Virtual reality and 3D models helping complex surgeries

Published: Feb. 1, 2018 at 4:49 PM EST
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James Vreeken wasn't worried when a couple of lumps appeared on his forehead until things got worse.

“It was just bothering me more and more,” he said. “I'd get headaches all the time and bloody noses, and I just definitely thought something was wrong.”

“The growth was in his eye socket, but it was also growing back toward the brain,” said Surgeon Alison Crum of University of Utah Hospital.

Surgeon Crum got additional insight into James’ surgery with virtual reality and this 3D model.

Neuroradiologist Edward Quigley and his team made both using small slices of James’ CT and MRI scans.

“We talked about components that surgeons or trainees would want to see, like they would want to see a potential blood vessel or where the optic nerve was or how displaced something was,” said Dr. Quigley, “So that sort of changed how we selected the components to put to build into the model.”

For now, these high-tech tools are just for education for medical teams and patients.

James isn't sure he'd have agreed to surgery if he hadn't seen the model, but, fortunately, his surgery was a success.

“Just being able to have that confidence in the doctors and being able to see exactly what they were going to do like, really helped,” said James.”

Dr. Quigley says this technology is starting to be part of pre-surgical planning in a few research settings around the country.

“As we move forward, anything which decreases surgical time, time in the operating room, or makes trainees and residents feel more comfortable can all help patient care,” said Dr. Quigley.

The FDA has not yet approved virtual reality or 3D modeling for surgeons to use.



REPORT: MB #4365

BACKGROUND: There are many reasons to undergo surgery, for instance; some relieve or prevent pain, reduce symptoms of a problem, improve certain functions, or to fix a problem. A surgeon may do a biopsy, which involves the removal of a piece of tissue for further examination. Some surgeries can save lives. Some operations may need large incisions, while some can now be done using much smaller cuts, also referred to as laparoscopic surgery. Surgeons insert thin tubes with a camera to see, and then use very small tools to perform the surgery. During post-surgery the patient runs the risk of complications, including bleeding, infection, reaction to anesthesia, or an accidental injury.



3D PRINTING: 3D printing is the manufacturing process of making a three dimensional and solid object from a digital file. It is achieved using additive processes; an object is created by layering successive layers of material until the object itself is created. Each of these layers is a thinly-sliced horizontal cross-section of the final object. This process is the exact opposite of subtractive manufacturing; hollowing out or cutting out a piece of metal or plastic for instance.



VIRTUAL REALITY: The term virtual reality means near-reality. Everything that we know comes about by way of our senses, and our entire experience of reality is a combination of sensory information and our brain making sense of these mechanisms. If presented with made-up information, your perception of reality also changes. You are then presented with a version that isnÕt real, but from your perspective it is perceived as such. This is what is referred to as virtual reality; presenting our senses with computer generated virtual environments that we can explore in some fashion.



NEW TECHNOLOGY: Collaboration within multidisciplinary teams is now allowing doctors and surgeons to take 2D images, and create educational tools to help with both training and patient education using both virtual and physical models. Taking software that was originally engineered for 2D images and creating 3D models from them, they can also take this medical imaging and create patient-specific medical models, including virtual models that can be loaded into software. This immersive experience allows them by use of a stereoscopic head mounted display to get a better grasp of the data that the surgeon might be dealing with. The 3D models and VR interaction can be an adjunct to the existing surgical plan or aid in the role of resident and fellow education.

(Source: Edward Patrick Quigley, MD, PhD and Alison Crum, MD)

MORE FROM DR. QUIGLEY: Our imaging team took conventional CT and MRI images made up of many slices and planes, and converted those to a 3D model made up of bones, vessels, nerves, globe, and the tumor. These 3D models were both visualized inside a virtual reality headset (Ocululs) and used to 3D print physical models for resident training, patient education, and simulation. The 3D models and VR interaction can be an adjunct to the existing surgical plan or aid in the role of resident and fellow education.