Virtual reality technology in medicine

Today, the vast majority of new IT technologies are primarily used in the field of entertainment. A vivid example of this is virtual reality. But helmets and goggles, immersing us in other worlds, may not be useful for sophisticated games alone. For example, virtual reality technology can be widely used in medicine.

When Microsoft unveiled the Project X-Ray prototype last October, gamers around the world were thrilled. The user in glasses of virtual reality (BP) and with a manipulator in his hands fought against robots breaking through walls. Back in the first half of the 1990s, there were repeated attempts to use BP technology in the gaming industry. And at that time few people imagined a different scope. But today, BP is increasingly finding applications in areas such as scientific research, sports, military development, education, vehicles, and even health care.

According to the forecast of the research and consulting company IndustryARC , by 2020 the global market for technologies of virtual and augmented reality in health care will reach $ 2.54 billion. They will mainly be used to train doctors and rehabilitate patients.
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In April of this year, an operation to remove a cancer was performed at the Royal London Hospital. This event is remarkable in that the entire course of the operation was transmitted to the network thanks to Google Glass glasses, which were worn on the surgeon. 13,000 medical students not only watched almost live (with a minute delay), but also asked the surgeon questions that were displayed as text on the periphery of his field of view, and he answered them with his voice.



Of course, operations were filmed before, but this is the first time when:

• Viewers could observe the whole process through the eyes of a surgeon.
• The operation could be viewed in near real time on any mobile device, including BP glasses.
• It was possible to remotely ask the surgeon questions and get answers.

By the way, Dr. Shafi Ahmed, who conducted the operation, is not at all alien to high-tech, and is now experimenting with 360-degree shooting. In his opinion, this will allow creating more effective educational videos for surgeon students.

But even having the opportunity to freely look around when watching a video, students remain passive observers. Therefore, it is completely logical that BP is also used to create three-dimensional, fully immersive simulations in which future doctors can hone their skills in examining and treating patients. For example, the company Medical Simulation Corp. developed the Simantha complex, where cardiologists learn to examine a human heart. It uses a full-size dummy, which allows you to introduce a contrast agent in the "artery" and use various tools to carry out all sorts of manipulations with the "heart". A person controls all his actions on the monitors, which displays a full-fledged simulation of the internal organs of the heart. In this case, the complex removes all kinds of telemetry and accurately responds to the actions of the doctor, as it happens in life. The individual characteristics of the patient’s circulatory system, and even a non-standard response to various medications, can be simulated.



For the training of medical workers of different specialties, more traditional types of BP technologies are used — thematic applications based on three-dimensional engines. For example, under the HumanSim brand there are programs for learning the basics of communicating with patients, anesthesiology, sedation and ventilation of the lungs, first aid in the military field, etc. The HumanSim engine can also be used to create your own medical simulations.





Perhaps it is in surgery that BP technologies are most widely used. It is understandable - it is difficult to find another area of ​​medicine in which visualization and feedback on the actions of the doctor plays an even more important role.

As in any other profession, in surgery, skill is acquired with experience. No dummies compare in terms of likelihood degree to a high-quality virtual simulator. And when training in an anatomical body, the “ working material ” does not always respond to students' mistakes in the same way as a living person, for example, if a blood vessel is accidentally touched. Yes, and all the students will not save enough. And virtual simulators do not suffer from a shortage of samples and virtual bodies.

For example, at Stanford University , software and hardware systems with a high degree of detail of various organs and parts of the human body, providing tactile feedback, are developed and applied . This allows the surgeon, when learning, to navigate the situation not only visually but also tactilely.





Working with digital models of human organs, in a virtual environment that replicates the present, already existing surgeons are trained to perform subtle and complex procedures. This helps to improve the accuracy of the doctor's actions, reduce the likelihood of errors and postoperative complications. In addition, sometimes treatment requires the use of quite rare interventions that many ordinary doctors simply did not encounter. And the lack of real experience can be partly compensated by virtual simulators.

By the way, BP also allows practicing doctors who use robotic surgery units - teleheurologists and microsurgeons.



In this respect, they are even somewhat simpler, because the display is an essential working tool of these specialists. According to a number of studies , VR simulators markedly increase the effectiveness of doctors specializing in robosurgery.

All for the benefit of patients

BP technologies are used in health care not only for training doctors. Rehabilitation of patients is an important step towards recovery or adaptation. For example, many patients who have lost limbs as a result of injury or surgery experience phantom pain syndrome. This can be expressed in the sensation of burning, itching, tingling and other forms. Until recently, there were not enough effective ways to get rid of phantom pains. At Chalmers University of Technology (Chalmers University of Technology), Sweden, a patient with an amputated arm was connected to a cult by sensors that were taking signals from contracted muscles, and the computer translated them into movements of the virtual hand displayed in BP glasses. And the hand did not just move, the patient could with its help drove a virtual car. That is, the brain received at least a visual confirmation that the limb, which it is trying to control, exists and does not respond to signals. As the patient noted, the intensity of the pain after that was noticeably reduced, and they began to appear less frequently. True, it was not a full-fledged clinical study on a fairly representative sample, but still the result is encouraging.

Another interesting example of the use of BP is the therapy of patients with neurophysiological disorders. For example, the installation MindMaze tracks the movements of a person and displays them on the display. According to the developers, trying to perform the proposed tasks, the brain gradually restores and rebuilds the broken neural connections.



Our consciousness is an incredibly powerful tool that can completely change our perception of ourselves, our body and the world around us. Unfortunately, we are very poor at managing this tool. But there are positive examples. Patients with extensive body burns suffer from severe pains that cannot be completely removed with medication.



Especially for them was developed a virtual game SnowWorld. The action takes place in the ice world, snowmen and penguins act as enemies, and all weapons are made of ice and snow. According to research results , thanks to this game, burn patients spend three times less time thinking about the pain from burns: 22% of the time instead of 76% .



Used BP and for the treatment of psychological disorders. For example, there have been numerous cases of weakening of phobias when using exposure therapy in combination with BP glasses. For example, a person with arachnophobia is demonstrated by virtual spiders. First, at a distance, then you can approach them, and even interact with the spiders.



And those suffering from acrophobia are sent to walk on the roofs of virtual buildings, with a gradual increase in the number of floors. There are applications for the prevention of fear of flying, driving a car and a number of other phobias.

Virtual war simulators can serve not only to entertain and train soldiers, but also to alleviate the symptoms of post-traumatic stress disorder among veterans. This is achieved by playing on different scenarios and traumatic events that caused this mental disorder, with parallel work with a psychologist. Often, tracking of the patient's eye movements is used, which helps to more accurately determine the traumatic events for subsequent testing with a doctor. But so far, there are conflicting opinions among specialists regarding the effectiveness of using BP for the treatment of PTSD.



Finally, BP technologies are used for social adaptation of autists . This disorder manifests itself in different ways, and in many cases, autists have a hard time when they are faced with the rules and characteristics of human society and the world around them. And with the help of BP, one can play around different situations painlessly, showing how best to behave in certain situations.

In general, BP technologies are only taking the first steps in healthcare. The availability and variety of devices and software is growing, and it can be predicted with reasonable confidence that new technologies will be increasingly used in the training of doctors. It is possible that there will be new developments at the interface of BP, big data and artificial intelligence. For example, systems that will analyze the current situation in real time and produce visual recommendations and tips for the doctor, making it easier to diagnose and treat, reducing the likelihood of medical errors.