Inside One Hospital's Adoption of Virtual Training and Remote Support
General Surgeon Dr. Alexis Sanchez from Orlando Health showed us how they are using virtual and mixed reality to train surgeons.
Hospitals around the world are adopting virtual reality technology for surgeon training. This is a story that we often hear from the technologist’s perspective, but Orlando Health’s Dr. Alexis Sanchez took us into how one health network is using the technology and how it compares to the alternative.
Paging Dr. Sanchez
Dr. Sanchez is a general surgeon in the Orlando Health network, specializing in robotics. He’s particularly passionate about a future in which surgeons perform robotic surgeries remotely through immersive interfaces.
However, he’s already convinced of VR’s efficacy in more immediate use cases. That’s why he’s been instrumental in bringing VR training to Orlando Health.
“Virtual reality is a very useful technology, I would say, in pretty much every field,” said Dr. Sanchez. “When we introduce new technologies into healthcare, it’s important to know that it is being done properly.”
While VR might be relatively new to the operating room, it follows a long history of groundbreaking developments in medicine.
“We have been introducing new technology into the operating room for the last couple of decades,” said Dr. Sanchez. “It’s a very complex field.”
Teaching New Tricks
Surgeons don’t finish medical school with all the information that they’ll ever need to know. Rather, they continue learning new procedures and new approaches to procedures. One of the invaluable steps in this process is case observation – watching a surgeon who is already a specialist in a given procedure.
The typical practice for a case observation meant that the surgeon needed to travel to the physical operating room where the expert worked – which might be out of the state or even out of the country. This travel incurs great expense and adds to the time that a surgeon is away from his or her own operating room.
“Nowadays, if you want to take a look into our operating room, all you need is a VR headset,” said Dr. Sanchez. In fact, because the VR experience can be overlaid with additional information, “it might be even better than being in-person.”
A surgeon may use VR to observe a live surgery, or they may use VR to explore a spatially recorded surgery. Both approaches have their benefits. During a recorded session, the surgeon can pause the experience to explore additional data points. During a live experience, the surgeon can ask the expert questions in real time.
“We have already done a number of (VR) case observations, and most surgeons really like them,” said Dr. Sanchez.
Dr. Sanchez noted only one downside: healthcare providers aren’t immune to motion sickness. Sanchez believes that, since most surgeons aren’t casual VR users, they may have fewer problems with motion sickness as they spend more time in virtual environments.
Beyond Observation
Extended reality technology isn’t only being used in surgeon training. An even more recent development is being used in remote support as a surgeon tries their hand at a procedure.
Surgeons can use touchscreen technology to send visual guidance to remote surgeons. | Image: Orlando Health
“Teleproctoring” flips the scene from virtual training. Now, the experienced surgeon is remotely viewing a live feed while the learning surgeon performs an operation.
The operating surgeon isn’t wearing a headset this time, but can view annotations on their environment that the remote surgeon enters on a touchscreen. The effect is that of the remote surgeon drawing on the operating surgeon’s field of view.
“The surgeon-in-training could be doing a procedure, it could be the first time, and our expert surgeon can be there providing suggestions,” said Dr. Sanchez. “We can have our expert surgeons supporting surgeons in training remotely.”
Do Surgeons Know How to Use VR?
It’s an unfortunate fact of emerging technologies that for many people to use VR to learn, they first have to learn how to use VR. Is this the case for surgeons?
“It’s pretty easy. Obviously, it helps if you have some experience using VR, but it’s not rocket science,” said Dr. Sanchez. “It doesn’t require special training.”
Between prepping for motion sickness and getting spatial navigation down, it sounds like aspiring surgeons should fit more VR games into their study schedules.
VR in the Operating Room
Dr. Sanchez is hopeful that VR will one day find a solution to the sickness problem, but there’s at least one other improvement that he would like to see: Haptics.
“When you perform case observation, you’re not developing motor skills,” said Dr. Sanchez. “Once we have haptics, we could use these experiences for developing motor skills.”
Dr. Sanchez also sees a future for VR in the operating room beyond training and teleproctoring. He wants to see VR used as an input method allowing surgeons to control robots for performing remote surgeries.
Doctors might still need current VR experiences to learn how to perform the surgeries, however. At least for the foreseeable future, the age-old practice of case observation remains part of the surgeon’s life.
Hospitals of the Future
How much of the cost and burden of medical care can be alleviated when necessary procedures are easier for doctors to learn and can be carried out from anywhere? The reduced need for surgeons to travel to learn a procedure is compounded by the reduced need for patients to travel to find a qualified surgeon.
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