Scientists are utilising VR-assisted training methods to ensure vital surgical tuition continues through the coronavirus pandemic.
Talks are currently underway that could bring the pioneering technology to the UK and other European countries following the initial trial phase.
With COVID-19 restrictions limiting surgeons’ access to the operating room, the Zurich-based medical education company, VirtaMed is taking its latest VR training equipment to hospitals using a mobile surgical simulation lab.
Launched as a direct response to the coronavirus pandemic, the initiative provides hospitals and surgeons free access to VirtaMed’s range of surgical simulators. The technology combines virtual reality graphics with a tactile rubber anatomy to create a realistic experience of the operating room whilst reducing the risk of medical errors.
VirtaMed’s Head of Marketing and Analytics and member of the mobile team, Phil Norris, explains: “During this turbulent time, the VirtaMed team have rallied around to think of ways in which we can deliver medical training and education, given the constraints.
“Normally, we would be taking the simulators into the institutions, but we’re not currently able to do this. Registrars desperately need training, and we believe this is the best way to bring it to them.
“Given travel restrictions and the safety that we have to maintain for our team, we decided to find a compromise with a converted truck parked outside hospitals, allowing us to deliver medical training.”
Dr Martina Vitz, Head of Training & Education at VirtaMed adds: “Over the past months we have received a lot of requests for training. I am so pleased to offer it on-site and using VirtaMed’s newest fleet of simulators.”
With plans to work alongside hospitals across Switzerland over the next two months, the company aims to test the model and see if it can be replicated in other countries, including the UK.
“We ran a similar initiative three or four years ago where we brought simulators to hospitals in the United Kingdom,” says Norris, “so, having a model like this with a team travelling in the van and delivering training is something we would certainly consider.”
“We have worked with several institutions in the UK, including Bournemouth Orthopaedic Research Institute which was the first in the world to install our hip simulator back in 2016.
“We are also in discussions with a number of medical societies, including one of the Royal colleges about bringing the simulators to the UK.”
On board the mobile lab is a prototype version of VirtaMed’s Laparoscopic Simulator, which the company has launched early in order to give surgeons the opportunity to practice keyhole surgery on the abdomen and pelvis.
The company is directly benefitting from feedback received from surgeons, which it intends to use to adapt and improve the technology.
“We’ve had a really great response, which we’re so pleased about. Laparoscopic simulation is an industry that has existed for more than 20 years and there have been many simulators developed before. The feedback we’re getting is that this is the most life like simulator,” says Phil Norris.
VirtaMed build on the current research and previous simulation technology, with innovative advances such as the use of original surgical tools and virtual reality graphics.
Norris continues: “Previous simulators haven’t used actual surgical tools, instead they have used styluses; a type of robotic arm. Our simulators are able to create a more realistic experience by combining the adapted surgical instruments with our tactile technology that is able to simulate organs and our interventions with them.
“The improvement in gaming engines and GPU in recent years has given us the freedom to look at any organ inside the abdomen rather than just focus on one or two, as previous simulators have.”
In the current landscape of surgical training, a registrar’s professional development is measured by either the number of procedures they have performed or the number of hours they have spent in the operating room under the supervision of senior surgeons.
VirtaMed intends to shift this current apprenticeship model by taking advantage of machine learning and data feedback to test manual skills and objectively distinguish competency levels of surgical trainees.
Aiming to solve some of the key issues with the current surgical training model, the simulators allow for trainees to practice unsupervised, make mistakes and focus on specific techniques, rather than teaching a full operation.
The technology can also simulate what happens when a procedure goes wrong, so trainees can become confident dealing with exceptional cases within a safe and controlled environment.
Phil Norris added, “Surgeons may not always be taught in the right order as they have to treat patients as and when they come in. But, with the simulator we can be a lot more systematic. We focus on a specific part of the procedure and repeat that, so trainees can concentrate on one skill until they reach a good proficiency level before moving on.”
“All of this is a stepping stone between the classroom and the operating room. It allows them to familiarise themselves with the techniques before carrying out a real surgical procedure.”
VirtaMed claims that surgical simulators have the potential to reduce costs for medical institutions by replacing other forms of training, such as cadaver training, animal models and supervised surgery.
Norris concluded, “Medical institutions do have to purchase a simulator in order to benefit from it and this is a decision that has a big financial component to it, but it does have many cost savings on the other side.
“We know that the cost of operating room time is high and there are several peer reviewed papers which show that a procedure like the one we simulate typically takes 20-40% longer if a resident is in the operating room.”
VirtaMed was born from a Swiss Government initiative in 2001 which brought together medical experts and computer scientists across sixteen PhD theses. In 2007, VirtaMed’s first surgical simulator was brought to the market and since then, the company has released simulators across four medical specialities: Orthopaedics, Obstetrics and Gynaecology, Urology and Laparoscopy.
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