Academic Stress Assessment Using Virtual Reality as an Educational Tool in Spine Surgery

Introduction: The evaluation of academic stress in medical students and residents is a topic of significant interest, given the considerable challenges they face during their learning process with traditional teaching methods. The use of technologies like virtual reality presents an opportunity to enhance their skills through simulations and training. The main objective of this study is to qualitatively assess the stress levels experienced by medical students and residents by integrating virtual reality into their current learning methods, aiming to improve their ability to manage stressors in their practice. Material and Methods: A questionnaire was conducted with 12 medical students and 12 Traumatology and orthopedics residents. The purpose of the questionnaire was to evaluate the levels of academic stress using the SISCO inventory. The stress levels were calculated by transforming average values into percentages, and the following criteria were assigned: 0 to 33% for Mild Stress, 34 to 66% for Moderate Stress, and 67 to 100% for Deep Stress. Then, a virtual reality class focused on spine surgery was provided. Both medical students and residents were trained using the Non Nocere SharpSurgeon software platform and Oculus Quest 2 virtual reality glasses. At the end of the session, a second questionnaire related to the practice with virtual reality was conducted with the same evaluation criteria and a comparative analysis was carried out. Results: 12 undergraduate students from Hospital Angeles Mexico, CDMX and 12 traumatology and orthopedics residents at Hospital Santa Fe, Bogota were evaluated. The students in CDMX reported an average qualitative stress of 28.50% during habitual practices, which decreased to an average of 14.67% after virtual reality practice. Residents in Bogotá experienced an average qualitative stress of 30.50% with their current learning methods but this reduced to an average of 13.92% after using virtual reality. These findings indicate that the use of virtual reality has a positive impact on reducing stress levels qualitatively. Conclusions: The use of virtual reality as a learning method for medical students and residents qualitatively improves stress levels. Further studies are required to define the potential uses of Virtual Reality to improve learning methods and emotional state in medical students and residents and for a quantitative assessment to validate the training as certified learning methods.

Review of Digital Campus Construction Led by Virtual Reality Technology

In recent years,the government has issued a series of documents to promote the construction of digital campuses.This initiative serves to encourage the deep integration of information technology and intelligent technology education and digital reform,the combination of virtual reality and campus management is the need for innovative thinking and economic and social development,and then better change our learning style and living environment.The construction of the digital campus is based on virtual reality technology,BIM,GIS,and three-dimensional modeling technology to provide an immersive platform for students,promote the integration of virtual reality technology and education,help teachers,students,and parents to understand all kinds of education information and resources,to achieve their interoperability.From the off-campus environment to the school teaching equipment,teachers to teaching quality certification,and learning,to extracurricular entertainment,opening ceremonies to graduation parties,to bring more efficient,convenient,and safe campus life for teachers,students,and staff in school,and break the traditional information restrictions.

Towards engineering a portable platform for laparoscopic pre-training in virtual reality with haptic feedback

Background Laparoscopic surgery is a surgical technique in which special instruments are inserted through small incision holes inside the body.For some time,efforts have been made to improve surgical pre training through practical exercises on abstracted and reduced models.Methods The authors strive for a portable,easy to use and cost-effective Virtual Reality-based(VR)laparoscopic pre-training platform and therefore address the question of how such a system has to be designed to achieve the quality of today's gold standard using real tissue specimens.Current VR controllers are limited regarding haptic feedback.Since haptic feedback is necessary or at least beneficial for laparoscopic surgery training,the platform to be developed consists of a newly designed prototype laparoscopic VR controller with haptic feedback,a commercially available head-mounted display,a VR environment for simulating a laparoscopic surgery,and a training concept.Results To take full advantage of benefits such as repeatability and cost-effectiveness of VR-based training,the system shall not require a tissue sample for haptic feedback.It is currently calculated and visually displayed to the user in the VR environment.On the prototype controller,a first axis was provided with perceptible feedback for test purposes.Two of the prototype VR controllers can be combined to simulate a typical both-handed use case,e.g.,laparoscopic suturing.A Unity based VR prototype allows the execution of simple standard pre-trainings.Conclusions The first prototype enables full operation of a virtual laparoscopic instrument in VR.In addition,the simulation can compute simple interaction forces.Major challenges lie in a realistic real-time tissue simulation and calculation of forces for the haptic feedback.Mechanical weaknesses were identified in the first hardware prototype,which will be improved in subsequent versions.All degrees of freedom of the controller are to be provided with haptic feedback.To make forces tangible in the simulation,characteristic values need to be determined using real tissue samples.The system has yet to be validated by cross-comparing real and VR haptics with surgeons.

Virtual Reality in Surgery: Double Blind, Randomized Clinical Trial of Pain Control and Augmented Satisfaction

Introduction: Virtual reality (VR) utilizing a head-mounted display allows viewers to immerse themselves in a virtual environment. This technology may be useful in attenuating pain and anxiety and reducing patient subjective stress as well as objective physiological increase in heart rate and blood pressure. Aside from the improved experience, physiological stress is reduced which results in improved patient outcomes. Patients and methods: Eligible participants were all adults aged 18 or over who had non craniofacial lesions requiring minor surgery. A total of 99 adult patients who were capable of independent consent were randomized to receive a virtual reality experience (VR) or standard music distraction (no VR). Patients were recruited for the study during their office visit when scheduling minor procedure surgery. This was a single center, double-blind, controlled study conducted at Guthrie Clinic Robert Packer Hospital in Sayre, Pennsylvania between March 2019 to January 2020 (pre-pandemic). Ethics approval for this study was obtained from the Institutional Review Board of the Guthrie Clinic. Results: The change in systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) significantly decreased from pre-procedure to mid-procedure in the VR group compared with standard. Herein our results are presented. Conclusions: Reductions in intraprocedural SBP, DBP and HR can be achieved when using VR. Although subjective reporting of pain and anxiety were not different between groups, VR significantly improves patient satisfaction compared with non VR standards.

Exploring the use of virtual reality in surgical education

Virtual reality(VR)technologies have rapidly developed in the past few years.The most common application of the technology,apart from gaming,is for educational purposes.In the field of healthcare,VR technologies have been applied in several areas.Among them is surgical education.With the use of VR,surgical pathways along with the training of surgical skills can be explored safely,in a cost-effective manner.The aim of this mini-review was to explore the use of VR in surgical education and in the 3D reconstruction of internal organs and viable surgical pathways.Finally,based on the outcomes of the included studies,an ecosystem for the implementation of surgical training was proposed.

The Application of Virtual Reality Technology to Ear Microsurgery

The broad application of virtual reality (VR) to medicine has been of great value. The virtual surgery is one of technically difficult applications. With the expansion of the increasingly fine and complicated ear microsurgery, new methods are required to train the doctors. It is necessary and of practical significance to apply VR to the ear micro-operation, which is a functional operation with high precision and great difficulties. In this article, medical VR applications were reviewed. The application of VR to the ear microsurgery was discussed and the virtual ear microsurgery system was designed.

Three-dimensional visualization and virtual reality simulation role in hepatic surgery:Further research warranted

Artificial intelligence(AI)is the study of algorithms that enable machines to analyze and execute cognitive activities including problem solving,object and word recognition,reduce the inevitable errors to improve the diagnostic accuracy,and decision-making.Hepatobiliary procedures are technically complex and the use of AI in perioperative management can improve patient outcomes as discussed below.Three-dimensional(3D)reconstruction of images obtained via ultrasound,computed tomography scan or magnetic resonance imaging,can help surgeons better visualize the surgical sites with added depth perception.Preoperative 3D planning is associated with lesser operative time and intraoperative complications.Also,a more accurate assessment is noted,which leads to fewer operative complications.Images can be converted into physical models with 3D printing technology,which can be of educational value to students and trainees.3D images can be combined to provide 3D visualization,which is used for preoperative navigation,allowing for more precise localization of tumors and vessels.Nevertheless,AI enables surgeons to provide better,personalized care for each patient.

Digital earth, Virtual Reality and urban seismic disaster simulation

US Vice President Al Gore's vision of Digital Earth applies us with prospects for brand-new ways of solving problems the earth is facing such as seismic disaster. ms paper first briefly introduces the concept of Digital Earth. Then in the context of Digital Earth. the Origin, concept and application of Virtual Reality technology are reviewed. After that we present in detail our preliminary case study--CVR-USD (Computer Virtual Reality for Urban Seismic Disaster Simulation) System which aims to simulate and manage seismic disaster through integrating RS, GIS and VR technologies. For this system, we've built USD subsystem, developed SMVR software to implement CVR. and also developed a Spatial Dare Analysis Package to handle spatial data related to earthquake disaster.

Gamification and virtual reality for digital twin learning and training:architecture and challenges

Background Digital Twins are becoming increasingly popular in a variety of industries to manage complex systems.As digital twins become more sophisticated,there is an increased need for effective training and learning systems.Teachers,project leaders,and tool vendors encounter challenges while teaching and training their students,co-workers,and users.Methods In this study,we propose a new method for training users in using digital twins by proposing a gamified and virtual environment.We present an overall architecture and discuss its practical realization.Results We propose a set of future challenges that we consider critical to enabling a more effective learning/training approach.

Application of Virtual Reality Technology in Disaster Medicine

The occurrence of major emergencies often leads to environmental damage,property damage,health challenges and life threats.Despite the tremendous progress we have made in responding to the many challenges posed by disasters in recent years,there are still many shortcomings.As an emerging technology widely used in recent years,virtual reality(VR)technology is very suitable for many fields of disaster medicine,such as basic education,professional training,psychotherapy,etc.The purpose of this review article is to introduce the application of VR technology in the disaster medical field and prospect its trend in the future.

Research on Application of Digital Art and Virtual Reality in Animal Medical Education

With the development of social science and technology,digital technology has been widely used in all walks of life.Especially in the field of medical education,the rational application of digital technology will create a simulated learning environment for students,which has a key impact on the improvement of medical education.This article is an analysis of the application of art and virtual reality in animal medical education.I hope that this analysis can play a certain role in improving the effect of today’s animal medical education,and provide a certain reference value for the reasonable application of digital technology and virtual reality technology in today’s animal medical education.

Virtual Reality Surgical Training in Ear, Nose and Throat Surgery

Virtual reality has been introduced to the medical field and it is now used in medical education as an alternative high fidelity simulator. The major components to successful learning that has contributed to the efficacy of the virtual reality system are the ability to provide repetitive practice under controlled environment, self-directed learning and proved construct validity. This review evaluated the validity and the efficacy of current virtual reality systems in ear, nose and throat surgery.

A virtual reality based surgical skills training simulator for catheter ablation with real-time and robust interaction

Background Atrial fibrillation(AF)is the most common sustained cardiac arrhythmia that can cause severe heart problems.Catheter ablation is one of the most ideal procedures for the treatment of AF.Physicians qualified to perform this procedure need to be highly skilled in manipulating the relevant surgical devices.This study proposes an interactive surgical simulator with high fidelity to facilitate efficient training and low-cost medical education.Methods We used a shared centerline model to simulate the interaction between multiple surgical devices.An improved adaptive deviation-feedback approach is proposed to accelerate the convergence of each iteration.The periodical beating of the human heart was also simulated in real time using the position-based dynamics(PBD)framework to achieve higher fidelity.We then present a novel method for handling the interaction between the devices and the beating heart mesh model.Experiments were conducted in a homemade simulator prototype to evaluate the robustness,performance,and flexibility of the proposed method.Preliminary evaluation of the simulator was performed by medical students,residents,and surgeons.Results The interaction between surgical devices,static vascular meshes,and beating heart mesh was stably simulated in a frame rate suitable for interaction.Conclusion Our simulator is capable of simulating the procedure of catheter ablation with high fidelity and provides immersive visual experiences and haptic feedback.

The application of virtual reality training for anastomosis during robot-assisted radical prostatectomy

Objective:To investigate the application of virtual reality training in vesicourethral anastomosis during robot-assisted radical prostatectomy(RARP).Methods:Three certified robotic urologists who underwent virtual reality training were enrolled in the study group.The other three without training were enrolled in the control group.Parameters were recorded before and after the training.Then a total of 18 patients undergoing RARP were enrolled and randomized assigned to receive anastomosis procedures with certified urologists who either obtained or did not obtain training.The quality of the anastomosis was evaluated.Results:For the virtual training evaluation,the overall score was significantly improved from 65.0±10.8 to 92.7±3.5(p=0.014);the time of anastomosis was shortened;the economy of motion improved;instrument collisions decreased after training(p<0.05).Besides,the effectiveness of the virtual training was evaluated in the 18 real anastomosis procedures which were completed either by three urologists with training or three urologists without training.Most intriguingly,the average time of anastomosis was shortened from 40.0±12.4 min to 25.1±7.1 min(p=0.015).The parameters including time of operation,creatinine level of drainage,postoperative hospital stay and duration of catheter drainage were comparable before and after training.Two leakages,which were observed in procedures by doctors without training,needed salvage sutures by a senior doctor.Conclusions:Virtual reality training enabled surgeons to become quickly familiar with robotic system manipulation,improved their skills for vesicourethral anastomosis and shortened the learning curve,thus helping them operate with high efficacy and quality.

Retroperitoneal teratoma resection assisted by 3-dimensional visualization and virtual reality:A case report

BACKGROUND Primary retroperitoneal tumor is a rare type of tumor with insidious onset,large tumor size at the time of diagnosis,and often extensive involvement of surrounding tissues and blood vessels in the retroperitoneum.Surgery for primary retroperitoneal tumors is technically challenging.Preoperative imaging evaluation is critical for the selection of the optimal surgical approach and can influence complete resection and recurrence rates.Three-dimensional model reconstruction combined with virtual reality is useful for preoperative assessment.CASE SUMMARY A 17-year-old female patient was admitted for abdominal pain lasting for half a year that had been worsening for half a month.Abdominopelvic enhanced helical computed tomography revealed a retroperitoneal space-occupying lesion about 11.3 cm×9.1 cm in size,with well-defined borders in the upper left quadrant of the abdomen.The lesion compressed the left renal artery and vein resulting in vascular displacement and deformation.A multidisciplinary team decided on the optimal treatment approach.Preoperative three-dimensional visualization and virtual reality technology were used to assess and simulate the surgical procedure.Then,retroperitoneal tumor resection along with renal artery reconstruction was decided as the treatment.Complete resection of the retroperitoneal tumor was performed.Stable blood flow was established after renal artery reconstruction.The tumor was diagnosed as mature cystic teratoma(retroperitoneal tumor)by postoperative pathologic analysis.The patient,who recovered well,was discharged after 2 wk and maintains regular follow-ups.CONCLUSION A combination of three-dimensional reconstruction and virtual reality technology before surgery improves the rate of complete resection of retroperitoneal teratoma.

Digital twin-and extended reality-based telepresence for collaborative robot programming in the 6G perspective

In the context of Industry 4.0,a paradigm shift from traditional industrial manipulators to Collaborative Robots(CRs)is ongoing,with the latter serving ever more closely humans as auxiliary tools in many production processes.In this scenario,continuous technological advancements offer new opportunities for further innovating robotics and other areas of next-generation industry.For example,6G could play a prominent role due to its human-centric view of the industrial domains.In particular,its expected dependability features will pave the way for new applications exploiting highly effective Digital Twin(DT)-and eXtended Reality(XR)-based telepresence.In this work,a novel application for the above technologies allowing two distant users to collaborate in the programming of a CR is proposed.The approach encompasses demanding data flows(e.g.,point cloud-based streaming of collaborating users and robotic environment),with network latency and bandwidth constraints.Results obtained by analyzing this approach from the viewpoint of network requirements in a setup designed to emulate 6G connectivity indicate that the expected performance of forthcoming mobile networks will make it fully feasible in principle.

Real-Time Deformation Simulation of Kidney Surgery Based on Virtual Reality

Virtual reality-based surgery simulation is becoming popular with the development of minimally invasive abdominal surgery,where deformable soft tissue is modelled and simulated.The mass-spring model(MSM)and finite element method(FEM)are common methods used in the simulation of soft tissue deformation.However,MSM has an issue concerning accuracy,while FEM has a problem with efficiency.To achieve higher accuracy and efficiency at the same time,we applied a co-rotational FEM in the simulation of a kidney with a tumour inside,achieving a real-time and accurate deformation simulation.In addition,we set a multi-model representation for mechanical simulation and visual rendering.The implicit Euler method and conjugate gradient method were adopted for setting and solving the linear system.For a realistic simulation of surgery,constraints outside the kidney and between the kidney and tumour were set with two series of mechanical properties for the two models.Experiments were conducted to validate the accuracy and real-time performance.

Virtual reality system for diagnosis and therapeutic planning of cerebral aneurysms

Background The virtual reality （VR） system can provide the neurosurgeon to intuitively interact with and manipulate the three dimensional （3-D） image similarly to manipulate a real object.it was seldom reported that the system was used in diagnosis and treatment of cerebral aneurysms.This study aimed to investigate the application of VR system in diagnosis and therapeutic planning of cerebral aneurysms.Methods A total of 24 cases of cerebral aneurysms were enrolled in this study from 2006 to 2008, which diagnosed by 3-D digital subtraction angiography （3D-DSA） or VR-based computed tomography angiographies （CTA）.The VR system and 3D-DSA system were used to observe and measure aneurysms and the adjacent vessels.The data of observation and measurements were compared between VR image and 3D-DSA image.All the patients underwent surgical plan and simulated neurosurgical procedures in the VR system.Results There were 28 aneurysms detected in VR system and 3D-DSA system.The VR system generated clear and vivid 3-D virtual images which clearly displayed the location and size of the aneurysms and their precise anatomical spatial relations to the parent arteries and skull.The location, size and shape of the aneurysms and their anatomical relationship with the adjacent vessels were similar between 3-D virtual image and 3D-DSA, but the spatial relationship between aneurysms and skull only been displayed by VR system.This VR system also could simulate simple surgical procedures and surgical environments.Conclusions The VR system can provide a highly effective way to provide precise imaging details as same as 3D-DSA system and assist the diagnosis of cerebral aneurysms with virtual 3-D data based on CTA.It significantly enhances the chosen therapeutic strategy of cerebral aneurysms.

VR-based digital twin for remote monitoring of mining equipment:Architecture and a case study

Background Traditional methods for monitoring mining equipment rely primarily on visual inspections,which are time-consuming,inefficient,and hazardous.This article introduces a novel approach to monitoring mission-critical systems and services in the mining industry by integrating virtual reality(VR)and digital twin(DT)technologies.VR-based DTs enable remote equipment monitoring,advanced analysis of machine health,enhanced visualization,and improved decision making.Methods This article presents an architecture for VR-based DT development,including the developmental stages,activities,and stakeholders involved.A case study on the condition monitoring of a conveyor belt using real-time synthetic vibration sensor data was conducted using the proposed methodology.The study demonstrated the application of the methodology in remote monitoring and identified the need for further development for implementation in active mining operations.The article also discusses interdisciplinarity,choice of tools,computational resources,time and cost,human involvement,user acceptance,frequency of inspection,multiuser environment,potential risks,and applications beyond the mining industry.Results The findings of this study provide a foundation for future research in the domain of VR-based DTs for remote equipment monitoring and a novel application area for VR in mining.

Improved Cubemap model for 3D navigation in geo-virtual reality

Due to advances in rendering techniques and hardware capability,stereoscopic 3D(s3D)visualization is becoming increasingly common in daily life.However,this does not change the fact that stereo effects and visual comfort depend greatly on how the related parameters are controlled during the production of the s3D images.In geovirtual reality systems,which are important browsers for Digital Earth,the maintenance of these parameters is deeply related to the navigation process.Therefore,the navigation method in such systems requires special care.This paper presents a new flying method based on a Cubemap structure.The method defines a Vehicle model and modifies the original Cubemap structure by adding a front view camera during the navigation;it allows the users to fly through a virtual geographic environment with automatic speed control,smooth collision resolution,and dynamic adjustment of the s3D-related parameters.A user test was conducted to compare this new method with the original method based on the Cubemap structure.The results show that the new method performs better than the former one for it provides a convenient interaction experience with improved stereoscopic effect,and diminishes visual discomfort.