How do you become a surgeon? Really, there’s only the one way. Read all the textbooks you like, but sooner or later, you’re going to have to grab a scalpel and get slicing. It’s a millennia-old method of on-the-job training, usually summarized with the worryingly abrupt expression “see one, do one, teach one.”
But at the headquarters of London startup FundamentalVR, I got to try out what might be the surgical training tool of the future. It uses cheap virtual reality components combined with haptic feedback to give doctors as realistic a training experience as current tech will allow. Wearing an HTC Vive headset and wielding a pair of pen-shaped 3D manipulators, I sawed off a knee bone and bored holes in the spine of an unprotesting virtual patient. And while I don’t quite feel confident enough to don scrubs and head to the nearest OR, the simulation felt to me like much more than a novelty. It felt like a learning experience.
“A good comparison is commercial pilots,” says Vincent. “Flight simulators are just a regular part of training for them, and the same should be true of surgery.”
So while there are VR surgery trainers already available, FundamentalVR — which is launching in the US today — says its tech is uniquely appealing for two reasons. One, the incorporation of haptic feedback, and two, prices that won’t break the hospital budget.
Haptic feedback or “haptics” is the deployment of vibration or physical resistance to engage your sense of touch when using technology. The most common example is your phone’s vibrate function, which buzzes to let you know when a friend is calling or if the president has just tweeted out the nuclear codes. But in virtual reality, haptic feedback does so much more, adding a physical dimension to the simulated world.
With FundamentalVR’s technology, when you run your VR scalpel up and down a VR spine, the resistance created by the handheld peripherals means you can feel the tip of the knife bouncing off each vertebra. It’s not a seamless experience, and if you push hard enough you’ll go right through your patient (which, fair enough, could also happen in real life). But it’s certainly much more immersive than operating on empty air.
A 2018 report in theJournal Of Surgical Education, for example, found that haptic feedback helped with learning complex procedures, but offered only “minor improvements for novice surgeons.” A 2012 study looking at VR training for suturing found that surgeons learned to perform the procedure faster when training with haptic feedback, but these benefits only showed during the first five hours of training. After this period, those training using non-haptic systems quickly caught up. And a report published in April this year even suggested that there might be an “uncanny valley of haptics,” where, when sensation is very close to real life but still imperfect, it becomes distracting.
FundamentalVR will have to prove it’s better than this record if it wants to attract customers. Dr. Phil Pucher, part of the company’s panel of medical experts, tellsThe Vergethat the firm is setting a new round of tests of their equipment with Imperial College London, “one of the global leaders in simulation research.”
“We’re going to be running studies, looking at assessing the efficacy of the system,” says Pucher. “You do that by taking it to a lot of orthopedic surgeons and looking at their performance with the system. Does an expert perform better with this than a novice?” He adds that while it’s right to test the company’s system, past studies on VR trainers suggest its benefits are a “no-brainer.”
And getting VR surgery simulators into more hospitals might only be the beginning. In the future, says Vincent, modeling software might allow the company to turn patient’s data (like CT and MRI scans) into 3D models that can be inserted into the simulation. This would allow surgeons to practice operations on a facsimile of their patient, potentially reducing risk even further. Vincent stresses that this is just a sketch of what’s technically possible, not an active area of research, but it’s a tantalizing concept.