Dr. Brian Vianney is the first neurosurgeon to host a virtual reality spine surgery education session in the Metaverse

January 2, 2023 /OrthoSpineNews/ – In December 2022, Dr. Brian Viani made history when he hosted a Virtual Reality Spine Surgery Symposium in the Metaverse for 50 spine surgeons from 10 different countries. The demonstration was a resounding success. Dr. Vianney was one of the first neurosurgeons to publish articles on virtual reality when he published his paper, Virtual Reality in Neurosurgery: Can You See It? “- A review of current applications and future potential” in early 2020, a paper with over 20,000 views and has been cited more than 1,600 times to date. Since then, he has continued to pioneer the development of surgical technology and advocate for its use in the operating room. Dr. Vianney has always been fascinated by the power of innovation and what it brings to surgeons and patients. As a boy, he was a creative thinker creating new inventions and credits this passion as one of his motivations to pursue spine surgery. He has worked with many companies over the years to develop software and hardware components for intraoperative technology that have been breaking down barriers in the operating room and expanding capabilities. Dr. Vianney’s patented, ultimate goal of surgical technology is to improve patient care in the operating room.

Dr. Vianney says that technology and innovation are constantly evolving and that new developments make it interesting to modernize medicine. For him, virtual reality is where creativity and science meet. Virtual reality gives participants the ability to do things we can’t do in the real world. Some of the special surgical teaching features include visualization of preoperative 3D reconstructions, surgical planning, surgical simulations, and postoperative analysis, all while decentralizing surgical education so that participants can be anywhere in the world at that particular time.

The Virtual Reality Symposium was held at the New York City Minimally Invasive Spine Surgery Symposium (NYC-MISS) in New York City, New York, USA from December 15-17, 2022. During the two-day lesson plan, participants activated headphones that 3D visualization capabilities and manual controls yielded limitless motion and action features.

50 spine surgeons from 10 different countries joined! More than 30 of the world’s top spine surgery professors joined the Metaverse and 20 other spine surgeons chose to watch without headphones because the virtual reality world was simultaneously broadcast on the auditorium screens in the real world by an actor inside the Metaverse.

In preparation, Dr. Vianney worked with a company called Non Nocere from Germany. The company gets its name from the phrase “primum non nocere” which in Latin means “first, do no harm”. They shipped all of their recent headsets and controllers to New York City for the event. They sent him an overnight headset and controls to practice one week before the event. Software technicians and sales representatives from Germany and Turkey trained and helped him practice using the Metaverse’s features for several days. It was a clue to the producer that they met in the Metaverse from three different countries at the same time to achieve a goal. The company made the process very user-friendly for him. They downloaded pre- and post-operative images, as well as presentation slides, from 4 surgical cases. The four surgeries were categorized as degenerative spine surgery, spinal tumor surgery, deformity surgery, and revision surgery. Within a few days of preparation, he became comfortable with the Metaverse Surgical Auditorium which serves as a Lecture Theatre, a Virtual Anatomy Lab and also a Virtual Reality Operating Room which serves as a Surgical Simulation Lab.

Dr. Vianney commented that the system was very intuitive and after a few minutes you feel at one with the world of virtual reality and its attendants. Hand controls make maneuvering simple and give actions haptic feedback. The system responds instantly without any glitches or delays.

Dr. Vianney says virtual reality is transforming spine surgery education. During the Covid-19 pandemic and even after, people have been gathering on Zoom as a platform for meetings. He believes that virtual reality is the natural evolution of enhancing engagement by creating a space for discussions and interaction. The decentralization of surgical education allows for international participation, which is particularly important in the fields of medicine and surgery. Metaverse virtual reality allows surgeons to simulate surgeries before they are performed.

Virtual reality allows the presenter and participants to participate in one place while logging in from anywhere in the world internationally. Reconstructed models based on patient imaging allow better visualization of simulated spine models and preoperative surgical practice. Surgical simulations can help provide frequent training in a safe environment to create faster and more efficient real-world workflows for younger surgeons and lower learning curves with new products for experienced surgeons.

Virtual reality sessions took place over two days. On the first day, participants gathered in a virtual ballroom here in New York City and logged in with headphones and hand controls and learned the basics of maneuvering to get comfortable with the Metaverse. Two technicians and sales representatives were present in the auditorium room to assist the participants. He was one of the programmers inside the Metaverse to help out there. He gave two case shows, each containing a detailed slideshow downloaded into the Metaverse and projected onto what appeared to be a 100-foot screen with real-world estimation. Preoperative imaging including X-rays, CT scans, and MRI scans were shown with scrolling. One case was cervical spondylopathy and the other was a lumbar deformity. The program built large 30-foot models using preoperative imaging. Imaging was also superimposed on the model and we used features to select or pick out parts of the anatomy to better view what was behind or around it, for example, removing a bone to see pressure on the spinal cord. These two cases were presented so that participants could perform their required surgical plan in a real-world cadaver lab the next morning. On the second day, the participants were now more comfortable with the Metaverse which allowed for an excellent academic discussion. He hosted two additional case presentations with slideshow presentations including intraoperative footage. The tumor-built pre-operative model displayed great specificity and the postop model displayed excision and instrumentation for our tumor case. The revision surgery case demonstrated the ability of VR to measure preoperative screw and penis sizes and compare them to a postoperative model generated from imaging.

The participants were in awe. The best master level spine surgeons in the world were having the times of their lives. Participants enjoyed the audiovisual quality with haptic feedback, life-like spinal anatomy models, imported CT and MRI projection, and surgical simulation features. Surgeons were like children discovering new toys on Christmas morning. Smiles, the sound of laughter, and the appearance of curiosity filled the hall.

Dr. Vianney is excited about the future of Virtual Reality (VR) and Augmented Reality (AR) for spine surgery. Virtual reality will continue to be more life-like as the computer and brain sync and headsets will become so lighter that they become glasses and maybe even contact lenses. VR hand controls will potentially become gauntlets for more realistic movements and control for simulated procedures and surgical simulations. In terms of augmented reality, headsets will also become lighter and smaller and transform into glasses or contact lenses. More companies will be created and competition will grow. When it comes to the future, Dr. Vianney says “In the very near future, very likely in 2023, I will be hosting the first annual virtual reality spine surgery conference. Stay tuned, the planning has already begun.”

Dr.. Brian Vianney

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