Mexican surgeon distracts patients from surgery using virtual reality

A 61-year-old woman named Ana Maria has long wanted to visit Machu Picchu . Despite the warnings of doctors (Ana Maria - hypertensive), she still went to Peru. And she investigated the historical sights in the hospital clothes. The thing is that the journey took place in virtual reality.

The journey was made possible by a Mexican surgeon from Mexico City who performs some operations using virtual reality to reduce the patient’s nervousness. Anya Maria should have removed the lipoma. This operation is performed under local anesthesia and presents almost no danger. But the woman was worried because she was afraid of hospitals and surgeons. But all the fears were in vain - everything went without a hitch. Yes, and it could not be otherwise, because the surgeon is not the first time using this practice.

Ana's pressure, when she is nervous, rises to the level of 183/93. This complicates the operation, increases the pain and makes the doctors themselves, who do not want any problems during the operation, nervous.
')
When a person sees how a surgeon works with his limb or another part of the body, the patient experiences - this applies both to people who are generally afraid of doctors and people who are more or less resistant in terms of the perception of medicine. Wearing virtual reality glasses, the patient will not see any scalpels or other medical equipment. Instead, she will observe the ancient city, first from a height, then from the surface of a virtual earth, assessing details near.

54-year-old surgeon named Jose Luis Mosso Vazquez (Jose Luis Mosso Vazquez) has long been decided to retool his operating room, adding virtual reality. It uses a special technology that provides a display of virtual reality with high accuracy and resolution. In many cases, his colleagues use powerful sedatives to reduce the patient's anxiety. Mosso also works only with local anesthesia, refusing this kind of medication. He believes that this will not only reduce the costs of hospitals, especially budget ones, but also reduce the patient’s recovery time. After a powerful sedative man has to recover for a long time.

At the same time, the doctor keeps sedatives at the ready. If a problem arises and the patient begins to get too nervous, then it is precisely such means that are used. Such patients as Ana cannot be nervous, and doctors try to prevent this.

In the specific case of this patient, no additional means of sedation was needed. The lipoma was removed without any problems, the blood was stopped, the wound was sewn up. The whole procedure took only 20 minutes. And Ana was never nervous, on the contrary, during the journey she smiled. She had no time to listen to the sense of touch, since her other senses, sight and hearing, were busy with the perception of virtual reality. “Usually I am in a stressful state (with a doctor - ed.), But now I felt very relaxed,” said the patient immediately after the operation. And this is true, since the pressure sensors showed that everything is normal.

How it all began

Mosso not just decided to use virtual reality in their work. It all started in 2004, when the doctor bought a video game about Spiderman for his youngest son, and you had to play with the use of some kind of video glasses. A display was attached to the head onto which images were projected. Mossos then wondered how much his son was immersed in the game. “His mother called him to dinner, but he did not react at all. I already thought then - what if we use it for patients, ”the doctor says.

For the first time, he realized the idea for working with patients who needed to perform gastroentroscopy, when a flexible tube with a camera at the end is inserted through the throat through the throat. It is always unpleasant, patients often needed sedatives in order for everything to go well. But after the first patient was offered to play Spiderman in the likeness of virtual glasses, the result did not hesitate to wait - the person seemed not to notice the tube being inserted through the throat.


This is not an image of the virtual reality itself, but only a picture created by the artist. The virtual environment distracts the person from reality with its doctors and the operating table

The surgeon asked patients to evaluate the pain and nervousness during the procedure in points, and presented the results of a survey at the Medicine Meets Virtual Reality conference held in 2006 in California, USA. The idea of ​​using virtual reality to relieve the stress of medical procedures was first used at the University of Seattle, Washington, USA. The idea belongs to the psychologist Hunter Hoffman and his colleagues, who created the game called Snow World. This game, as they could see, significantly reduces a person’s negative impressions of medical procedures. According to experts, the level of stress is reduced by 50%, since the activity of certain areas of the brain, which are responsible for pain, is also reduced.

Despite the positive assessment of the new technique, it was used very rarely. For example, at the same conference, one of the surgeons told only about 10 cases of using virtual reality or some kind of its similarity in his practice. Even then, Mosso conducted “virtual” operations with several dozens of patients. His colleague, described above, worked with an expensive and rather fragile device. But the image quality was about the same as in the game with Spiderman, which was used by the Mexican surgeon.

Together, the two doctors, with the help of engineers, created new equipment that was reliable and did not cost too much, and began to test it in various cases - from the birth to recovery from heart surgery. The results were about the same as before - patients had decreased pain levels and people generally felt better. Therefore, surgeons began to use virtual reality for operations like removal of lipomas, cysts and hernias. In most cases, full anesthesia is not required, but sedatives are used very often.

Outdated Spiderman game decided to replace the new environment. It became nature - a virtual copy of a certain region with mountains, rivers, lakes. The virtual world soothed patients, reduced the level of their stress. If the doctors began to use something like shooters, it would, on the contrary, increase the negative sensations, since during the game the pressure would rise in patients. And this would also lead to excessive bleeding, which is very undesirable.

Now the possibility of using virtual reality is being studied all over the world. But only Mosso regularly publishes the results of its work. In one of these works, he indicated that among the 140 patients with whom the surgeon had been dealing with recently, almost everyone noted a significant reduction in pain. On average, the reduction was 24% (patients evaluated in points. "He received about the same result in the course of his other study.

Even if the patient needs a sedative drug, with virtual reality it is required less than in the usual case. In other cases, doctors generally do without sedatives such as fentanyl and midazolam , which are very expensive. He estimates that VR can reduce the cost of some operations by about a quarter. Reducing the number of injected drugs also reduces the risk of complications and reduces recovery time. In the near future, the surgeon plans to conduct additional research. But in general, he says, patients can go home within an hour after surgery under local anesthesia. But if such patients take sedatives before surgery, then they often need a full day or even more to recover.



“It reduces the cost of surgery, recovery time and reduces the likelihood of side effects. This is incredible. But we still have nothing in the US, ”says Gregorio Obrador of the Pan American University.

Now the Mexican surgeon has already performed about 350 operations using virtual reality, technology has become his auxiliary tool used every day.

Recently, the doctor decided to test his technology in one of the most remote villages in Mexico, called El Tepeyac. This is a remote village that is located hundreds of kilometers from busy roads in the mountains of the state of Guerrero . People here live very poorly, and there is practically no medical care - the nearest hospital is located tens of kilometers from the village.

Mosso with his wife are in El Tepeyaka quite often - since 2000, they have been helping the locals. Once a year, a married couple of doctors comes to the village, where he treats old and young, children and teenagers. In one morning, they often have to examine 20 or even more patients. Now the doctors decided to experience the virtual reality. One of the first to test a new technology was a 9-year-old girl who needed to perform a local operation on the scalp.

Before the start of the operation, she was very worried, crying and calling her mother. But as soon as she was wearing the video glasses on her head, turning on the “aquarium” mode, the little patient subsided. So she sat all the time while the doctor was cleaning and washing the wound on the girl's head. She never cried or did not twitch, without any problems she sat through until the end of the operation and after that, recovering herself, she went home, and not tearful, but happy. Of course, local anesthesia was used, but sedatives were not used at all.

Now Mosso and his colleagues are going to test the technology in other villages - perhaps this will help facilitate medical operations in places where the anesthetic is not so easy to get, not to mention the possibility of acquiring sedatives. Virtual reality, according to the surgeon, can solve some of the problems of a medical nature both in El Tepeyak and throughout Mexico.