Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Die Highlights vom Kongress des American College of Cardiology 2024

Im April diskutierten die Herz-Kreislauf-Spezialisten aus der ganzen Welt auf dem  Kongress des American College of Cardiology (ACC) u.a. neue Therapieansätze bei akutem Myokardinfarkt, koronarer Herzerkrankung, kardiogenem Schock oder Aortenklappenstenose. In unserem Kongress-Dossier haben wir für Sie Berichte über die „Late-Breaking Trials“ und andere wichtige Studien zusammengestellt. 
Erweiterte Suche
Anmelden
nach oben
Current Reviews in Musculoskeletal Medicine
Erschienen in: Current Reviews in Musculoskeletal Medicine 6/2020

11.08.2020 | The Use of Technology in Orthopaedic Surgery—Intraoperative and Post-Operative Management (C Krueger and S Bini, Section Editors)

Virtual Reality and Augmented Reality—Translating Surgical Training into Surgical Technique

verfasst von: R. Randall McKnight, Christian A. Pean, J. Stewart Buck, John S. Hwang, Joseph R. Hsu, Sarah N. Pierrie

Erschienen in: Current Reviews in Musculoskeletal Medicine | Ausgabe 6/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

As immersive learning outside of the operating room is increasingly recognized as a valuable method of surgical training, virtual reality (VR) and augmented reality (AR) are increasingly utilized in orthopedic surgical training. This article reviews the evolving nature of these training tools and provides examples of their use and efficacy. The practical and ethical implications of incorporating this technology and its impact on both orthopedic surgeons and their patients are also discussed.

Recent Findings

Head-mounted displays (HMDs) represent a possible adjunct to surgical accuracy and education. While the hardware is advanced, there is still much work to be done in developing software that allows for seamless, reliable, useful integration into clinical practice and training.

Summary

Surgical training is changing: AR and VR will become mainstays of future training efforts. More evidence is needed to determine which training technology translates to improved clinical performance. Volatility within the HMD industry will likely delay advances in surgical training.
Literatur
1.
Bass BL. Fundamental changes in general surgery residency training. Am Surg. 2007;73:109–13.CrossRef
2.
Ziv A, Small SD, Wolpe PR. Patient safety and simulation-based medical education. Med Teach. 2000;22:489–95.CrossRef
3.
4.
Shervin N, Rubash HE, Katz JN. Orthopaedic procedure volume and patient outcomes: A systematic literature review. Clin Orthop Relat Res. Lippincott Williams and Wilkins; 2007. p. 35–41.
5.
6.
7.
Bedigrew KM, Blair JA, Possley DR, Kirk KL, Hsu JR. Comparison of calcaneal exposure through the extensile lateral and sinus tarsi approaches. Foot Ankle Spec. 2018;11:142–7.CrossRef
8.
Beltran MJ, Blair JA, Huh J, Kirby JM, Hsu JR. Articular exposure with the swashbuckler versus a “mini- swashbuckler” approach. Injury. 2013;44:189–93.CrossRef
9.
Blair JA, Stinner DJ, Kirby JM, Gerlinger TL, Hsu JR. Quantification of femoral neck exposure through a minimally invasive Smith-Petersen approach. J Orthop Trauma. 2010;24:355–8.CrossRef
10.
Larsen CR, Soerensen JL, Grantcharov TP, Dalsgaard T, Schouenborg L, Ottosen C, et al. Effect of virtual reality training on laparoscopic surgery: randomised controlled trial. BMJ [Internet]. BMJ Publishing Group; 2009 [cited 2017 Jul 12];338:b1802. Available from: http://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​19443914
11.
Atesok K, MacDonald P, Leiter J, Dubberley J, Satava R, VanHeest A, et al. Orthopaedic education in the era of surgical simulation: still at the crawling stage. World J Orthop [Internet]. Baishideng Publishing Group Inc; 2017 [cited 2017 Jul 14];8:290–4. Available from: http://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​28473955
12.
Baker DK, Fryberger CT, Ponce BA. The emergence of augmented reality in orthopaedic surgery and education. Orthop J Harvard Med School. 2015;23:8–16.
13.
14.
15.
16.
17.
18.
Khor WS, Baker B, Amin K, Chan A, Patel K, Wong J. Augmented and virtual reality in surgery-the digital surgical environment: applications, limitations and legal pitfalls. Ann Transl Med [Internet]. AME Publications; 2016 [cited 2017 Aug 29];4:454. Available from: http://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​28090510
19.
20.
21.
Bartlett JD, Lawrence JE, Stewart ME, Nakano N, Khanduja V. Does virtual reality simulation have a role in training trauma and orthopaedic surgeons? Bone Jt. J. Br Editorial Society of Bone and Joint Surgery; 2018. p. 559–65.
22.
Tulipan J, Miller A, Park AG, Labrum JT, Ilyas AM. Touch surgery: analysis and assessment of validity of a hand surgery simulation “app.” Hand. SAGE Publications Inc.; 2018;
23.
Sugand K, Mawkin M, Gupte C. Training effect of using Touch SurgeryTM for intramedullary femoral nailing. Injury Elsevier Ltd. 2016;47:448–52.CrossRef
24.
Moro C, Štromberga Z, Raikos A, Stirling A. The effectiveness of virtual and augmented reality in health sciences and medical anatomy. Anat Sci Educ. John Wiley and Sons Inc. 2017;10:549–59.CrossRef
25.
Luciano CJ, Banerjee PP, Bellotte B, Lemole GM, Oh M, Charbel FT, et al. Learning retention of thoracic pedicle screw placement using a high-resolution augmented reality simulator with haptic feedback 1.
26.
27.
28.
Homma Y, Mogami A, Baba T, Naito K, Watari T, Osamu O, et al. Is actual surgical experience reflected in virtual reality simulation surgery for a femoral neck fracture? Eur J Orthop Surg Traumatol [Internet]. 2019 [cited 2019 Nov 13];29:1429–34. Available from. https://​doi.​org/​10.​1007/​s00590-019-02465-9.
29.
Cho HS, Park YK, Gupta S, Yoon C, Han I, Kim H-S, et al. Augmented reality in bone tumour resection: an experimental study. Bone Joint Res [Internet]. British Editorial Society of Bone and Joint Surgery; 2017 [cited 2018 Mar 19];6:137–43. Available from: http://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​28258117
30.
Kalun P, Wagner N, Yan J, Nousiainen M, Sonnadara R. Surgical simulation training in orthopedics: current insights. Adv Med Educ Pract. Dove Medical Press Ltd. 2018;9:125–31.CrossRef
31.
32.
33.
34.
35.
36.
37.
38.
39.
Tillander B, Ledin T, Nordqvist P, Skarman E, Wahlström O. A virtual reality trauma simulator. Med Teach. 2004;26:189–91.CrossRef
40.
Blyth P, Stott NS, Anderson IA. Virtual reality assessment of technical skill using the Bonedoc DHS simulator. Injury. 2008;39:1127–33.CrossRef
41.
42.
43.
LeBlanc J, Hutchison C, Hu Y, Donnon T. Topics in training: a comparison of orthopaedic resident performance on surgical fixation of an ulnar fracture using virtual reality and synthetic models. J Bone Jt Surg - Ser A. 2013;95:1–6.CrossRef
44.
Akhtar K, Sugand K, Sperrin M, Cobb J, Standfield N, Gupte C. Training safer orthopedic surgeons. Acta Orthop. 2015;86:616–21.CrossRef
45.
46.
• Buck JS, Wally MK, Patt JC, Scannell B, Seymour RB, Hsu JR. Teaching cortical-screw tightening: a simple, affordable, torque-directed training protocol improves resident performance. J Bone Joint Surg Am. NLM (Medline). 2019:101, e51. The authors developed a low-fidelity training protocol to teach residents how to insert cortical screws without stripping the screw-bone interface. Immediately following training, all residents demonstrated improved ability to insert screws without stripping, but at 3-month follow-up, only senior residents retained the benefits of the training protocol.
47.
48.
49.
Blackwell M, Morgan F, Di Gioia AM. Augmented reality and its future in orthopaedics. Clin Orthop Relat Res. Lippincott Williams and Wilkins; 1998. p. 111–22.
50.
Ponce BA, Jennings JK, Clay TB, May MB, Huisingh C, Sheppard ED, et al. J Bone Jt Surg - Am Vol. Journal of Bone and Joint Surgery Inc. 2014;96:e84(1).CrossRef
51.
Davis MC, Can DD, Pindrik J, Rocque BG, Johnston JM. Virtual interactive presence in global surgical education: international collaboration through augmented reality. World Neurosurg [Internet]. NIH Public Access; 2016 [cited 2018 Mar 19];86:103–11. Available from: http://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​26342783
52.
53.
54.
Ewurum CH, Guo Y, Pagnha S, Feng Z, Luo X. Surgical navigation in orthopedics: workflow and system review. Adv Exp Med Biol. Springer New York LLC; 2018. p. 47–63.
55.
56.
•• Yong M, Pauwels J, Kozak FK, Chadha NK. Application of augmented reality to surgical practice: a pilot study using the ODG R-7 Smartglasses. Clin Otolaryngol [Internet]. 2019 [cited 2019 Nov 12]; Available from: http://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​31610087. Remote attending surgeons ODG R7 HMD to guide trainees through simulated temporal bone dissection. Uploaded imaging and annotations to trainees field of view. Found issues with connectivity, lack of eye protection, no built-in headlight, angle of camera didn't align with user.
57.
58.
Armstrong DG, Rankin TM, Giovinco NA, Mills JL, Matsuoka Y. A heads-up display for diabetic limb salvage surgery: a view through the Google looking glass. J Diabetes Sci Technol [Internet]. Diabetes Technology Society; 2014 [cited 2017 Aug 29];8:951–6. Available from: http://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​24876445
59.
60.
61.
62.
63.
64.
65.
66.
67.
68.
•• Elmi-Terander A, Burström G, Nachabe R, Skulason H, Pedersen K, Fagerlund M et al. Pedicle screw placement using augmented reality surgical navigation with intraoperative 3D imaging: a first in-human prospective cohort study. Spine (Phila Pa 1976). NLM (Medline); 2019;44:517–25. AR assisted in vivo pedicle screw placement. Found 6% of screws breeched 2-4mm. Used display screen monitor system and noninvasive patient monitoring including C-arm mounted 3D cone-beam CT. Found low intraoperative screw revision rate (1.2%).
69.
• Gibby JT, Swenson SA, Cvetko S, Rao Raj, Javan R, Rao R. Head-mounted display augmented reality to guide pedicle screw placement utilizing computed tomography. Int J Comput Assist Radiol Surg [Internet]. 2019 [cited 2019 Nov 12];14:525–35. Available from: https://​doi.​org/​10.​1007/​s11548-018-1814-7. Bench model using Hololens to give superimposed CT-based image guidance during pedicle screw placement. Found 97% accuracy.
70.
71.
Edström E, Burström G, Omar A, Nachabe R, Söderman M, Persson O, et al. Augmented reality surgical navigation in spine surgery to minimize staff radiation exposure. Spine (Phila Pa 1976). Ovid Technologies (Wolters Kluwer Health); 2019;1.
72.
73.
Cho HS, Oh JH, Han I, Kim HS. The outcomes of navigation-assisted bone tumour surgery: minimum three-year follow-up. J Bone Jt Surg - Ser B. 2012;94(B):1414–20.CrossRef
74.
Choi H, Park Y, Lee S, Ha H, Kim S, Cho HS, et al. A portable surgical navigation device to display resection planes for bone tumor surgery. Minim Invasive Ther Allied Technol. Taylor and Francis Ltd. 2017;26:144–50.CrossRef
75.
Cho HS, Park MS, Gupta S, Han I, Kim HS, Choi H, et al. Can augmented reality be helpful in pelvic bone cancer surgery? An in vitro study. Clin Orthop Relat Res. Lippincott Williams and Wilkins. 2018;476:1719–25.CrossRef
76.
Laitinen MK, Parry MC, Albergo JI, Grimer RJ, Jeys LM. Is computer navigation when used in the surgery of iliosacral pelvic bone tumours safer for the patient? Bone Jt J. 2017;99-B:261–6.CrossRef
77.
Gerrand C. CORR Insights®. Clin Orthop Relat Res. Ovid Technologies (Wolters Kluwer Health). 2018;476:1726–7.CrossRef
78.
• van Duren BH, Sugand K, Wescott R, Carrington R, Hart A. Augmented reality fluoroscopy simulation of the guide-wire insertion in DHS surgery: a proof of concept study. Med Eng Phys. Elsevier Ltd; 2018;55:52–9. Augmented and VR combo trainer for inserting guidewires with optical tracking and fake fluoroscopic image overlay using sawbones model. Found accuracy to within 2mm.
79.
Hiranaka T, Fujishiro T, Hida Y, Shibata Y, Tsubosaka M, Nakanishi Y, et al. Augmented reality: the use of the picolinker smart glasses improves wire insertion under fluoroscopy. World J Orthop. Baishideng Publishing Group Co. 2017;8:891–894.pdf.CrossRef
80.
Diotte B, Fallavollita P, Wang L, Weidert S, Euler E, Thaller P, et al. Multi-modal intra-operative navigation during distal locking of intramedullary nails. IEEE Trans Med Imaging. Institute of Electrical and Electronics Engineers Inc. 2015;34:487–95.CrossRef
81.
Ma L, Zhao Z, Zhang B, Jiang W, Fu L, Zhang X, et al. Three-dimensional augmented reality surgical navigation with hybrid optical and electromagnetic tracking for distal intramedullary nail interlocking. Int J Med Robot Comput Assist Surgvery. John Wiley and Sons Ltd; 2018;14.
82.
83.
Wang H, Wang F, Leong APY, Xu L, Chen X, Wang Q. Precision insertion of percutaneous sacroiliac screws using a novel augmented reality-based navigation system: a pilot study. Int Orthop Springer Verlag. 2016;40:1941–7.CrossRef
84.
85.
86.
Fotouhi J, Alexander CP, Unberath M, Sing GT, Lee C, Fuerst B, et al. Plan in 2-D, execute in 3-D: an augmented reality solution for cup placement in total hip arthroplasty. Med Imag. 2018;5:21205.
87.
• Logishetty K, Western L, Morgan R, Iranpour F, Cobb JP, Auvinet E. Can an augmented reality headset improve accuracy of acetabular cup orientation in simulated THA? A randomized trial. Clin Orthop Relat Res. Ovid Technologies (Wolters Kluwer Health); 2019;477:1190–9. Looked at accuracy differences in acetabular cup placement between novices trained by a surgeon vs. those trained with AR assistance with Hololens guidance. Found no differences in placement accuracy between groups.
88.
•• Lei P-F, Su S-L, Kong L-Y, Wang C-G, Zhong D, Hu Y-H. Mixed Reality Combined with three-dimensional printing technology in total hip arthroplasty: an updated review with a preliminary case presentation. 2019; First example of using 3D printing, HMD, and anatomic referencing intraoperatively to perform Total Hip Arthroplasty. The authors developed a low-fidelity training protocol to teach residents how to insert cortical screws without stripping the screw-bone interface. Immediately following training, all residents demonstrated improved ability to insert screws without stripping, but at 3-month follow-up, only senior residents retained the benefits of the training protocol.
89.
Guraya SY. Using telementoring and augmented reality in surgical specialties. J. Taibah Univ. Med. Sci. Elsevier B.V.; 2019. p. 101–2.
90.
91.
92.
Ponce BA, Menendez ME, Oladeji LO, Fryberger CT, Dantuluri PK. Emerging technology in surgical education: combining real-time augmented reality and wearable computing devices. Orthopedics Slack Incorporated. 2014;37:751–7.
93.
94.
95.
96.
Vávra P, Roman J, Zonča P, Ihnát P, Němec M, Kumar J, et al. Recent development of augmented reality in surgery: a review. J. Healthc. Eng. Hindawi Limited; 2017.
97.
Antonini G, Stuflesser W, Crippa C, Touloupakis G. A distal-lock electromagnetic targeting device for intramedullary nailing: Suggestions and clinical experience. Chinese J Traumatol - English Ed Elsevier BV. 2016;19:358–61.
98.
Veliceasa B, Bandac R, Popescu D, Puha B, Alexa O. Evaluation of TRIGEN SURESHOT® distal targeting system - a new electromagnetic computer-assisted guidance system. 2015 E-Health Bioeng Conf EHB 2015. Institute of Electrical and Electronics Engineers Inc.; 2016.
99.
Elmi-Terander A, Skulason H, Soderman M, Racadio J, Homan R, Babic D, et al. Surgical navigation technology based on augmented reality and integrated 3D intraoperative imaging a spine cadaveric feasibility and accuracy study. Spine (Phila Pa 1976). 2016;41:E1303–11.CrossRef
Metadaten
Titel
Virtual Reality and Augmented Reality—Translating Surgical Training into Surgical Technique
verfasst von
R. Randall McKnight
Christian A. Pean
J. Stewart Buck
John S. Hwang
Joseph R. Hsu
Sarah N. Pierrie
Publikationsdatum
11.08.2020
Verlag
Springer US
Erschienen in
Current Reviews in Musculoskeletal Medicine / Ausgabe 6/2020
Elektronische ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-020-09667-3

Weitere Artikel der Ausgabe 6/2020

Current Reviews in Musculoskeletal Medicine 6/2020 Zur Ausgabe

Updates in Spine Surgery—Techniques, Biologics, and Non-Operative Management (W Hsu, Section Editor)

Injectable Biologics for the Treatment of Degenerative Disc Disease

Management of Ankle Instability (M Hogan, Section Editor)

Open Brostrom for Lateral Ligament Stabilization

Reverse Shoulder Arthroplasty (C Chambers and E Craig, Section Editors)

Baseplate Options for Reverse Total Shoulder Arthroplasty

Compressive Neuropathies in the Upper Extremity (E Shin, Section Editor)

Upper Extremity Compressive Neuropathies in the Pediatric and Adolescent Populations

Updates In Spine Surgery—Techniques, Biologics, and Non-Operative Management (W Hsu, Section Editor)

Optimizing the Spinal Interbody Implant: Current Advances in Material Modification and Surface Treatment Technologies

Surgical Management of Massive Irreparable Cuff Tears (J Sanchez-Sotelo, Section Editor)

Pectoralis Major and Anterior Latissimus Dorsi Transfer for Subscapularis Tears

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

TEP mit Roboterhilfe führt nicht zu größerer Zufriedenheit

15.05.2024 Knie-TEP Nachrichten

Der Einsatz von Operationsrobotern für den Einbau von Totalendoprothesen des Kniegelenks hat die Präzision der Eingriffe erhöht. Für die postoperative Zufriedenheit der Patienten scheint das aber unerheblich zu sein, wie eine Studie zeigt.

Lever-Sign-Test hilft beim Verdacht auf Kreuzbandriss

15.05.2024 Vordere Kreuzbandruptur Nachrichten

Mit dem Hebelzeichen-Test lässt sich offenbar recht zuverlässig feststellen, ob ein vorderes Kreuzband gerissen ist. In einer Metaanalyse war die Vorhersagekraft vor allem bei positivem Testergebnis hoch.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise