Operating room technology
room could help train more surgeons to a high standard, much quicker. Once in theatre, extended reality tools can help make surgery safer, too – such as enhancing a surgeon’s view of a patient’s anatomy so they can operate with greater precision. And these solutions are already being rolled out in universities and hospitals around the world.
Immersive learning
What if trainees could watch a procedure being performed in front of them, as many times as they needed to, without needing to physically be in the operating room? It’s what Dhanda, who is the director of extended reality education company VRiMS, has made possible by creating the world’s largest immersive training library. To access it, you put on a VR headset that’s synched to a 360º video of a procedure being performed on a cadaver. You can see the operation happening in 3D, right in front of you, as if you’re in the room yourself. And you can see it from different angles via multiple views that are overlaid onto the video, too. “You would never normally see that little blood vessel, but you can in an overlay,” says Dhanda.
Interactive elements can also be included, such as narration of what’s happening and quiz questions that pop up intermittently. These can be tweaked depending on the audience: a medical student would get a different set of questions than an experienced surgeon watching to brush up their memory.
These videos allow trainees to gain a familiarity with different procedures as if they were observing them in the operating room. Medical students often have to wait until their third or fourth year before they can get into the theatre, and they won’t necessarily get to engage in the specialties they’re interested in. Even the most experienced surgeons will have operations they rarely perform and could use a refresher on. And while the technology doesn’t allow you to participate in the virtual procedure – you can’t manipulate any objects or change the course of what’s happening – the immersive experience also makes it easier to retain knowledge, Dhanda explains. “If I train you to do something with a VR headset, you’re 16 times more likely to remember it than reading it in a book.”
Simulating surgery It’s possible to actually practice surgery in virtual reality, too. These solutions also use a VR headset that’s synced up to training materials, only they’re high-fidelity simulations rather than pre-recorded videos. Osso VR is one of the companies that makes them. “Everything we do is a fully interactive simulation,” says Barad. Here’s how it works: you put on a headset that can track the 3D position of your hands and choose your content. Then, you can interact with it either by holding hand controllers that give haptic feedback or moving your hands as
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you would normally (though you’d lose the feedback in this case).
As with Dhanda’s library, each video offers varying levels of guidance. If it’s your first time with a particular simulation, it will tell you what to do. But if you’ve got a lot of experience, you can do the operation from memory. For some procedures, there’s a zoom-in function so you can see a particular area blown up, in a way that wouldn’t be possible in real life. In validation studies, Barad shares that people using Osso’s technology had a 200–300% increase in performance outcomes. In one such trial, published in the journal Surgical Education, a group of participants trained for a particular procedure using Osso to a set level of proficiency, while another followed the traditional route – learning from lecture materials, though taking as much time as they needed. Both groups performed the operation in a test environment and were graded. Those trained with VR outscored their peers in all assessments – and in four out of five categories, the difference was significant. This also speaks to the impact of having standardised assessments for surgery, like benchmarks or scores for different skills. Currently, there’s little to none of this, Barad explains. “It is very subjective. It’s, ‘I feel ready to do this’, or ‘I feel that someone else is ready to do it’.” In the above study, confidence in one’s skill wasn’t enough: the lecture materials group studied until they felt capable yet were outperformed by those
Above top: VR has the potential to train more surgeons quicker, and to a higher standard.
Above: The simulations mimic a real operating theatre, complete with imaging.
Opposite page: With VR training, hours of simulated operating theatre training can be had.
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Osso VR
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