VR, AR and its Future Role in Surgery

From VR Medicine News–Two review articles published this week in the Annals of Translational Medicine focus on the role of VR in surgery. One of the studies1, led by Wee Sim Khor, MD, with the Department of Plastic & Reconstructive Surgery, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK, reviews some of the the potential areas of development in the surgical arena as well as legal aspects of its use.  The other study2, led by Ido Badash, a medical student at the Keck School of Medicine of the University of Southern California, Los Angeles, CA, describes the past, present and future of surgery simulation, including 3D printing, AR, and VR. Advances in surgical simulation, Badash and colleagues note, will “strengthen the surgeon’s skill set, decrease hospital costs, and improve patient outcomes.” Both full text articles are available at the links below.

1.  Khor WS, Baker B, Amin K, Chan A, Patel K, Wong J. Augmented and virtual reality in surgery-the digital surgical environment: applications, limitations and legal pitfalls. Ann Transl Med. 2016 Dec;4(23):454. doi: 10.21037/atm.2016.12.23.
2. Badash I, Burtt K, Solorzano CA, Carey JN. Innovations in surgery simulation: a review of past, current and future techniques. Ann Transl Med. 2016;4(23):453. doi: 10.21037/atm.2016.12.24.

Virtual Reality “Easily Implementable” in Abdominal Surgery

In 15 patients undergoing pancreatic, hepatic or renal surgery, VR was used to facilitate preoperative surgical planning and intraoperative guidance. A 3D reconstruction of target anatomy was exported into a VR environment and some details of the 3D scene were printed. Open-source software and low-cost hardware was used in the method, which researchers describe as “easily implementable by other surgical services.” Of the 20 surgeons who evaluated the approaches, most scored the quality and usefulness as very good. The authors conclude that more resources are needed “to train physicians to adopt these technologies routinely, even if further and larger studies are still mandatory.” Why it’s relevant: this type of research, especially larger studies will help bring VR technology into routine clinical practice.

Sampogna G, Pugliese R, Elli M, Vanzulli A, Forgione A. Routine clinical application of virtual reality in abdominal surgery. Minim Invasive Ther Allied Technol. 2017 Jan 13:1-12. doi: 10.1080/13645706.2016.1275016.

VR and Benchtop Arthroscopy Simulator Show Different Training Outcomes

British researchers have compared a virtual reality (VR) arthroscopy simulator with a benchtop (BT) arthroscopy simulator and found that both simulators delivered improvements in arthroscopic skills. However, BT training led to skills that readily transferred to the VR simulator, whereas skills acquired after VR training did not transfer as readily to the BT simulator. “Despite trainees receiving automated metric feedback from the VR simulator, the results suggest a greater gain in psychomotor skills for BT training,” the authors conclude. “Further work is required to determine if this finding persists in the operating room.”

Middleton RM, Alvand A, Garfjeld Roberts P, Hargrove C, Kirby G, Rees JL. Simulation-Based Training Platforms for Arthroscopy: A Randomized Comparison of Virtual Reality Learning to Benchtop Learning. Arthroscopy. 2017 Jan 7. pii: S0749-8063(16)30893-3. doi:10.1016/j.arthro.2016.10.021.