SurGenVR: Innovative Surgical Simulation

Team Leader

Jitesh Rajpaul

Project Overview

Project Name:

One-line project summary:

Comprehensive open fracture and soft tissue surgical management module utilizing innovative Virtual Reality (VR) simulation technology

Pitch your project.

SurGenVR provides an innovative solution by delivering a VR simulation module to train Orthopaedic residents & medical officers in the critical steps required in the surgical management of open fractures.

Using a cognitive task analysis (CTA) approach, our software will allow the resident to achieve both enhanced technical skill and improve their critical decision-making ability. Self assessment is performed through algorithmic decision making pathways, SBA, and data analysis of technical skill. The system assigns a level of expertise and this encourages the surgeon to ‘level-up’ their performance.

Originally developed in the military special forces, this method lends itself to improving self-assessment. While summative self-assessment can readily be achieved through procedure-specific competency tools, it is the formative assessment where CTA really excels.

We believe that this approach allows us to train the surgeon to develop a combination of skills that will ensure improved patient outcomes in open fracture surgery.

Film your elevator pitch.

What is your surgical training module?

We have envisioned a 3-tiered approach to our surgical training model based on the doctors level of expertise and the availability of hardware in our resource constrained environment:

1. VR Simulation Training (Oculus Quest VR):

Haptic feedback and photo-realistic graphics rendering combined with the hands on experience allows the surgeon to master their surgical technique and cognitive ability prior to performing surgery in the operating room.

2. VR Visualization Training (Google Cardboard):

Applicable to trainees who do not have access to the Oculus Quest hardware, but want to watch and learn a surgical procedure in the same virtual life-like environment.
Stunning 360degree video will be recorded using the software developed for the Oculus Quest platform.
The procedure will be automated and the critical steps narrated using voiceover.
This provides the surgeon access to a library of content which enhances their ability to visualize fixation of complex open fractures in a virtual theatre environment.

3. VR Mobile App (Android & iOS):

Pairs with the Oculus Quest to augment VR learning capabilities and self-asssessment ( Video library, SBA, Validated Data)
Also works as a standalone application to teach the surgical training module using multi-touch and gestures on a touch screen (Algorithmic approach).

What specific surgical skills are you teaching?

As orthopaedic surgeons working in a busy hospital in Durban, South Africa, a large part of our work is treating victims of motor vehicle accidents. We encounter open fractures on a daily basis in our resource constrained environment and the treatment of these injuries require a prompt and systematic approach. In LMIC, open fractures are associated with high morbidity due to the unique challenges faced in these regions.

VR simulation training will help eliminate the anxiety experienced when managing these complex injuries. The training module will enable surgeons to make the correct management decisions as well as confidently apply the appropriate surgical device in the real world setting.

As opposed to teaching a specific surgical technique, our training module aims to teach the following critical surgical steps which enhances the surgeons cognitive decision making ability:

Soft tissue management and closure techniques
Flaps
Thorough wound debridement and irrigation techniques
Bone stabilisation and reconstruction techniques

Our first training module focuses on open fractures of the tibia and will present the surgeon with different grades of injury. They will have to make critical management decisions and the software will analyse their cognitive and technical ability and rank them accordingly.

Who does your project serve, and in what ways will the project improve their skills?

Mastering a surgical technique has typically been achieved through an apprenticeship where the transference of skills is passed on from consultant to resident during surgery. There are 2 unique challenges in LMIC:

1. The specialist surgical workforce to population ratio is extremely low eg. SouthAfrica: 11 surgeons per 100 000 population (lacentglobalsurgery.org: 2014)

2. Patients access to specialized healthcare is hampered by infrastructure, transport and logistical challenges. A patient managed in a rural hospital (lack of adequate supervision/training) may have a worse clinical outcome then a patient treated in an academic institution.

This opens up an exciting opportunity to use VR as a means to develop skills, enhance techniques and improve surgical outcomes for orthopaedic resident and medical officers, as they are often the first doctor to treat traumatic injuries.

The ability to perform a case in a virtual setting that is adapted to different patients, implants and techniques will improve a trainees confidence, skill set and lead to better patient outcomes.

To ensure that our module is relevant to the surgical training platform, we have integrated orthopaedic residents into our team. Their perspective will provide invaluable knowledge during the prototype and implementation phase of our development cycle.

In what city, town, or region is your project team headquartered?

Durban, South Africa

What is your project's stage of development?