VR and haptics: how technology is transforming surgery training

Future of Healthcare 2022

The UK’s healthcare system is facing chronic challenges, from antiquated administrative systems to staff and capital shortages. How can the NHS effectively modernise and ease the blockage? Which technologies will help treat the underlying causes of inefficiency and unlock innovation? And what does recent legislation and legal action mean for patients and employers?

Haptic technology, when combined with virtual reality, is aligning the neglected sense of touch with sight and situational awareness in surgical training; add in AI and it’s a game changer

Press a scalpel into human flesh and, as the blade moves, the sensation subtly changes. Skin has a specific feeling: arteries offer a level of resistance, veins less so, while bone and muscle can be tougher. The complex catalogue of sensations that travels from blade to hand to brain is known as haptic feedback. If a surgeon is less than a millimetre out, it can mean life or death. Now technology can recreate this accurately and cost effectively. 

Haptics is the science of simulating pressure, texture, resistance and other feelings related to touch. Married with virtual reality (VR), it can be vital in reducing medical errors. One in 10 patients are harmed accidentally while receiving healthcare, while one in 300 die, according to the World Health Organisation. More than 250,000 NHS patients in England suffer disability or death resulting from healthcare interventions every year. Any effort to reduce these numbers is welcome.

“Healthcare professionals do an amazing job in often difficult conditions. The fact is critical errors do still occur. Now, we don’t have to accept error as inevitable. It’s not just a human and societal tragedy, the cost is also huge, with the NHS paying more than £2bn yearly for medical-error settlements. A change in safety culture is crucial and it starts with innovation. This is where more accurate surgical simulations can make a real difference,” explains Richard Vincent, CEO of FundamentalVR, a global leader in virtual reality and haptic healthcare software. 

The healthcare system across the globe, and surgery in particular, faces a perfect storm. There’s a shortage of trained surgeons worldwide and a lack of cadavers to practise on in some settings. The pandemic also stalled physical training for surgical techniques and operating room observations. Concurrently, face-to-face operating room teaching is increasingly expensive and time consuming to deliver. 

“By combining immersive VR with cutting-edge haptics and AI at scale, we can now create an incredibly life-like training experience with accurate physical sensations. This is a gamechanger. We are laser focused on pre-human competence, which is about training surgeons in the most realistic way possible before they enter any operating theatre,” says Vincent, who also co-founded FundamentalVR, which counts The Mayo Clinic, one of America’s leading centres of medical excellence, and Sana Kliniken, one of Europe’s leading medical organisations, among its investors.

“It’s all about lowering the risk to real-life patients. Digital twins of surgical realities can help with this. Virtual surgeries are repeatable and safe environments to operate in. We also deploy machine learning and deep data insights to inform our models and assessments so that training via our software continually improves.”

When you run your virtual instrument up and down a spine, as you view the backbone through a VR headset, the resistance created by the handheld device or haptic gloves in real time means that you can actually feel the tip of the instrument ricocheting off each vertebra. Muscle memory and sub-millimetre precision is a key aim of this immersive experience since many surgical techniques require an incredibly high degree of accuracy. 

A near-infinite array of surgery scenarios can now be performed in VR without harming actual patients, ensuring that learning from medical errors is risk-free. Software and 3D recordings also allow surgeons to review their work visually, with real-time feedback, so they can learn from their mistakes. 

 “We need to shorten the learning curve and accelerate the speed of medical knowledge and skills acquisition. This is where VR and haptics is invaluable.”

Hundreds of data points can now be tracked to provide a level of analysis not previously available. Specific metrics include economy of movement, 3D spatial awareness, surgical gaze, respect for tissue and human factors, such as dealing with adverse events and complications. 

The focus is now on value-based care: we want to speed up the adoption of new procedures and products.Innovations and greater complexity to do with surgical devices, robotics and new drugs is also driving the need for a new approach to surgery. We need to shorten the learning curve and accelerate the speed of medical knowledge and skills acquisition. This is where VR and haptics is invaluable,” says Vincent, whose scaling operation employs more than 100 people globally. 

“Our Fundamental Surgery platform is the first in the world to combine VR, haptics, deep data, AI and multi-modal learning. We are also helping Life Science companies accelerate the safe and compliant introduction of medical innovations,” says Vincent. The simulations created by FundamentalVR have so far received accreditations from the prestigious Royal College of Surgeons and American Academy of Orthopedic Surgeons. 

“Focusing on software and cloud solutions means we are hardware agnostic. This allows surgeons and teachers to adopt new headsets and devices when they are released. We have future proofed our solution. At the same time medical professionals around the world can use equipment that is readily available to them locally.”

The aim is to scale surgical simulations so they are easily accessible, particularly in developing countries that use off-the-shelf, low-cost equipment. That way surgical students even in the remotest areas of the world can train. Haptic devices are also small enough to fit inside a flight case – portability matters if surgical knowledge is to be delivered to isolated regions.

The future looks bright. VR and haptics are already supporting ophthalmology and regenerative therapies, as well as robotic and orthopaedic medical disciplines. Future simulations will support general surgery, as well as emerging procedures.

“Combining immersive VR with cutting-edge haptics and AI at scale.”

The development of 5G infrastructure should increase the power, quality and reach of immersive solutions in this field. New types of virtual reality training will also be needed as robotic surgical interfaces, patient specific modelling and new procedures around genomic and regenerative gene therapy are developed. 

“As the use of immersive solutions continues to grow, the industry will need to develop new content delivery channels to meet capacity. Rather than multiple systems, a single interface and access points for users will emerge – a Netflix of medical education. We want to be there delivering at the forefront of this. It will not only train the surgeons of tomorrow, it will also help to save many more lives,” says Vincent.

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