IMHOTEP: cross-professional evaluation of a three-dimensional virtual reality system for interactive surgical operation planning, tumor board discussion and immersive training for complex liver surgery in a head-mounted display

Abstract

Background Virtual reality (VR) with head-mounted displays (HMD) may improve medical training and patient care by improving display and integration of different types of information. The aim of this study was to evaluate among different healthcare professions the potential of an interactive and immersive VR environment for liver surgery that integrates all relevant patient data from different sources needed for planning and training of procedures. Methods 3D-models of the liver, other abdominal organs, vessels, and tumors of a sample patient with multiple hepatic masses were created. 3D-models, clinical patient data, and other imaging data were visualized in a dedicated VR environment with an HMD (IMHOTEP). Users could interact with the data using head movements and a computer mouse. Structures of interest could be selected and viewed individually or grouped. IMHOTEP was evaluated in the context of preoperative planning and training of liver surgery and for the potential of broader surgical application. A standardized questionnaire was voluntarily answered by four groups (students, nurses, resident and attending surgeons). Results In the evaluation by 158 participants (57 medical students, 35 resident surgeons, 13 attending surgeons and 53 nurses), 89.9% found the VR system agreeable to work with. Participants generally agreed that complex cases in particular could be assessed better (94.3%) and faster (84.8%) with VR than with traditional 2D display methods. The highest potential was seen in student training (87.3%), resident training (84.6%), and clinical routine use (80.3%). Least potential was seen in nursing training (54.8%). Conclusions The present study demonstrates that using VR with HMD to integrate all available patient data for the preoperative planning of hepatic resections is a viable concept. VR with HMD promises great potential to improve medical training and operation planning and thereby to achieve improvement in patient care.

Using virtual 3D-models in surgical planning: workflow of an immersive virtual reality application in liver surgery

“…Also, medical education and specialized HPB apprentices may profit from immersive virtual reality applications due to the interactive use and the possibility to interact with multiple participants and over distances. This is in concordance with recent literature that evaluated a similar VR application to be suited mostly for student and resident training [17]. To date, this is the main development goal of the presented application.…”

Virtual Simulation in Undergraduate Medical Education: A Scoping Review of Recent Practice

“…Despite the diversification of virtual simulators/platforms/systems used in undergraduate medical education, we found that 48 (52%) studies ( 18 , 22 , 23 , 27 – 31 , 33 – 35 , 37 – 39 , 42 , 44 – 48 , 50 , 52 , 54 , 57 – 67 , 71 , 72 , 75 , 78 , 81 – 84 , 93 , 96 , 99 , 101 , 103 , 105 ) reported the immersive VR application, which is characterized by the use of VR equipment consisting of head-mounted displays (headsets or goggles) and/or hand controllers. This finding suggested that VR might be a typical and popular representative of modern VS technology used in medical education.…”

“…From the 92 published studies, VS was reported to be applied in the educational practice involving undergraduate medical students across 25 countries including the United States [26 studies ( 15 – 40 )], the United Kingdom [9 studies ( 41 – 49 )], Germany [7 studies ( 50 – 56 )], China [6 studies ( 10 , 57 – 61 )], Denmark [6 studies ( 62 – 67 )], France [4 studies ( 68 – 71 )], Japan [4 studies ( 72 – 75 )], Sweden [3 studies ( 76 – 78 )], Canada [3 studies ( 79 – 81 )], Netherlands [3 studies ( 82 – 84 )], Spain [3 studies ( 85 – 87 )], Australia [2 studies ( 88 , 89 )], Singapore [2 studies ( 90 , 91 )], Korea [2 studies ( 92 , 93 )], Finland [1 study ( 94 )], Italy [1 study ( 95 )], Ireland [1 study ( 96 )], Colombia [1 study ( 97 )], Pakistan [1 study ( 98 )], Thailand [1 study ( 99 )], Iran [1 study ( 100 )], Poland [1 study ( 101 )], Mexico [1 study ( 102 )], Norway [1 study ( 103 )], Saudi Arabia [1 study ( 104 )], and Switzerland [1 study ( 105 )]. The distribution of included studies among different continents was shown in Figure 1 .…”

Intraoperative holography navigation using a mixed-reality wearable computer during laparoscopic cholecystectomy

“…Cartucho et al 13 compared 2D images and 3D models displayed by a wearable mixed-reality device and reported that the 3D models were more highly evaluated by the surgeons. As surgeons with less surgical experience evaluated 3D models more highly than experienced surgeons, 10,14 we speculate that less experienced surgeons with lower spatial awareness may benefit more from 3D models. The surgeons in this study had 20 and 32 years of surgical experience.…”