Examining the benefits of extended reality in neurosurgery: A systematic review

Dadario, Nicholas B.; Quinoa, Travis; Khatri, Deepak; Boockvar, John A.; Langer, David; D’Amico, Randy S.

doi:10.1016/j.jocn.2021.09.037

Cited by 34 publications

(18 citation statements)

References 84 publications

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“…For patient outcomes, there is a scarcity of controlled studies that have examined patient outcomes, highlighting the necessity for further investigation in this regard. 20,60,61 As such, we did not expect to find many patient-centered outcomes based on the modality of training (XR vs standard). Of the few outcomes available, however, there is likely potential for improving patient care with XR training.…”

Section: Discussionmentioning

confidence: 95%

“…For time to task completion and technical scores, XR enhances procedural accuracy and surgical confidence by facilitating a deeper understanding of the patient's anatomy. 21 The integration of XR in surgical procedures holds potential therapeutic benefits, particularly for complex cases [18][19][20]54,55 because the learning curve is high. There is evidence that learning curves for complex procedures can be mitigated with repetition and motivation 56 and intelligent tutoring systems.…”

Section: Discussionmentioning

confidence: 99%

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Does Extended Reality Simulation Improve Surgical/Procedural Learning and Patient Outcomes When Compared With Standard Training Methods?

Woodall,

Chang,

Toy

et al. 2024

Sim Healthcare

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Introduction The use of extended reality (XR) technologies, including virtual, augmented, and mixed reality, has increased within surgical and procedural training programs. Few studies have assessed experiential learning- and patient-based outcomes using XR compared with standard training methods. Methods As a working group for the Society for Simulation in Healthcare, we used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and a PICO strategy to perform a systematic review of 4238 articles to assess the effectiveness of XR technologies compared with standard training methods. Outcomes were grouped into knowledge, time-to-completion, technical proficiency, reactions, and patient outcomes. Because of study heterogeneity, a meta-analysis was not feasible. Results Thirty-two studies met eligibility criteria: 18 randomized controlled trials, 7 comparative studies, and 7 systematic reviews. Outcomes of most studies included Kirkpatrick levels of evidence I–III (reactions, knowledge, and behavior), while few reported level IV outcomes (patient). The overall risk of bias was low. With few exceptions, included studies showed XR technology to be more effective than standard training methods in improving objective skills and performance, shortening procedure time, and receiving more positive learner ratings. However, XR use did not show significant differences in gained knowledge. Conclusions Surgical or procedural XR training may improve technical skill development among trainees and is generally favored over standard training methods. However, there should be an additional focus on how skill development translates to clinically relevant outcomes. We recommend longitudinal studies to examine retention and transfer of training to clinical settings, methods to improve timely, adaptive feedback for deliberate practice, and cost analyses.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Does Extended Reality Simulation Improve Surgical/Procedural Learning and Patient Outcomes When Compared With Standard Training Methods?

Woodall,

Chang,

Toy

et al. 2024

Sim Healthcare

View full text Add to dashboard Cite

show abstract

“…The Metaverse, with the help of XR, enables surgeons to visualize organs, tumors, X-rays, and ultrasounds in real- time and from numerous angles without losing focus on the patient while performing the operations. The Metaverse's 3D representations of a patient's body increase efficiency and accelerate the treatment [102]. In situations where an ordinary person is required to perform resuscitation, doctors can guide to perform resuscitation in the Metaverse based on the stimulated environment using XR equipment [103].…”

Section: A Extended Realitymentioning

confidence: 99%

Metaverse for Healthcare: A Survey on Potential Applications, Challenges and Future Directions

et al. 2023

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The rapid progress in digitalization and automation have led to an accelerated growth in healthcare, generating novel models that are creating new channels for rendering treatment at reduced cost. The Metaverse is an emerging technology in the digital space which has huge potential in healthcare, enabling realistic experiences to the patients as well as the medical practitioners. The Metaverse is a confluence of multiple enabling technologies such as artificial intelligence, virtual reality, augmented reality, internet of medical devices, robotics, quantum computing, etc. through which new directions for providing quality healthcare treatment and services can be explored. The amalgamation of these technologies ensures immersive, intimate and personalized patient care. It also provides adaptive intelligent solutions that eliminates the barriers between healthcare providers and receivers. This article provides a comprehensive review of the Metaverse for healthcare, emphasizing on the state of the art, the enabling technologies to adopt the Metaverse for healthcare, the potential applications, and the related projects. The issues in the adaptation of the Metaverse for healthcare applications are also identified and the plausible solutions are highlighted as part of future research directions.INDEX TERMS Metaverse, healthcare, virtual reality, digital twin, cybersecurity.

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“…Computer-generated realistic images, sounds, and other sensations in VR immerse users in artificial and synthetic environments that simulate a desired situation [ 17 , 20 , 39 , 40 , 65 ]. Given that VR users have the ability to explore the artificial environment, move within it, and interact with other users [ 16 ], a simulation could be devised that enables neurosurgeons to train and plan for conducting an awake craniotomy (AC). Intraoperative brain mapping using direct electrical stimulation of cortical and subcortical regions can be performed in AC to reduce the risk of permanent loss of neurological functions in eloquent areas, such as areas associated with language, motor, or vision by real-time monitoring of neurological functions with the patient participating in different tasks [ 26 , 29 , 42 , 48 , 53 , 54 , 87 , 88 ].…”

Section: Introductionmentioning

confidence: 99%

Augmented and virtual reality usage in awake craniotomy: a systematic review

et al. 2022

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Augmented and virtual reality (AR, VR) are becoming promising tools in neurosurgery. AR and VR can reduce challenges associated with conventional approaches via the simulation and mimicry of specific environments of choice for surgeons. Awake craniotomy (AC) enables the resection of lesions from eloquent brain areas while monitoring higher cortical and subcortical functions. Evidence suggests that both surgeons and patients benefit from the various applications of AR and VR in AC. This paper investigates the application of AR and VR in AC and assesses its prospective utility in neurosurgery. A systematic review of the literature was performed using PubMed, Scopus, and Web of Science databases in accordance with the PRISMA guidelines. Our search results yielded 220 articles. A total of six articles consisting of 118 patients have been included in this review. VR was used in four papers, and the other two used AR. Tumour was the most common pathology in 108 patients, followed by vascular lesions in eight patients. VR was used for intraoperative mapping of language, vision, and social cognition, while AR was incorporated in preoperative training of white matter dissection and intraoperative visualisation and navigation. Overall, patients and surgeons were satisfied with the applications of AR and VR in their cases. AR and VR can be safely incorporated during AC to supplement, augment, or even replace conventional approaches in neurosurgery. Future investigations are required to assess the feasibility of AR and VR in various phases of AC.

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Examining the benefits of extended reality in neurosurgery: A systematic review

Cited by 34 publications

References 84 publications

Does Extended Reality Simulation Improve Surgical/Procedural Learning and Patient Outcomes When Compared With Standard Training Methods?

Does Extended Reality Simulation Improve Surgical/Procedural Learning and Patient Outcomes When Compared With Standard Training Methods?

Metaverse for Healthcare: A Survey on Potential Applications, Challenges and Future Directions

Augmented and virtual reality usage in awake craniotomy: a systematic review

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