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How Virtual Reality is Revolutionizing Neurosurgery

At Stanford University School of Medicine, medical residents file into a room in the hospital basement to attend a virtual reality “class.” Seated comfortably in reclining chairs (equipped with drink holders, no less) in front of three giant screens, they adjust their headsets under the hazy glow of the classroom’s dimmed lighting. While this may sound like the optimal setting for a private screening of the latest Keanu Reeves flick, the residents are in for an even sweeter treat: a heart-racing trip inside the human skull.

The applications of virtual reality — a computer technology used to generate realistic imagery, sounds and sensations to closely resemble a user’s physical environment through lifelike virtual experiences — are by no means limited to video games. The extensive use of virtual reality has lent itself to nearly every field of study, including cinema and entertainment, social science and psychology, education and training, fine arts, engineering, archeology, architecture, music and marketing.

According to Stanford Medicine, virtual reality continues to break the mould with its introduction in the field of healthcare and medicine. The news centre has reported that a new software system integrating imaging from MRIs, CT scans and angiograms to produce a 3-dimensional model is being used by Stanford’s medical institutions. The system will allow physicians and patients both see and manipulate the generated images, similar to those of a virtual reality game.

How Virtual Reality is Revolutionizing Neurosurgery

(Image Source: VRJournal.com)

Stanford’s VR system was created by Surgical Theater, a virtual reality medical visualization company, with the intention to train residents and assist surgeons in the preparations of upcoming operations. The residents each wear individual headsets for the duration of the class, and are guided through the patient’s brain by an avatar sporting a white lab coat — their instructor. The virtual reality system enables the instructors to highlight specific areas of the brain and rotate the view to perceive the structures from varying angles: for example, arteries to demonstrate an aneurysm, bones to display skull deformities or tissue to reveal a tumour. As an avatar, the instructors can also progress through the steps for removing a tumour or fixing an aneurysm, beginning outside of the skull.

“It’s a window into the brain — and a window into the brain of the particular patient we’re going to operate on,”

Surgeons practice for upcoming operations in the Neurosurgical Simulation Lab using images from their actual patients — as opposed to a generic brain — allowing them to meticulously plan the surgeries ahead of time. “It’s a window into the brain — and a window into the brain of the particular patient we’re going to operate on,” said Anand Veeravagu, MD, an assistant professor of neurosurgery and the head of the Stanford Neurosurgical Simulation Lab. The 3-dimensional component of the virtual reality imagery not only facilitates pre-op planning, but also improves the accuracy of the surgery with the ultimate objective of producing safer procedures. “We can plan out how we can approach a tumor and avoid critical areas like the motor cortex or the sensory areas,” explains neurosurgeon Gary Steinberg, MD, PhD, professor and chair of neurosurgery. “Before, we didn’t have the ability to reconstruct it in three dimensions; we’d have to do it in our minds. This way it’s a three-dimensional rendering.”

How Virtual Reality is Revolutionizing Neurosurgery

Physicians apply virtual reality technology before brain surgery.  (Image Source: Hoag, Business Insider)

To allow patients to see and better understand what is involved in their medical procedures, Malie Collins, MS, senior program lead for the VR program, is responsible for transporting a mobile unit with a headset into an examination or hospital room. She explains that the system is especially valuable for young patients or those who do not understand English. The imagery can be downloaded to a thumb drive and presented to a patient as a “souvenir.”

“Traditionally, doctors can show their patient a standard physical model of the brain or of the spine and say, ‘On this model, imagine your tumor is located here,’” she said. “But with VR, we are able to immerse patients in their own anatomy, so they can very clearly get a sense of what’s going on.”

How Virtual Reality is Revolutionizing Neurosurgery

(Image Source: Paul Sakuma)

Unlike other body parts which move with blood flow and breathing, Stanford Medicine’s physicians are using the virtual reality technology for the brain and spinal cord since these organs are relatively stable and can be depicted well using imagery. Collins anticipates that the technology will be available for the remainder of the body in the near future.

While surgeons usually use video feeds during their operations, the new virtual reality technology supplements a 3-dimensional perspective which can be superimposed in real-time video. Steinberg points out that the system provides much more detail, and explains that the 3-dimensional rendering of a patient’s anatomy could be matched up with the surgical microscopic view, a feat that could not be achieved with any other technology. For example, in one of his patient’s cases, an artery was attached to the top of an aneurysm. “You couldn’t see it on conventional imaging,” Steinberg said. “Had I not known about it, it could have been a real disaster.”

According to Stanford Medical’s report, some patients have decided to receive treatment at Stanford over other nearby hospitals exclusively due to Stanford’s virtual reality technology. “This software really helps them understand what it is they are about to undergo,” Veeravagu said. “Seeing it on the screen, in 3-D, really helps put a patient’s mind at ease.”

Author

How Virtual Reality is Revolutionizing Neurosurgery
Jordyn is a recent graduate from the University of Guelph's Biomedical Sciences program, and currently works for Bell Canada Supply Chain.