At the same time consumer purchases of AR and VR devices have reached something of a disappointing plateau, those technologies are finding an increasing number of homes in industry. One field where various forms of augmented experiences are gaining ground is medicine.
That was clear at Stanford’s recent symposium on medical uses for AR and VR, hosted by the University’s SCIEN program. Literally dozens of projects were represented, along with a wide array of commercial vendors offering solutions for doctors, hospitals, and patients. These ranged from classical surgical planning all the way to patient education.
Pre-Planning Surgery in VR
One of the first applications of VR in medicine was the pre-visualization of upcoming operations. The surgeon could navigate a 3D view of the patient’s MRI or other scans, get a sense for what they would find during the procedure, and plan how they might want to proceed. More recently, there have been attempts to provide that same information in real time during the surgical procedure itself.
Kicking off the symposium, oral-maxillofacial surgeon Sabine Girod provided an overview of how visualizing both a surgical procedure and its results is a powerful tool both for the doctor and for communicating to patients. She can practice different ways of performing a particular surgery to find the best one before beginning the actual procedure.
However, overlaying augmented information onto the patient requires extremely accurate modeling and alignment, so it has a lot of limitations. For example, it works much better for bones than it does for more flexible soft tissue. It also requires that the patient be still, as systems that can dynamically track patient movements with the overlay are still in the early stages.
Surgical Robots Make Virtual Surgery Possible
In many cases, such as when using one of Intuitive Surgical’s da Vinci robot, surgery has moved past the doctor interacting directly with the physical tools and seeing the procedure directly with their eyes. A computer and robot are in the middle, translating hand motions to surgical instrument movements, and relaying 3D views of the surgery through custom viewing stations or monitors.
Once there’s a computer system between the surgeon and the patient, it’s possible to simulate the surgical theater and the surgery itself. Tony Jarc, a Manager of Research at Intuitive Surgical, explained that there are numerous uses and benefits to simulating surgery. One is to use it like Girod, to plan and practice. Surgical training is another very important use case.
Jarc demonstrated several different ways VR systems can provide training tools. The system can provide a guidance overlay for training, or let the surgeon go completely unguided — potentially evaluating their performance at the same time. There’s even a capability for what Intuitive calls “ghost tools” that can be directed by a supervising surgeon to help guide the student. It’s a little early to know how effective these tools are over existing solutions like 2D telestration on the student’s monitor, but some initial user studies say that having 3D tools overlaid may greatly reduce errors.
HoloLens Provides AR-Based Surgical Assist
Stanford’s Medical Center has been collaborating with Microsoft’s HoloLens team on a system that addresses the real-time alignment issues for use in breast cancer surgery. The system currently uses surface markers to keep the augmented reality display aligned during surgery, but they’re working with Microsoft and Stanford’s Bio-X to develop better ways of maintaining alignment in 3D.
Already, though, cancer surgeon Amanda Wheeler says the system is a big improvement over older ways of accurately removing a tumor, like the 1970-vintage technique of using wires to locate a tumor. She describes it as giving her “X-Ray Vision” once it’s set up and correctly aligned. The ability to control what she sees through it with simple hand gestures is also a selling point.
AR and VR Also Have a Lot to Offer Patients
Surgeons aren’t the only ones interested in exactly what’s going on inside a patient. Patients are too, of course. By using VR, doctors can show patients exactly what the issues are in their heart, or brain, or joint, rather than showing them a generic plastic model or sketching a simple picture. This takes extra work on the part of the doctor or their team, but patients are often thrilled with the extra information.
AR and VR can also be used to distract younger patients from their discomfort. The CHARIOT (Children Anxiety Reduction through Innovation and Technology) Program pioneered by Packard Children’s Hospital has been doing just that. Until now, children who suffer pain or are anxious about medical procedures like getting an IV or dressing a wound were often given drugs, including opioids, for the pain. Now, in many cases, they can distract themselves with an AR or VR experience and eliminate the use of drugs.
VR at Your Local Hospital? Don’t Hold Your Breath
As exciting as all the applications of AR and VR on display during Stanford’s SCIEN symposium are, they’re only slowly gaining broad acceptance. Various of the speakers explained why. First, the solutions are still quite expensive, particularly in the time needed to develop and implement them. Even setting up and using the systems takes time. For example, each time a surgeon puts on the HoloLens to use in an AR-assisted surgery, the unit needs to be carefully calibrated and aligned to make sure the image overlays are accurate.
Second, there are few studies that have tied the use of AR or VR to improved patient outcomes. According to one brain surgeon I spoke with at the event, VR provides his team with an improved patient experience and improved education for both patients and aspiring surgeons, but he couldn’t prove that it also improved patient outcomes. Until there’s proof an advanced technology improves patient outcomes or reduces cost, it’s unlikely to be paid for by insurance, or find itself in the budgets of the majority of financially challenged hospitals.