The use of virtual reality in the medical field has been steadily developing over the past decade. Currently, the most effective methods of direct medical application are for psychiatric treatment. VR has been used to treat individuals with irrational fears and post-traumatic stress disorder. Virtual reality programs offer a controlled, gradual method of introducing otherwise troubling ideas and experiences. Despite the realism of virtual reality, there is still a physical disconnect from the experience generated in the screen, which offers patients a sense of safety from what is occurring in the headset. Yet, it is this same sense of disconnect which has posed a challenge to practitioner-sided VR applications.
Virtual reality in surgery training has slowly become more mainstream since 2010, as VR technology has become increasingly open sourced. However, not all virtual reality is created equal, and there are actually quite a few types of virtual reality. For example, what the company, GIBLIB, refers to as their virtual reality surgical stream, is in actuality a live broadcast of 360 degree video in an operating room. While this is irrefutably a positive use of technology for furthering surgical observation, it is difficult to truly describe GIBLIB’s interface as an implementation of virtual reality. This level, would be classified as the lowest tier of integrated virtual reality implementation.
Senior Vice President and Chief Architect of Advanced Micro Devices (AMD), Raja Koduri, describes what he refers to as “good” and “bad” VR. To him, good VR is well integrated, often proprietarily developed, but as a byproduct, is incredibly expensive. The benefit of good VR is that it looks great, performs well, and has a specific purpose. However, good VR does not come cheap. While personal gaming machines may cost a few thousand dollars in hardware (already a significantly higher price point than “bad VR”), a professionally designed, proprietary, medical training system can easily command unattractive asking prices. Furthermore, this kind of virtual reality is not easily accessible to students and medical staff due to its exclusivity and relative lack of portability. On the other hand, bad virtual reality refers to virtual reality designed for mobile platforms, usually through smartphones. In these cases, not only is the hardware much less capable, but the software is clearly less refined, and few applications are designed with proprietary controllers or involvement of user input. That being said, the underpowered smartphones are relatively affordable, not to mention readily accessible by many smartphone users. For reference, only the headset for the HTC Vive (good VR) costs 800 dollars at the moment (PC bundles listed in the 2,000 to 3,000 USD range), more than the price of a Samsung GearVR smartphone and headset cost combined.
Currently, one of the strongest available virtual reality simulations is developed by Conquer Mobile, in their PeriopSim VR, which utilizes the use of handheld controllers in the place of medical instruments and offers users a fairly realistic simulation of a few surgical operations. Another current development is occurring at Stanford University, where researchers are developing programs specifically designed for different surgeries. For example, bone and sinus surgical simulations are currently available. The developers behind this project seem specifically interested in simulating otolaryngology operations. Another innovating implementation has come from a company called NeuroTouch, which uses a dedicated station for users to access handheld controllers and view the simulation through its own display. In this case, the entire contraption is proprietary, but is capable of simulating touch through haptic vibrational feedback. Interestingly, NeuroTouch’s implementation has been on the market for quite a few years now, and seemingly has not seen major developments within the last five years. As the name may suggest, the machine currently specializes in neurosurgery simulations and has been particularly noted for offering a realistic brain tumor removal simulation in which doctors are able to use to replicate the surgery of a specific patient in preparation for the actual procedure.
As technology advances, Robotics are also becoming more and more relevant in the medical field. One of the most well-known and widely used instruments from this category is the Da Vinci, a machine which allows surgeons to regularly perform minimally invasive operations impossible by hand.
Da Vinci machines are incredibly expensive and not readily accessible for many medical students who would greatly benefit from training on these machines. Products like the Robotic Surgery Simulator (R.O.S.S) have been developed to fill this niche, essentially functioning as a replica of the Da Vinci system in which the user is able to simulate real world procedures through R.O.S.S’s interface. Applications such as R.O.S.S. aim to help increase medical proficiency with robotic systems and allow users to be more comfortable and familiar with the hardware during a real operation.
As seen by the last decade of virtual reality development, there is room for both the advancement of current surgical VR applications, as well as the introduction of new VR technologies to better the experience of both the patient and doctor. Future developments of “good” and “bad” VR will likely be tailored toward different uses. Until technology has advanced to make virtual reality readily available and affordable to implement, “good” VR will likely continue to be developed for in-class use for students, or hospital department use for doctors. “Bad” VR will continue to allow for those in the medical field to access recordings and observe surgery in 360 video, using rudimentary, non-precise simulation tools.