Building capacity and capability in surgery in conflict ecosystems using novel technologies

Cervical cancer is one of the most common cancer-related causes of death in the developing world and is one of the most serious causes of premature disability and death for women living in conflict impacted countries. Surgery is essential to treat the disease, but traditional mentor-apprentice methods of surgical training have failed to provide developing regions with an adequate number of trained surgeons, especially in humanitarian organisations, largely due to the time investment required.

The Virtual Reality Surgery Simulator (VRSS) project utilizes inexpensive, off-the-shelf virtual reality (VR) equipment designed for use with video games, resulting in a total cost of less than $2,000 USD per unit. The low cost of this technology makes it feasible to install surgery simulators in training facilities that could not previously afford them, thereby reducing the per-surgeon cost of surgical training and increasing the availability of trained surgeons in low-resource settings (see Creating a low-cost cirtual reality surgical simulation to increase surgical oncology capacity and capability)

VR surgery training aims to create “pre-trained novices” who have mastered psycho-motor skills, sensory acuity, and – to a lesser extent – cognitive planning of surgical tasks. Studies have shown that VR training can reduce training time needed for a novice to reach the skill level of an intermediately skilled surgeon by half. Similarly, studies have shown that VR-trained surgeons are much less likely to make errors than those who have completed standard training only.

The Virtual Reality Surgery Simulator is a computer-based, interactive virtual reality program that runs on commercially available Oculus hardware. The simulator was built using standard VR development tools and applications that are commonly used by video game development studios and taught in top video game development education programs like SMU Guildhall.

VRSS trainees wear an Oculus Rift headset on their head and hold one Oculus Touch wireless hand controller in each hand. The simulation starts in a virtual training room with guidance to help the trainee get comfortable working in the virtual environment. The trainee is represented by an avatar, with the ability to view only their hands. Once the trainee is comfortable, the simulation transitions to a basic operating room environment, featuring an operating table with a tray of instruments and a virtual patient prepared for surgery.

The simulation begins at the point in the surgery where the key procedures for this training begin. Visual instructions are provided on a virtual monitor, and audio feedback is provided to reinforce procedural knowledge by guiding users through the steps. The headset view of each VR training session is recorded for review and reflection.

As VR and augmented technology continues to advance, new systems that are completely portable and even more cost-efficient are expected to be released. As these systems become available, the VRSS team in collaboration with partners from R4HC-MENA plan to utilize them to further reduce the cost of VR surgical training for surgeons in both conflict impacted countries and humanitarian organisations.

Professor Richard Sullivan

2019-05-09T12:13:32+00:00
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