How Cincinnati Children's uses VR in the OR

Fixing the smallest hearts is always a challenge, but Cincinnati Children's has developed a program to help physicians and patients through the difficult surgeries, using virtual reality.

The hospital is leveraging VR to improve surgical planning and empower patients. The program is the brainchild of David Morales, MD, director of congenital heart surgery and Ryan Moore, MD, director of the Heart Institute Digital Health Innovation program and former gamer. They spoke to Becker's about the program.

Prior to working in virtual reality, physicians would plan their surgeries using 3D printed models of a patient's heart and then they moved on to digital planning. However, these methods had some drawbacks that the virtual world helped solve.

"For what I'm doing, which is surgical planning, the materials are different and once you cut them then try to go back, you'd have to print another one," said Dr. Morales. "The virtual space had started opening up even more and Ryan had started developing a platform on that. So we'd work together to start doing planning first digitally, but that is a little time consuming."

"In 2018 we received a grant from the NIH through the NIH Centers for National Accelerated Innovations program, and that's really when it started to take off around 2018." said Dr. Moore.

The grant boosted the hospital's capacity for dedication to VR. Dr. Moore and Dr. Morales together created a virtual reality platform that allowed surgeons and patients alike to walk through operations.

Taking the MRI and CT scans of a patient's heart, the dedicated team creates a digital anatomical twin, so the patient's heart can be accurately represented in the virtual world. 

"To be honest, it allowed me to do things that I've never been able to do," said Dr. Morales. "One, to walk through the heart, right? It gives you a different perspective because when we're operating we only see the hearts in the front or we can flip it up and kind of look from the back but when I'm in the virtual space I can see aspects of the heart that I have not seen and I've seen a lot of hearts."

The platform is also multiuser, meaning multiple physicians can meet in the virtual space and run through operations together, easing the nerves of everyone involved. But it's not only the physicians who use the technology, but patients and their families. 

"I think there's a lot of power in the ability for [patients] to understand what their medical condition is, to understand what the doctors are talking about and I think empower them," said Dr. Moore. 

Currently, the hospital is studying what effects introducing patients to their condition through their VR technology has on stress and anxiety. The initial feedback from families though has been positive. 

"We've had kids that are old enough to express themselves to say that being able to do that made them feel better about going forward with surgery," Dr. Morales told Becker's.

The children also tend to be well-versed in the virtual world, given their generation's affinity for gaming. 

"Kids are on Minecraft with each other and their friends. They can easily hop into a virtual space and look at, you know, any sort of modeling and understand it like that. Kids as the patients can be in the forefront and they can really start to understand their health at a very young age," said Dr. Moore.

To keep up with the demands of the technology, the hospital employs a group of VR developers. Having the developers in-house has been a great asset to the team, Dr. Moore told Becker's.

"Working with those developers and they're right down the hallway and they come in and work with us directly means we're able to be very facile and very specific about what it is that we want," said Dr Moore.

The hospital has also worked closely with some of the biggest names in the tech industry, including Dell Technologies, NVIDIA and Microsoft. A large donation in 2020 from Dell helped the hospital create a Digital Experience Technologies lab, which develops tech including AR and VR, 3D modeling and virtual gaming.

In terms of the future, the hospital wants to explore more multi user options for the technology, as well as make the platforms scaleable for use at other institutions.

 

 

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