Potential Benefits of Applying Extended Reality Solutions to Surgical Stages

Author: Alex Dzyuba, Lucid Reality Labs Founder & CEO

Every day, medical institutions admit millions of patients globally, with septicemia, heart failure, osteoarthritis, pneumonia, and diabetes mellitus being among the most frequent diagnoses in the US. Nearly 310 million major surgeries are performed around the globe annually, with up to 50 million in the US alone. As the World Health Organization (WHO) predicts the fraction of the population at the age of 60 and above to accelerate and make up 2 billion by 2050,  there is no doubt that the number of surgical treatments will gradually increase in the following decades.

While the worldwide market of minimally invasive surgeries is projected to reach $44 billion by 2030, growing from $20.5 billion in 2019, the global general surgery device market is estimated to land at $26.5 billion by 2026. Promising an acceleration advanced by technological development, investment into R&D, and integration of robotics. Despite the devastating impact that the pandemic has had on healthcare institutions worldwide, Deloitte predicts an opportunity for the whole system’s rapid recovery, stimulated by the transformation and evolution of digital health technologies.

Extended Reality (XR) technologies like Augmented, Virtual, and Mixed Reality (AR, VR & MR) will play a significant role in this acceleration, with the AR & VR healthcare market alone expected to reach $10.82 billion by 2025—each of the technologies containing their benefits that could make a difference in the healthcare industry. The AR capabilities to overlay real-world objects and environments with digital capabilities, VR capabilities to submerge users into interactive virtual environments, and MR capabilities allow overlay and interact with digitally enhanced real-world objects and environments.

XR combinations that utilize several capabilities from each of these technologies can serve as the necessary leverage for the predicted system recovery. With that being said, you can find out more about each of these technologies and their integration into healthcare in our “How Immersive Technology Could Enhance Healthcare of The Post-Pandemic Reality” article.

Nevertheless, immersive technology is no news in healthcare. It has quite a comprehensive implementation in fields like anesthesiology, neurosurgery, gynecology, and rehabilitation, where it is vastly used to enhance training, upskilling, reskilling, and education. Today, however, we would like to talk about using Extended Reality during different surgical stages and the potential advantages it can deliver for medical specialists and patients around the globe.

The aging of the population and the potential increase in several patients who require both significant and minor surgery will push medical institutions to seek more efficient solutions that can be both cost and time-effective. This will touch upon surgical planning, the preoperative stage, the surgery itself as well as postoperative treatment. Immersive technology can significantly assist and cover many aspects, including advanced visualization, 3D planning, and pre-operation process simulation. XR can be utilized for standard surgical procedures like appendectomy, carotid endarterectomy, cataract surgery, cesarean section (c-section), and many more. As well as highly complex surgeries like craniectomy, spinal osteomyelitis surgery, and even oesophagectomy.

Benefits of Using XR in Surgery

XR technology can equip surgeons in numerous directions, including interactive high-precision and detailed patient anatomy visualization that can help improve surgical planning and precision. Depending on the need, medical specialists can turn to immersive technologies in many surgical fields. For example, AR capabilities to overlay objects and environments with digital overlays can provide a real-time display of critical structures, including tissue layers, vein mapping, cranial nerves, and many more, helping reduce surgical risks and post-surgery complications.

At the same time, XR can act as a medium that enables medical specialists to walk through, train, or develop skills in a safe and controlled environment that depicts real-life surgical scenarios. The technology can also allow medical trainees to engage in real-time immersive surgical training, practicing complex procedures without risking harm to actual patients. Incorporating XR can help advance medical education and build confidence and a sense of accomplishment, thus providing a more comprehensive learning experience.

Lastly, immersive technology can help reduce associated surgical procedure time and cost, as surgeons can hands-on practice and rehearse every step of the complex operations, reenacting scenarios of various complexity, thus minimizing the risk for the actual patient. XR technology carries several benefits for the surgical field, potentially revolutionizing the sector by improving outcomes, enhancing patient safety, and reducing related costs.

The advanced capabilities of XR headsets like Varjo XR-3 and Vrgineers XTAL 3, such as high visual fidelity, extended field of vision, eye-tracking, and many more, enable a tremendous variety of implementations that can enhance each of the surgical stages: preoperative, intraoperative, and postoperative. At this point, we would like to take a closer look at the potential XR implementation in each step.

Extended Reality in the Preoperative Stage

The stage where the patient or the person acting on their behalf decides to carry on with the surgery is considered the preoperative phase. According to a recent study, when it comes to surgery, only 11% of patients prefer to make the decision independently, with the majority of surgeons (57%) and patients (54%) choosing shared decision-making (SDM). During this stage, it is essential to prepare the patient physically and psychologically, setting the stage and providing the person with enough knowledge and data. On the other hand, this is the phase where the surgeon is planning for the operation, visualizing the operation, considering alternative variants for the surgical procedure, and selecting the best possible solution for the particular case.

During this stage, XR could serve as a great tool that can be used to visualize the condition in both augmented, mixed, and virtual reality environments, giving patients the much-needed help to comprehend and simplify complex new information. Several studies conducted over the past decade have shown significant advantages of 3D visualizations over traditional 2D methods. It can also provide specialists with the tool to not only visualize the collected diagnostic materials, like X-rays, bone scans, magnetic resonance images (MRI), or computerized tomography (CT) scans in 3D but also utilize them for preoperative VR simulation of the surgical procedure.

Extended Reality in the Intraoperative Stage

The start of the intraoperative stage can be considered once the patient enters the operating room (OR), where they are being monitored, prepped, and anesthetized for the surgery. This stage includes the surgery and nursing activities to ensure the patient’s safety, infection prevention, monitoring of vital signs, response to the procedure, and anesthesia.

Today, many institutions already use XR for medical specialist training, upskilling, reskilling, and education on procedure practices and equipment setups. Even though it will at least be a few more years before we will be able to speak about full-fledged XR implementations into the operative stages, which will require setting up several processes from procedure clearance, procedure safety evaluation, evaluation of clinical trials, and much more, we can already say that the surgery XR enhancement is on its way to reshaping how the entire process works today, allowing innovation to reshape whole healthcare systems with the digital capabilities of immersive technology. Medical specialists can utilize the power of XR for operative assistance, visualization, guidance, and communication in practically any healthcare direction, from ophthalmology and neurology to cardiology and gynecology.

Extended Reality in the Postoperative Stage

As the operation is complete, the patient enters the recovery stage, which is also referred to as the postoperative stage, where the patient receives additional care inside or outside of the medical facility. The postoperative stage also includes the after-surgery recovery process, where patients are provided more information on the current status of their condition and the next steps in the treatment or complete recovery.

During this stage, XR can showcase the progress made and visualize the after-surgery change, simplifying the process of delivering information. The technology can also help recreate conducted surgery for education and training purposes, to help surgeons practice and advance their skills, and at the same time, can be used to create a hands-on interactive simulation for medical practitioners and students. Immersive technology can also help during the recovery and rehabilitation process, utilizing the gamification capabilities of immersive technology that could be used for a more effective recovery process once combined with traditional rehabilitation processes.

In Conclusion

While we are still approaching the stage where XR will be massively implemented and require extensive clinical trials, we have come a long way with both the technological advancement and the shift of mindsets regarding the implementation. We can only expect to see more pioneering use cases and next-level promotions in the upcoming few years; this, without a doubt, is the beginning of a new XR-enhanced healthcare era.

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FAQ

How Can AR Technology Help Surgeons?

AR technology can help surgeons in every phase of surgery. It can enhance preoperative planning with digital overlays and help visualize diagnostic results for the medical specialist and the patient. We already know examples of when AR capabilities were used during the surgery for advanced visualization as an additional digital overlay to guide the surgeon. XR can also be used during the postoperative phase to demonstrate the result and visualize the treatment and recovery progression in 3D.

New Surgical Procedures: Can Our Patients Benefit While We Learn?

When it comes to new surgical procedures, risk mitigation is as essential as ever. XR allows surgeons to practice the procedure walk-throughs based on actual patient details and scenario simulation. While it cannot guarantee prevention, XR will enable surgeons to collect real-time feedback, helping assess potential threats, identify additional risks, and look at the procedure from many angles. XR can help enhance surgical planning, thus delivering better patient outcomes.