Working with virtual reality: “Erasmus MC can no longer do without it”

Virtual reality has been used in surgery for about six years, with increasing success. At Erasmus MC, 3D models are created almost every day based on CT scans, ensuring more accurate interpretations of scans, says Dr. Alexander Maat, cardiopulmonologist at Rotterdam Hospital.

The process actually consists of two parts. Before the operation, surgeons watch CT scans, allowing them to select the most important structures in the digital version using virtual reality glasses and follow all the steps that they will also perform during the operation. Then, instead of VR headsets, a laptop is taken into the operating room, says Chris Hordijk, founder and CEO of MedicalVR. “Our models are displayed on this laptop, so they can adapt the lung to the anatomy of that moment.”

It's also called a variant of Google Maps, or TomTom for doctors. Alexander Maat used this simulation this morning. Although he has little knowledge of other hospitals, he has long been convinced of this technology. I can say: we can't live without it anymore. A number of Dutch centers are participating in a study in different hospitals, to further support the value of this technology in larger numbers.

Lung center

Maat is convinced that the technology can also be applied in many other fields. This already happens in brain and abdominal surgery. “I think the applications are almost endless.” Maat says: It rarely happens that intraoperative situations cannot be captured with a 3D model. “We are interested in the center of the lungs and most errors occur outside the lung. Errors in the important part of the lung are extremely rare.

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It seems that a new phase has arrived with the recent introduction of the Apple Vision Pro. Hordijk has previously given hundreds of demos with other VR headsets, but for him, these are of a different order. “Apple has done a really excellent job of ensuring that the user experience is at the highest level: people put the glasses on and immediately understand what they need to do – setup and interaction: it will soon be possible for many people to look at the same model.”

The challenges are technical in nature

Then there's the privacy aspect, as Apple doesn't always have a squeaky-clean reputation. According to Hordik, it is necessary to adhere to general public regulations and this is widely hampered by privacy security officers in the hospitals themselves. But let's be clear that the data used has already been stripped of patient metadata, such as address, age, and name. The challenges lie mainly in the technical area. “The point is that you can create technology that meets the speed of the user.”

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This speed is critical, especially in a medical environment. Currently, the doctor first uploads the CT scan to the cloud platform, and then receives the result two days later. “We prefer local, so now we will also run the AI ​​algorithms locally, so this can be done in ten minutes instead of two days.” The next step is to reach out to patients with heart failure. “Now the drawing is done on a piece of paper, and using this technology the cardiologist displays what he sees on a virtual reality headset.”

what are you expecting

Then there is the training app. Operating rooms are often the most expensive places to learn, and with these types of equipment, it is very easy to practice at home or anywhere and become proficient in what you can expect in the operating room: sounds, steps, procedures, but also seeing what you can know more. “It's especially important that the students you put there reach a very high standard.”