Virtual-Augmented Reality and Life-Like Neurosurgical Simulator for Training: First Evaluation of a Hands-On Experience for Residents

Abstract

BackgroundIn the recent years, growing interest in simulation-based surgical education has led to various practical alternatives for medical training. More recently, courses based on virtual reality (VR) and three-dimensional (3D)-printed models are available. In this paper, a hybrid (virtual and physical) neurosurgical simulator has been validated, equipped with augmented reality (AR) capabilities that can be used repeatedly to increase familiarity and improve the technical skills in human brain anatomy and neurosurgical approaches.MethodsThe neurosurgical simulator used in this study (UpSurgeOn Box, UpSurgeOn Srl, Assago, Milan) combines a virtual component and a physical component with an intermediate step to provide a hybrid solution. A first reported and evaluated practical experience on the anatomical 3D-printed model has been conducted with a total of 30 residents in neurosurgery. The residents had the possibility to choose a specific approach, focus on the correct patient positioning, and go over the chosen approach step-by-step, interacting with the model through AR application. Next, each practical surgical step on the 3D model was timed and qualitatively evaluated by 3 senior neurosurgeons. Quality and usability-grade surveys were filled out by participants.ResultsMore than 89% of the residents assessed that the application and the AR simulator were very helpful in improving the orientation skills during neurosurgical approaches. Indeed, 89.3% of participants found brain and skull anatomy highly realistic during their tasks. Moreover, workshop exercises were considered useful in increasing the competency and technical skills required in the operating room by 85.8 and 84.7% of residents, respectively. Data collected confirmed that the anatomical model and its application were intuitive, well-integrated, and easy to use.ConclusionThe hybrid AR and 3D-printed neurosurgical simulator could be a valid tool for neurosurgical training, capable of enhancing personal technical skills and competence. In addition, it could be easy to imagine how patient safety would increase and healthcare costs would be reduced, even if more studies are needed to investigate these aspects. The integration of simulators for training in neurosurgery as preparatory steps for the operating room should be recommended and further investigated given their huge potential.

Assessing the impact of neurosurgery and neuroanatomy simulation using 3D non-cadaveric models amongst selected African medical students

“…Results from our study have it that it is easy to use and easy to get acquainted with, sanctioned by a 60% and 60.9% scores on our study. This is consistent with a similar study carried out using UpSurgeOn tools, where More than 89% of the residents assessed that the application and the augmented reality simulator were very helpful in improving orientation skills during neurosurgical approaches ( 34 ). Indeed, 89.3% of participants found brain and skull anatomy highly realistic during their tasks ( 34 ).…”

“…Also, the organization by the available neurosurgical centers of continental annual or bi-annual neurosurgery boot camps taking into consideration regional level of excellence and geographical proximity will improve the neurosurgical know-how of undergraduate students ( 4 , 32 ). A valid strategy to improve at the same time for neurosurgery exposure and cadaver dissection which is crucial to neurosurgical training is the use of hands-on-touch non-cadaver model for neuroanatomy/neurosurgery learning such as the UpSurgeOn models ( 33 , 34 ).…”

A new dimension in medical education: Virtual reality in anatomy during COVID‐19 pandemic

“…VR allows for the creation of realistic, interactive environments that can be used to train surgeons and other medical professionals, as well as to test new procedures and devices. Other research has shown that VR can be an effective tool for teaching surgical skills and for training healthcare professionals in laparoscopic surgery (Aoki et al, 2020; Gleason et al, 2022; Kamat et al, 2022; Mori et al, 2022; Yu et al, 2022) and neurosurgery (Petrone et al, 2022).…”

Letter: Improving Surgical Skills During Residency: A Scheduled and Certified Approach With Virtual-Augmented Reality and Life-Like Simulators: Experience in a Single School of Neurosurgery

“…The use of neurosurgical simulators (UpSurgeOn Box and UpSurgeOn Srl) plays a pivotal role in this course: They combine virtual and physical components to provide hybrid solutions of training so that virtual reality, augmented reality, and the physical simulator are able to guide residents from exploring anatomy to reproduce surgical approaches through a semispheric support. 6…”

“…The use of neurosurgical simulators (UpSurgeOn Box and UpSurgeOn Srl) plays a pivotal role in this course: They combine virtual and physical components to provide hybrid solutions of training so that virtual reality, augmented reality, and the physical simulator are able to guide residents from exploring anatomy to reproduce surgical approaches through a semispheric support. 6 The course is 1 year in duration and is completely managed by residents through a hierarchical structure according to years of residency and with the supervision of fully trained neurosurgeons.…”