Operating room technology
Above: VR developers are improving the realism of practice programs in order to simulate real surgical situations.
Below: Virtual reality technology allows trainee surgeons to perform procedures in a simulated environment similar to a video game.
videogame-like VR platforms, are changing the nature of surgical training. The numbers, as so often, are illuminating here. According to recent work by BlueWeave Consulting, the global industry for such platforms is predicted to enjoy CAGR of 42% through 2028. Nor is this explosion particularly hard to understand. Quite aside from Maciel’s financial considerations – 360° video and its cousins are obviously cheaper when you don’t need to source fresh cadavers – there are plenty of other advantages over traditional training too.
“Not only can you see the procedure, but you’ve also got multiple camera perspectives to see the fine anatomy.”
Jag Dhanda, oral and maxillofacial consultant surgeon.
One is the fact that teachers can integrate danger into proceedings, with some systems forcing headset-wearing doctors to deal with emergencies like cardiac arrests. Another strength, Maciel notes, is that headsets can give students useful data via augmented reality (AR), with information like heart rates beamed right into their eyes. At the same
time, there are signs that new technology might soon make VR training even more robust. A traditional problem of VR platforms is the fact that they’re by necessity, virtual – no matter how realistic the visual sensation, students aren’t actually practising with a real body. One solution, says Dhanda, has to do with the rising quality of the images themselves, especially for systems like his that rely on real-world footage. As he puts it: “Not only can you see the procedure, but you’ve also got multiple camera perspectives to see the fine anatomy.” That’s shadowed by other advances, designed to mimic the physicality of human flesh. As Maciel explains, his work in this area involves using sophisticated computers to “efficiently model tissue deformation and the interaction of instruments with the tissue”.
Keeping it real
Beyond these technical marvels, there’s increasing evidence that VR systems can bolster clinical outcomes. To explain what he means, Maciel uses the analogy of flight training. “Young surgeons,” he suggests, “can gain ‘hours of flight’ without leaving the ground.” That’s particularly useful, he emphasises, for complex and minimally invasive operations like laparoscopy – which without VR would take years of practice on real patients to master. These practical benefits are echoed by statistical improvements. As 2019 research by doctors at UCLA discovered, surgeons training in VR completed procedures 20% faster than their traditionally educated fellows. The same study found that VR training led surgeons to complete checklists of procedures far more accurately than ever before. Given all this, at any rate, it’s no wonder that VR training is transcending the operating table to enter other areas of medical life. If nothing else, Paul Kelly explains, that’s happening in his own field of expertise. “From an anaesthetic perspective, we have run a number of virtual intubation training sessions with another fantastic platform from Medtronic,” he says, adding that his team has already purchased 15 headsets, hoping to start a multidisciplinary VR training programme shortly. And if VR looks ready to march across departmental boundaries, Dhanda hopes to carry the technology internationally. Easy to share online, and with headsets now costing less than a games console, his unique form of VR has supported oral surgeons in developing nations. Kenya and Sudan are just two of the countries Dhanda has worked in so far, with the consultant now offering a library of 400 videos to choose from. If only the rugged barber- surgeons of older generations could come back and watch them.
68 Practical Patient Care /
www.practical-patient-care.com
Gorodenkoff/
Shutterstock.com; Anderson Maciel
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