Introduction:
Virtual reality (VR) has found application in neurosurgical planning. However, the use of VR beyond neurosurgical planning is still unexplored, and it opens several pathways to expand its utility. Virtual reality (VR) involves the user being kept in a system that restores the natural world and generates a virtual world that the user might experience. VR is further characterized as non-immersive and immersive based on whether the virtual world is created as a virtual environment or a substitute for the real world.
When Did Virtual Reality Develop?
The term virtual reality was coined in 1987. However, virtual reality was used for panoramic viewing in the eighteenth century. In 1929, the first VR simulator was a flight simulator. A young electrical engineer, Tom Furness, is responsible for the evolution of VR. For his contribution, he is regarded as the “godfather of virtual reality.”
A VR system in medicine was first introduced by Robert Mann in orthopedics in the 1980s. In 1998, VR was first applied to managing arachnophobia (fear of spiders). It is considered the first documented use of this technology in treating pathology. However, the first application of virtual reality (VR) in treating neurosurgical disorders is relatively recent. In 2009, David B Clarke excised a frontal meningioma (a tumor growing from the meninges, membranes surrounding the brain and spinal cord) with the help of a neurosurgical simulator.
What Is Virtual Reality?
VR, or virtual reality, is a computer-generated three-dimensional immersive world. It is a novel technology that has been excessively used in healthcare in recent years and is used for a wide range of diseases.
Virtual reality uses output tools such as vision, hearing, tactile, and power transmitters; input devices such as chasers, mice, and gloves; a graphical virtual environment’s manufacturing system and information software. In a virtual environment, all activity properties, like duration, severity, and type of feedback, can be adopted based on the type of treatment and the individual’s ability. In addition, individuals can see their motor results and correct them if necessary.
How Is Virtual Reality Used in Brain Surgery?
Virtual reality (VR) is highly used in brain surgery for various purposes. Here are some primary ways VR is integrated into brain surgery:
1. Preoperative Planning:
Detailed Visualization:
-
VR helps surgeons visualize three-dimensional models of a patient's brain created from magnet resonance imaging (MRI) or computed tomography (CT) scans. These models give a detailed idea of the brain's anatomy, like blood vessels, tumors, and other critical structures.
-
Surgeons can perform the procedure in a virtual environment, improving their understanding of the patient's distinctive anatomy and planning an adequate surgical approach.
Risk Assessment:
-
VR can replicate surgical scenarios, helping surgeons prepare for potential challenges and plan strategies to avoid risks.
-
Surgeons can work in collaboration with colleagues remotely in a virtual environment to discuss and improve the surgical plan.
2. Intraoperative Navigation:
Enhanced Precision:
-
VR systems can be used along with surgical navigation systems to give real-time guidance during the surgical procedure. It helps surgeons with better navigation through the brain with greater accuracy.
-
Some VR systems use augmented reality (AR) to overlay essential information directly onto the surgeon’s field of view. It is used to combine real-world and virtual environments for better precision.
Minimally Invasive Techniques:
-
VR helps guide endoscopic tools through small openings, reducing the requirement for large incisions and decreasing the damage to surrounding brain tissue.
-
VR can enhance the control and accuracy of robotic surgical systems, which further allows for more precise and minimally invasive interventions.
3. Medical Education and Training:
Surgical Training:
-
Medical students can perform brain surgery in a risk-free virtual environment, giving them experience and confidence prior to actual surgeries.
-
VR systems can track and assess trainees' performance, giving feedback on their technique and helping them improve their skills.
4. Continuing Education:
-
Practicing surgeons can use VR to review and learn from complicated cases, staying updated on the latest methods and approaches.
-
VR helps in collaborative learning sessions where surgeons from different regions can discuss and carefully examine surgical procedures.
5. Patient Engagement:
Patient Education:
-
VR can better and more engagingly explain the surgical procedure to patients, helping them visualize what will happen during surgery.
-
By providing a clear and detailed explanation of the surgery, VR can help lower patient anxiety and enhance their overall experience.
6. Informed Consent:
-
Patients can explore VR models of their own brain and understand the surgical risks, approach, and benefits better, leading to better-informed consent.
7. Postoperative Rehabilitation:
Rehabilitation Programs:
VR can be used in postoperative rehabilitation to provide engaging and effective therapy programs that help patients recover motor and cognitive functions. It also tracks patient progress and adjusts rehabilitation exercises accordingly to maximize recovery outcomes.
What Is the Future of VR in Brain Surgery?
The integration of VR in brain surgery can expand further with advancements in technology. Future developments may include:
-
Improving tactile feedback in VR simulations to mimic the physical sensations of brain tissue manipulation closely.
-
Combining VR with artificial intelligence (AI) to provide predictive analytics, real-time decision support, and personalized surgical planning.
Conclusion:
VR has benefits in preoperative planning and multifaceted neuro navigation for spine and brain surgery. Further, VR is also beneficial for medical education and neurosurgical training. VR in brain surgery has various possibilities beyond just planning for surgical procedures. To generate relevant evidence in the future, there is a need for rigorous evaluation of VR implementations. It also helps to understand the strengths and limitations of brain surgery and the tools used during surgery. The importance of VR, particularly in “social distancing” in brain surgery training for economically disadvantaged populations, pain management and rehabilitation, and prevention of medicolegal claims, is promising and demands further research.
The application of VR in brain surgery represents an important advancement in brain surgery practice. It offers help in preoperative planning, intraoperative navigation, medical education, patient communication, and postoperative rehabilitation. VR technology helps improve surgical outcomes and patient care in brain surgery by enhancing precision, providing detailed visualization and facilitating immersive training.
