Remote surgical education using synthetic models combined with an augmented reality headset

Nelson N Stone; Michael P Wilson; Steven H Griffith; Jos Immerzeel; Frans Debruyne; Michael A Gorin; Wayne Brisbane; Peter F Orio; Laura S Kim; Jonathan J Stone

doi:10.1016/j.sopen.2022.06.004

Remote surgical education using synthetic models combined with an augmented reality headset

Surg Open Sci. 2022 Jun 23:10:27-33. doi: 10.1016/j.sopen.2022.06.004. eCollection 2022 Oct.

Authors

Affiliations

¹ Department of Urology, The Icahn School of Medicine at Mount Sinai, New York, NY.
² Viomerse, Inc, Pittsford, NY.
³ Andros Clinics, Baarn, The Netherlands.
⁴ Urology Associates and UPMC Western Maryland, Cumberland, MD, USA.
⁵ Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
⁶ Department of Urology, University of Florida Health, Gainesville, FL.
⁷ Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA.
⁸ Department of Neurosurgery, University of Rochester Medical Center, Rochester, NY.

Abstract

Objective: The objective was to investigate the use of an augmented reality headset to remotely train clinicians on medical devices using anatomic models.

Design: Disease-specific phantoms were developed to train physicians in mpMRI-guided fusion prostate biopsy, brachytherapy, and rectal spacer insertion. Training was remotely demonstrated using 1-way virtual video conferencing format. Participants responded to an educational content survey. A heads-up display with software and augmented reality was used for remote 2-way training with the proctor and student using on their own phantoms.

Setting: The virtual video meeting took place during a prostate cancer conference in 2020, while the augmented reality training occurred in 2021. The proctor and student wore a heads-up display containing a projector and webcam where the ultrasound image was displayed onto a see-through optic along with the physician's hands. The heads-up display allowed the proctor to teach by line-of-sight while the student watched and repeated the steps.

Participants: Faculty with expertise with the medical devices used in these procedures provided training to urologists unfamiliar with these techniques.

Results: Participants responded that the 1-way training on the phantoms was realistic and mimicked human tissue. A total of 70.9% requested more training or training on the phantoms. The remote training platform was successfully beta tested at the 2 locations in transperineal prostate biopsy and rectal spacer insertion.

Conclusion: Remote training using augmented reality eliminates the need for travel. For training programs and workshops, this technology may mitigate the risk of infectious exposures, reduce training cost, and increase proctor availability, allowing training from their own institution or clinic.This investigation qualifies for the Accreditation Council for Graduate Medical Education competency in medical knowledge.