented Reality Tele-mentoring (ARTM) system was recently demonstrated for U.S. Army Col. Matthew Tucker, SOCNORTH Commander, and U.S. Army Col. Ted Brown, U.S. Northern Command Surgeon, highlighting its strategic value for future operations.

During the demonstration, Tucker stepped into the role of the "delegate." Wearing Augmented Reality (AR) glasses, he was guided through a small surgical procedure in real time. His "mentor" for the exercise was U.S. Army Trauma Surgeon Lt. Col. John Fletcher, who provided live, step-by-step visual guidance while forward deployed in Africa.

The technology directly addresses a critical modern combat gap: the high probability that wounded personnel cannot be medically evacuated to a surgeon within the traditional "golden hour."

"The motto for Special Operations Command North ... is 'Beyond the Watch,'" said U.S. Army Col. Avery Carney, SOCNORTH surgeon. "Because of that, our operators and our teams are way out in front, shaping conditions, often in austerity, and they don't really have the same degree of backside support."

To bridge this gap, developers built ARTM as a "hardware-agnostic, software-defined system that integrates information from both commercial off-the-shelf and military-issued equipment," according to U.S. Army Maj. Titus Rund, concept developer and flight surgeon for the Alaska Army National Guard's 207th Aviation Troop Command.

"This ensures the system is future-proofed as new SOF-peculiar hardware and software becomes available," Rund said. "ARTM is designed for maximum network flexibility, allowing it to be used securely on civilian networks or over secure, encrypted tactical networks."

Rund noted the system meets diverse operational priorities, ranging from aircraft tele-maintenance and tele-analysis to, in the case of the recent demonstration, guiding a medic through a surgical procedure necessary to facilitate a tourniquet conversion.

"Instead of trying to describe something to you, they're actually showing you what they want you to do," said U.S. Army Capt. Peter Lampman, a prior Special Forces Medical Sergeant and a current surgical resident at Oregon Health and Science University who, along with Fletcher, serves as a surgical subject matter expert for the ongoing development of the technology. "We're trying to find a solution to that problem in order to get the surgeon to the patient when the surgeon can't physically get to the patient."

Unlike legacy, audio-only telemedicine, ARTM relies on advanced visual communication. A remote expert can snapshot a live video feed, draw precise annotations on the image, and send it directly back to the medic's field of vision or mobile device.

The system was born out of rapid research and development for extreme Arctic environments. According to Rund, a prototype built in just 16 days was successfully tested on a moving hospital train in Alaska, where a flight medic treated a simulated casualty under the guidance of a trauma surgeon stationed in San Antonio.

The guiding philosophy is that surgery is "80% decision-making, 20% technical," Lampman noted. While a baseline of training is still required, visual guidance allows the remote expert to shoulder the cognitive burden of the procedure.

ARTM delivers unprecedented situational awareness to remote mentors via real-time biometric feedback, engineered specifically to meet the strict Size, Weight, Power, and Cost (SWaP-C) constraints of the SOF operator.

"ARTM integrates peripheral and wearable sensors in order to monitor both a casualty and a TeleDelegate performing a task," Rund said. "This ensures optimized situational awareness and communication between a TeleMentor and a TeleDelegate during high-risk and high-consequence procedures."

This data allows the mentor to dynamically adjust instructions based on the operator's real-time physical state.

"In real time, the coach or the TeleMentor on the other side ... is going to be able to see the vital signs and the cognitive load of the operator on the ground, and then be able to grade, adapt, [and] adjust their instruction," Carney added.

Beyond medicine, ARTM's utility extends to any scenario requiring remote, expert-led guidance and supervision, including explosive ordnance disposal, complex mechanical repairs, aircraft technical inspections, or hazardous operations in contaminated zones where keeping the physical team footprint to an absolute minimum is critical.

"Typically, Special Operation Forces are at the very cutting edge of technology. We have to bring exquisite capabilities in lieu of capacity," Carney said. "When this thing is in full use ... we're all going to be able to securely and tactically connect with a subject matter expert anywhere on the face of the planet."

SOCNORTH plans, coordinates, and conducts special operations in collaboration with mission partners, to assure allies and partners, compete below the level of armed conflict, deter conventional and irregular threats, and set conditions to execute contingency operations to defend the United States and its interests.