Operating room technology
of an engineer working for the company who manufactures the technology, Mabry then plans each step of the surgery in precise detail. He can map out the exact position and sizing for the replacement hip socket, for example.
The image is synched to a VR headset. When he puts it on, he can see a 3D hologram of the patient’s anatomy. It can be viewed in different modes, to show him how things should look at each stage of the procedure. Mabry can check these visuals at any point during the operation via voice command or by bringing his wrist into view and tapping at a virtual watch, which brings up a menu display. Here, he can pull information like a patient’s x-rays into his field of vision, too. All without physically touching anything.
In hip replacements, screws are used to secure the implant. Because of the precise visualisation this tool allows, “You can put in these great screws, you know exactly where they’re going into the bone,” says Mabry. This enhances the fixation of the implant, which means that patients can get back on their feet sooner after the operation, he adds.
Above top: The headset transports surgical trainees into a hyper realistic simulation.
Above: Like a serious video game, VR training has controllers for trainees to affect the virtual world.
Below: A full suite of surgical tools is available for virtual use.
who had to meet a set standard. “It’s not just the training that’s so valuable,” Barad says. “It’s that assessment component: having objective insight into how ready you are to do something.”
Extended reality in the OR And then there’s being in the operating theatre itself, standing over a patient. Here, extended reality can help surgeons plan and execute complex procedures with greater precision. At the University of Alabama at Birmingham, MD and assistant professor in the Department of Orthopaedic Surgery, Scott Mabry, is using mixed reality to perform total hip replacements. First, he takes a CT scan of the hip ahead of surgery, which is then modelled into a 3D image. With the help
For complex cases where you can’t use the regular landmarks you would in surgery, for instance if a patient had plates or screws where a round hip socket would naturally be, the impact of this technology could be significant. Mabry can see this approach being used for other joint replacement procedures, too, like shoulder or ankle replacements. “Anytime you’re planning a surgery with three dimensions, then you need to see all of those views. Having this headset is very beneficial.” He estimates that around 5–10% of hospitals in the US are currently using, or at least dabbling with, extended reality tools like his. Other solutions for surgery are currently being investigated in research, including those that assist with the placement of screws during orthopaedic trauma surgery and allow for enhanced visualisation of anatomy.
What’s next for VR? “We’re seeing a lot more uptake and exploration of VR in today’s health systems,” says Barad. “And this is not only for surgeons, but the technology can be used to upskill wider members of care teams, too,” he adds. And because all you need to participate is a headset and access to the training materials, these solutions could be scaled globally. Dhanda is presently working to share his training programme with hospitals across Africa and at the time of writing, a roll-out across every medical school in the UK had just gone underway. While there’s still room for improvement with the technologies themselves – for example, Mabry’s hologram can be thrown off if you don’t position a screw exactly right during an operation – Mabry, Dhanda and Barad all agree that they’re set to take off within the next few years. “I think it’s one of the biggest inflection points in healthcare, outside of major discoveries like antibiotics,” says Barad.
40 Practical Patient Care /
www.practical-patient-care.com
Osso VR
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