New dimensions in surgical training: immersive virtual reality laparoscopic simulation exhilarates surgical staff.

INTRODUCTION: Virtual reality (VR) and head mount displays (HMDs) have been advanced for multimedia and information technologies but have scarcely been used in surgical training. Motion sickness and individual psychological changes have been associated with VR. The goal was to observe first experiences and performance scores using a new combined highly immersive virtual reality (IVR) laparoscopy setup. METHODS: During the study, 10 members of the surgical department performed three tasks (fine dissection, peg transfer, and cholecystectomy) on a VR simulator. We then combined a VR HMD with the VR laparoscopic simulator and displayed the simulation on a 360° video of a laparoscopic operation to create an IVR laparoscopic simulation. The tasks were then repeated. Validated questionnaires on immersion and motion sickness were used for the study. RESULTS: Participants' times for fine dissection were significantly longer during the IVR session (regular: 86.51 s [62.57 s; 119.62 s] vs. IVR: 112.35 s [82.08 s; 179.40 s]; p = 0.022). The cholecystectomy task had higher error rates during IVR. Motion sickness did not occur at any time for any participant. Participants experienced a high level of exhilaration, rarely thought about others in the room, and had a high impression of presence in the generated IVR world. CONCLUSION: This is the first clinical and technical feasibility study using the full IVR laparoscopy setup combined with the latest laparoscopic simulator in a 360° surrounding. Participants were exhilarated by the high level of immersion. The setup enables a completely new generation of surgical training.

CardioGenesis4D: Interactive Morphological Transitions of Embryonic Heart Development in a Virtual Learning Environment.

In the embryonic human heart, complex dynamic shape changes take place in a short period of time on a microscopic scale, making this development difficult to visualize. However, spatial understanding of these processes is essential for students and future cardiologists to properly diagnose and treat congenital heart defects. Following a user centered approach, the most crucial embryological stages were identified and translated into a virtual reality learning environment (VRLE) to enable the understanding of the morphological transitions of these stages through advanced interactions. To address individual learning types, we implemented different features and evaluated the application regarding usability, perceived task load, and sense of presence in a user study. We also assessed spatial awareness and knowledge gain, and finally obtained feedback from domain experts. Overall, students and professionals rated the application positively. To minimize distraction from interactive learning content, such VRLEs should consider features for different learning types, allow for gradual habituation, and at the same time provide enough playful stimuli. Our work previews how VR can be integrated into a cardiac embryology education curriculum.

Highly immersive virtual reality laparoscopy simulation: development and future aspects.

PURPOSE: Virtual reality (VR) applications with head-mounted displays (HMDs) have had an impact on information and multimedia technologies. The current work aimed to describe the process of developing a highly immersive VR simulation for laparoscopic surgery. METHODS: We combined a VR laparoscopy simulator (LapSim) and a VR-HMD to create a user-friendly VR simulation scenario. Continuous clinical feedback was an essential aspect of the development process. We created an artificial VR (AVR) scenario by integrating the simulator video output with VR game components of figures and equipment in an operating room. We also created a highly immersive VR surrounding (IVR) by integrating the simulator video output with a [Formula: see text] video of a standard laparoscopy scenario in the department's operating room. RESULTS: Clinical feedback led to optimization of the visualization, synchronization, and resolution of the virtual operating rooms (in both the IVR and the AVR). Preliminary testing results revealed that individuals experienced a high degree of exhilaration and presence, with rare events of motion sickness. The technical performance showed no significant difference compared to that achieved with the standard LapSim. CONCLUSION: Our results provided a proof of concept for the technical feasibility of an custom highly immersive VR-HMD setup. Future technical research is needed to improve the visualization, immersion, and capability of interacting within the virtual scenario.