Surgeries put someone’s life at stake, so there’s no room for errors. That’s why proper surgical training is essential in medical education. Traditional learning methods, however, come with their limitations, which is where innovative solutions step in. Extended reality (XR) is one of them — it offers immersive environments that transform how surgeons learn and prepare for operations. In this article, we’ll discuss how XR boosts medical professionals’ confidence and revolutionizes surgical training.

What is extended reality in surgical practice?

Put simply, surgical XR is a cutting-edge technology that combines virtual reality (VR), augmented reality (AR), and mixed reality (MR) to create interactive simulated environments for surgical training and to enhance intraoperative procedures.

Here’s a breakdown of how XR components work:

  • Virtual reality: With VR, users are fully immersed in a digital world. In surgical training, this means practicing operations in a completely simulated operating room. Students and healthcare professionals can use virtual tools to perform procedures on virtual patients and 3D models of organs.

  • Augmented reality: AR overlays digital elements onto the real world. During minimally invasive procedures, AR can be used to project patient-specific imaging data (CT scans, MRI) directly onto the patient’s body to guide instrument placement and improve precision. AR also allows surgeons to manipulate 3D models of organs and practice techniques while still being aware of their real-world surroundings.

  • Mixed reality: MR takes it further by blending the virtual and real worlds and allowing digital elements to interact with the real environment in real time. Imagine wearing VR glasses during surgery and seeing a 3D holographic overlay of a patient’s anatomy projected directly onto the body. This provides surgeons with a clear and enhanced visualization of the surgical field. It’s handy for complex procedures that require precise navigation.

Limitations of traditional surgical training

Traditional surgical training methods, like observation learning or cadaver-based training, have long been the backbone of surgical education. However, they often can’t replicate real-world scenarios and leave trainees feeling unprepared. Let’s explore the limitations of traditional approaches that highlight the growing need for innovative approaches like extended reality in medical practice:

Lack of hands-on practice

In most cases of traditional surgical training, students spend much time observing experienced surgeons in action. While this is valuable for understanding the flow of a procedure, it doesn’t give trainees much hands-on experience. They may occasionally assist, but observing isn’t the same as performing. As a result, newly qualified surgeons often feel uncertain when they face their first solo surgeries, particularly in critical situations where quick decision-making is vital.

Inconsistent exposure to rare cases

One of the biggest hurdles in surgical training is the lack of exposure to rare or unusual cases. Trainees are limited by the cases they encounter in their medical rotations. A student might perform numerous appendectomies but never encounter a complex pancreatic resection or a rare congenital anomaly. This inconsistency leaves gaps in their skill set and complicates tackling uncommon surgical cases later on.

Limited opportunities for pre-surgical rehearsal

Until recently, pre-surgical planning mainly involved studying imaging data, patient charts, and diagnostic results. But this approach doesn’t allow practitioners to rehearse a specific procedure for a particular patient they’re about to perform. For example, a surgeon preparing for a complex tumor resection can study the scans but cannot physically practice the steps involved in navigating critical structures. Without a chance to virtually simulate the operation, being precise in terms of incisions and predicting potential complications is harder.

6 Ways XR improves surgical training

XR introduces innovative ways to learn, addressing the limitations of traditional surgical training. In this section, we’ll dive into the ways extended reality technology is making surgical training smarter and safer:

Enhanced spatial understanding

Traditional anatomical learning often relies on 2D representations, which limits the spatial understanding of surgical students. XR provides interactive 3D anatomical models that trainees can manipulate and explore to develop a deeper understanding of spatial relationships crucial for surgical planning.

Applications like VOKA 3D Anatomy and Pathology use augmented reality to overlay these 3D models onto real-world objects. It helps further enhance spatial visualization and anatomical localization skills.

Virtual reality learning environments

For beginners, stepping into an operating room for the first time can be overwhelming — there’s complex equipment, a high-pressure atmosphere, and a team that needs to work in perfect sync. VR helps trainees get comfortable with this environment before they ever set foot in the real operating room.

Using advanced platforms like Surgical XR, trainees can enter a fully simulated operating room, choose any procedure from an extensive library, and learn to manage the flow of a surgical team. It’s like a rehearsal where they can refine skills and build confidence without the fear of making mistakes. Such an approach is invaluable for developing technical and situational awareness.

Availability of diverse cases

Every patient is unique, so trainees need exposure to diverse cases to prepare for as many scenarios as possible. XR medical training helps students build problem-solving skills and adapt to unexpected situations.

XR provides access to a broader range of cases than typically encountered in a training setting. Platforms like Touch Surgery offer extensive libraries of surgical procedures. It covers various specialties and includes complex or rare cases. This allows trainees to experience and practice on a broader spectrum of pathologies, improving their preparedness for real-world scenarios.

Integration with haptic feedback

Tactile experiences are invaluable for mastering delicate maneuvers in the operating room. At this point, medical extended reality can be combined with haptic feedback, a technology that recreates the sense of pressure, resistance, and movement. This method allows trainees to feel what it’s like to interact with tissues, organs, and surgical instruments.

Not being an inherent part of XR technology, haptic feedback can be integrated into XR setups. For example, the HapticVR simulator by FundamentalVR combines the XR environment with advanced haptic devices, allowing trainees to practice suturing, incision techniques, and more with realistic tactile feedback. Another example is the SenseGlove, a wearable haptic glove that lets users feel textures and forces while interacting with virtual models.

By incorporating haptic feedback into XR-based training, surgeons can refine their motor skills and develop muscle memory. This combination of touch and visualization helps closely mimic real-life surgeries.

Instant performance evaluation

As a rule, students’ assessments depend on the instructor and can be subjective. As opposed to traditional feedback methods, XR systems can immediately and objectively identify mistakes and highlight areas for improvement. The system can quickly spot mistakes and offer advice on correcting them, so the students don't carry them into their practice.

Imagine practicing a complex surgery in a virtual environment and receiving instant feedback on factors like precision, timing, or technique. The system can also flag an incorrect incision angle, improper tool use, or delayed completion of a critical step.

Real-world examples include tools like the already mentioned FundamentalVR, which tracks performance metrics such as force applied, procedural accuracy, and efficiency. After every session, the students receive detailed feedback. Another example is Osso VR, which uses virtual simulations to score trainees on their surgical performance and provide actionable insights to help them improve.

Opportunities for collaborative training

Surgical procedures aren’t a solo effort — they’re a team endeavor where surgeons, assistants, nurses, and anesthesiologists work together. Extended reality in medical practice empowers surgical teams to rehearse procedures together and improve coordination.

For instance, Osso VR provides collaborative features, allowing multiple users to join a shared virtual environment for team-based surgical simulations. By using XR for collaborative training, surgical teams can streamline workflows. It’s a powerful way to strengthen the cooperation between team members and improve patient outcomes.

Applications of surgical XR: notable cases

XR surgical training has demonstrated its transformative potential in some of the most complex medical fields. Here are the notable cases showcasing its impact:

Cardiac surgery

The Journal of Surgical Case Reports published a notable case where XR enabled surgeons to visualize patient-specific anatomy in unprecedented detail. A 73-year-old male patient was diagnosed with three-vessel coronary artery disease through CTA and coronary angiography. This condition needed coronary artery bypass grafting (CABG) surgery.

To enhance preoperative planning, the surgical team employed an extended reality tool with a custom AI-driven algorithm to generate a patient-specific 3D model of the coronary arteries from the CTA data. This model provided an accurate anatomical and pathological representation of the patient's coronary system.

Integrating this 3D model into the XR platform enabled the surgical team to interact with a full 3D view of the patient's coronary anatomy during preoperative planning and intraoperative guidance. The XR tool augmented spatial orientation, facilitated precise localization of stenoses, and enhanced the surgeon’s operative proficiency.

Neurosurgery

Another groundbreaking case published in the Journal of Neurosurgery showcased how XR enhanced the treatment of a 59-year-old patient with a 3 cm intracerebral hemorrhage (ICH) in the thalamus.

Given the deep-seated location of the hemorrhage, the surgical team leveraged an extended reality platform to enhance both preoperative planning and intraoperative navigation. Using VR, they created a detailed 3D model of the patient’s brain, which allowed them to map out the optimal surgical trajectory and carefully avoid critical structures.

During the surgery, AR provided real-time visualization to ensure precise navigation to the hemorrhage site. This technology enabled a minimally invasive endoscopic approach and successful evacuation of the hemorrhage without causing additional brain injury. The patient tolerated the procedure well and demonstrated significant recovery within 11 months.

Use case: VR arthroscopic wrist simulator for surgeons

XR medical training: challenges

While XR is transforming medical training with its innovative features, it also comes with certain challenges:

Budget constraints

A major barrier to adopting XR medical training is the high cost of hardware and software. Advanced XR headsets, haptic gloves, and specialized platforms require significant investment. This makes XR tools out of reach for smaller medical schools and hospitals. For example, a high-fidelity haptic feedback system can cost tens of thousands of dollars, not including the cost of the XR headsets and software licenses.

Additionally, integrating XR into existing training programs or hospital systems isn’t always seamless – it requires additional resources for infrastructure upgrades, such as powerful computers, dedicated spaces, and technical support.

To address this challenge, institutions can start with smaller pilot programs to gradually incorporate more XR tools. Thus, they can minimize initial costs and work through technical integration challenges over time.

User acceptance

Even the best technology won’t make an impact if people are reluctant to use it. Many practicing surgeons and healthcare professionals may hesitate to invest time in learning how to use XR tools, either due to busy schedules or skepticism about their benefits.

Some may view XR as an unnecessary addition to their already demanding workload, while others might prefer traditional training methods they’re familiar with. Overcoming this resistance requires demonstrating the tangible value of XR and making the learning process as accessible as possible.

Content development and standardization

Creating high-quality XR training content is a complex task as well. Developing realistic simulations, accurate anatomical models, and engaging interactive scenarios requires specialized expertise. The lack of standardized curricula and assessment methods for XR-based training also poses a challenge.

To tackle this, industry-wide collaboration on standardized training protocols is essential for ensuring consistency and making comparisons easier across platforms and institutions.

Technical limitations

Current XR technology still faces limitations that can impact the training experience. These include limitations in graphical fidelity, processing power, field of view in headsets, and the accuracy and reliability of haptic feedback systems. For example, while haptic gloves can provide some sense of touch, they may not fully replicate the complex tactile sensations experienced during real surgery.

However, ongoing advancements in VR, AR, and haptic technology are improving the realism and reliability of XR systems. As these technologies keep evolving, we can expect more immersive and accurate simulations in the near future.

Read our new case studies

Wrapping up

XR is transforming surgical training by overcoming the limits of traditional methods and making learning more hands-on. It allows surgeons to practice on a variety of cases in risk-free environments. This technology is paving the way for safer and more innovative medical training. As XR continues to evolve, it will play an even more prominent role in medical education, helping surgeons gain the skills they need to deliver excellent patient care.

Comments (0)

Cancel