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Banerjee S, Pham T, Eastaway A, Auffermann WF, Quigley EP. The Use of Virtual Reality in Teaching Three-Dimensional Anatomy and Pathology on CT. J Digit Imaging 2023; 36:1279-1284. [PMID: 36717519 PMCID: PMC9886418 DOI: 10.1007/s10278-023-00784-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 02/01/2023] Open
Abstract
While radiological imaging is presented as two-dimensional images either on radiography or cross-sectional imaging, it is important for interpreters to understand three-dimensional anatomy and pathology. We hypothesized that virtual reality (VR) may serve as an engaging and effective way for trainees to learn to extrapolate from two-dimensional images to an understanding of these three-dimensional structures. We created a Google Cardboard Virtual Reality application that depicts intracranial vasculature and aneurysms. We then recruited 12 medical students to voluntarily participate in our study. The performance of the students in identifying intracranial aneurysms before and after the virtual reality training was evaluated and compared to a control group. While the experimental group's performance in correctly identifying aneurysms after virtual reality educational intervention was better than the control's (experimental increased by 5.3%, control decreased by 2.1%), the difference was not statistically significant (p-value of 0.06). Significantly, survey data from the medical students was very positive with students noting they preferred the immersive virtual reality training over conventional education and believed that VR would be a helpful educational tool for them in the future. We believe virtual reality can serve as an important tool to help radiology trainees better understand three-dimensional anatomy and pathology.
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Affiliation(s)
- Soham Banerjee
- Department of Radiology, Baylor College of Medicine, One Baylor Plaza BCM360, TX, Houston, USA.
| | - Theresa Pham
- Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | - Adriene Eastaway
- Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | | | - Edward P Quigley
- Department of Radiology, University of Utah, Salt Lake City, UT, USA
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Bruening DM, Truckenmueller P, Stein C, Fuellhase J, Vajkoczy P, Picht T, Acker G. 360° 3D virtual reality operative video for the training of residents in neurosurgery. Neurosurg Focus 2022; 53:E4. [DOI: 10.3171/2022.5.focus2261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/17/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE
Training of residents is an essential but time-consuming and costly task in the surgical disciplines. During the coronavirus disease 2019 pandemic, surgical education became even more challenging because of the reduced caseload due to the increased shift to corona care. In this context, augmented 360° 3D virtual reality (VR) videos of surgical procedures enable effective off-site training through virtual participation in the surgery. The goal of this study was to establish and evaluate 360° 3D VR operative videos for neurosurgical training.
METHODS
Using a 360° camera, the authors recorded three standard neurosurgical procedures: a lumbar discectomy, brain metastasis resection, and clipping of an aneurysm. Combined with the stereoscopic view of the surgical microscope, 7- to 10-minute 360° 3D VR videos augmented with annotations, overlays, and commentary were created. These videos were then presented to the neurosurgical residents at the authors’ institution using a head-mounted display. Before viewing the videos, the residents were asked to fill out a questionnaire indicating their VR experience and self-assessment of surgical skills regarding the specific procedure. After watching the videos, the residents completed another questionnaire to evaluate their quality and usefulness. The parameters were scaled with a 5-point Likert scale.
RESULTS
Twenty-two residents participated in this study. The mean years of experience of the participants in neurosurgery was 3.2 years, ranging from the 1st through the 7th year of training. Most participants (86.4%) had no or less than 15 minutes of VR experience. The overall quality of the videos was rated good to very good. Immersion, the feeling of being in the operating room, was high, and almost all participants (91%) stated that 360° VR videos provide a useful addition to the neurosurgical training. VR sickness was negligible in the cohort.
CONCLUSIONS
In this study, the authors demonstrated the feasibility and high acceptance of augmented 360° 3D VR videos in neurosurgical training. Augmentation of 360° videos with complementary and interactive content has the potential to effectively support trainees in acquiring conceptual knowledge. Further studies are necessary to investigate the effectiveness of their use in improving surgical skills.
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Affiliation(s)
| | | | - Christian Stein
- Cluster of Excellence: “Matters of Activity. Image Space Material,” Humboldt University, Berlin
- gamelab.berlin, Cluster of Excellence: “Matters of Activity. Image Space Material,” Humboldt University, Berlin
| | - Josch Fuellhase
- Department of Neurosurgery, Charité–Universitätsmedizin Berlin
| | - Peter Vajkoczy
- Department of Neurosurgery, Charité–Universitätsmedizin Berlin
| | - Thomas Picht
- Department of Neurosurgery, Charité–Universitätsmedizin Berlin
- Cluster of Excellence: “Matters of Activity. Image Space Material,” Humboldt University, Berlin
- Berlin Simulation and Training Center (BeST), Charité–Universitätsmedizin Berlin; and
| | - Gueliz Acker
- Department of Neurosurgery, Charité–Universitätsmedizin Berlin
- Berlin Institute of Health, BIH Academy, Clinician Scientist Program, Charité–Universitätsmedizin Berlin, Germany
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Bräutigam K, Christe L, Banz Y. Value of an Action Cam in Surgical Pathology. MEDICAL SCIENCE EDUCATOR 2022; 32:43-46. [PMID: 35154893 PMCID: PMC8814123 DOI: 10.1007/s40670-021-01480-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/17/2021] [Indexed: 06/14/2023]
Abstract
Grossing of surgical pathology specimens is a complex task, which may be challenging to master correctly. Despite the growing use of digital technology in other aspects of surgical pathology, little has been done so far to modernize the documentation of grossing. We used a portable video camera ("GoPro") to document different grossing procedures. The video material may be used for teaching purposes or might enhance the more commonplace macroscopic description by adding another dimension. Furthermore, video documentation may encourage the discussion of upcoming clinical questions or help rectify some possible initial impreciseness.
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Affiliation(s)
- Konstantin Bräutigam
- Institute of Pathology, University of Bern, Murtenstrasse 31, CH-3008 Bern, Switzerland
| | - Lucine Christe
- Institute of Pathology, University of Bern, Murtenstrasse 31, CH-3008 Bern, Switzerland
| | - Yara Banz
- Institute of Pathology, University of Bern, Murtenstrasse 31, CH-3008 Bern, Switzerland
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Koizumi S, Shojima M, Dofuku S, Saito A, Nomura S, Ono H, Ishikawa O, Saito N. Neuroendovascular Training Using Multisource Video-Recording System in a Hybrid Operating Room. World Neurosurg 2021; 154:e320-e324. [PMID: 34271148 DOI: 10.1016/j.wneu.2021.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Increasing restrictions over trainees' working hours and the recent coronavirus disease 2019 pandemic warrant new educational methods of surgical skills. We assessed a novel video-recording system for neuroendovascular skill education, developed with the installation of a hybrid operating room (OR) at our institution. METHODS A single-plane angiography unit with a large flat display (FlexVision XL; Philips Medical Systems) was installed in our OR. All media sources in the OR, including live fluoroscopy and ceiling-mounted camcorders, were connected to a video switcher. This video switcher laid up to 8 video images into one big image, which was transferred to the large display and the professional-use Blu-ray recorder. The recording was performed continuously during the procedure. This recording system was evaluated retrospectively with a questionnaire administered to the 5 trainees. RESULTS Using this system, 68 interventional procedures were recorded. Among the potential merits, the trainees assigned the greatest value to the simultaneous recording of the operator's hand motions and the fluoroscopy images. Among the potential limitations of the system, the prolonged time and the increased volume of the video data bothered the trainees the most. The recorded video looked like a live demonstration. CONCLUSIONS Our "selfie" video recording system was useful for skill training of neuroendovascular interventions.
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Affiliation(s)
- Satoshi Koizumi
- Department of Neurosurgery, The University of Tokyo, Tokyo, Japan; Department of Neurosurgery, Asama General Hospital, Nagano, Japan
| | - Masaaki Shojima
- Departmemt of Neurosurgery, Saitama Medical Center, Saitama, Japan; Department of Neurosurgery, Asama General Hospital, Nagano, Japan.
| | - Shogo Dofuku
- Department of Neurosurgery, The University of Tokyo, Tokyo, Japan; Department of Neurosurgery, Asama General Hospital, Nagano, Japan
| | - Akira Saito
- Departmemt of Neurosurgery, Saitama Medical Center, Saitama, Japan; Department of Neurosurgery, Asama General Hospital, Nagano, Japan
| | - Seiji Nomura
- Department of Neurosurgery, Yamada Memorial Hospital, Tokyo, Japan; Department of Neurosurgery, Asama General Hospital, Nagano, Japan
| | - Hideaki Ono
- Department of Neurosurgery, Fuji Brain Institute and Hospital, Shizuoka, Japan; Department of Neurosurgery, Asama General Hospital, Nagano, Japan
| | - Osamu Ishikawa
- Department of Neurosurgery, The University of Tokyo, Tokyo, Japan; Department of Neurosurgery, Asama General Hospital, Nagano, Japan
| | - Nobuhito Saito
- Department of Neurosurgery, The University of Tokyo, Tokyo, Japan; Department of Neurosurgery, Asama General Hospital, Nagano, Japan
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Saun TJ, Zuo KJ, Grantcharov TP. Video Technologies for Recording Open Surgery: A Systematic Review. Surg Innov 2019; 26:599-612. [PMID: 31165687 DOI: 10.1177/1553350619853099] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Video recording of surgical procedures is an important tool for surgical education, performance enhancement, and error analysis. Technology for video recording open surgery, however, is limited. The objective of this article is to provide an overview of the available literature regarding the various technologies used for intraoperative video recording of open surgery. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines using the MEDLINE, Cochrane Central, and EMBASE databases. Two authors independently screened the titles and abstracts of the retrieved articles, and those that satisfied the defined inclusion criteria were selected for a full-text review. A total of 2275 publications were initially identified, and 110 were included in the final review. The included articles were categorized based on type of article, surgical subspecialty, type and positioning of camera, and limitations identified with their use. The most common article type was primary-technical (29%), and the dominant specialties were general surgery (22%) and plastic surgery (18%). The most commonly cited camera used was the GoPro (30%) positioned in a head-mount configuration (60%). Commonly cited limitations included poor video quality, inadequate battery life, light overexposure, obstruction by surgical team members, and excessive motion. Open surgery remains the mainstay of many surgical specialties today, and technological innovation is absolutely critical to fulfill the unmet need for better video capture of open surgery. The findings of this article will be valuable for guiding future development of novel technology for this purpose.
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Affiliation(s)
- Tomas J Saun
- 1 St Michael's Hospital, Toronto, ON, Canada.,2 University of Toronto, ON, Canada
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Harrington CM, Kavanagh DO, Wright Ballester G, Wright Ballester A, Dicker P, Traynor O, Hill A, Tierney S. 360° Operative Videos: A Randomised Cross-Over Study Evaluating Attentiveness and Information Retention. JOURNAL OF SURGICAL EDUCATION 2018; 75:993-1000. [PMID: 29122571 DOI: 10.1016/j.jsurg.2017.10.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 10/09/2017] [Accepted: 10/13/2017] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Although two-dimensional (2D) and three-dimensional videos have traditionally provided foundations for reviewing operative procedures, the recent 360º format may provide new dimensions to surgical education. This study sought to describe the production of a high quality 360º video for an index-operation (augmented with educational material), while evaluating for variances in attentiveness, information retention, and appraisal compared to 2D. DESIGN A 6-camera synchronised array (GoPro Omni, [California, United States]) was suspended inverted and recorded an elective laparoscopic cholecystectomy in 2016. A single-blinded randomised cross-over study was performed to evaluate this video in 360º vs 2D formats. Group A experienced the 360º video using Samsung (Suwon, South-Korea) GearVR virtual-reality headsets, followed by the 2D experience on a 75-inch television. Group B were reversed. Each video was probed at designated time points for engagement levels and task-unrelated images or thoughts. Alternating question banks were administered following each video experience. Feedback was obtained via a short survey at study completion. SETTING The New Academic and Education Building (NAEB) in Dublin, Royal College of Surgeons in Ireland, July 2017. PARTICIPANTS Preclinical undergraduate students from a medical university in Ireland. RESULTS Forty students participated with a mean age of 23.2 ± 4.5 years and equal sex involvement. The 360º video demonstrated significantly higher engagement (p < 0.01) throughout the experience and lower task-unrelated images or thoughts (p < 0.01). Significant variances in information retention between the 2 groups were absent (p = 0.143) but most (65%) reported the 360º video as their learning platform of choice. Mean appraisal levels for the 360º platform were positive with mean responses of >8/10 for the platform for learning, immersion, and entertainment. CONCLUSIONS This study describes the successful development and evaluation of a 360º operative video. This new video format demonstrated significant engagement and attentiveness benefits compared to traditional 2D formats. This requires further evaluation in the field of technology enhanced learning.
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Affiliation(s)
- Cuan M Harrington
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin.
| | - Dara O Kavanagh
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin
| | | | | | - Patrick Dicker
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin
| | - Oscar Traynor
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin
| | - Arnold Hill
- Department of Surgery, Beaumont Hospital, Dublin, Ireland
| | - Sean Tierney
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin
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