Medical application of virtual reality (VR)

The use of virtual reality or 3D visualising technology is, of course, not new. Since the 1990s, 3D models of, for example, patients' organs have been used. But advancements in computing have made the images much more realistic and can be created much faster.

X-rays, CT scans, and MRI scans can now be converted into 3D images within a minute, according to Sergio Agirre, CTO of EchoPixel. The visualisation software of this company is used in hospitals worldwide. "Twenty years ago, something like this might have taken a week."

Some surgical procedures, such as removing an appendix or performing a caesarean section, can be reasonably standardised as one case is very similar to another. But other, more complicated procedures, such as separating conjoined twins, present challenges that require precise planning. For these types of challenging operations, 3D visualisation proves to be of immense value.

Recently, VR played a crucial role in the successful separation of conjoined twins. At the Masonic Children's Hospital in Minneapolis (USA), a three-month-old twin was conjoined in a much more complicated way than others, with intricate connections between the heart and liver. Operating and separating these twins was naturally very difficult and even dangerous for them.

VR technology is also used by vascular specialists. By using interactive 3D visualisations, surgeons can prepare well for procedures such as treating an aneurysm or blocked arteries. One of the benefits is that they can already estimate which measures and actions will yield the best results.

Where doctors use VR equipment, patients do too. They use headsets, for example, to immerse themselves in a virtual world that helps them focus on things other than medical problems and treatments.

Because anaesthesia or sedation can pose risks for some patients, more and more hospitals are offering VR headsets to their patients to control pain during less severe procedures. At the moment, this is still experimental, but the results are so far positive.

Similarly, VR appears to help reduce anxiety in cancer patients undergoing chemotherapy. It also helps children by reducing anxiety during injections or other treatments.

You look through the headset and can virtually walk through the structure and thereby see exactly what you need have during the operation.

Burn patients may benefit the most from VR technology. The daily cleaning and wrapping of burns or performing skin grafts are considered some of the most painful procedures. Pain medication helps, but often not enough.

For these patients, the VR game "SnowWorld" was developed. Dr. Hunter Hoffman, a scientist at the University of Washington with expertise in the use of VR for pain management, explains: "This game contains images specifically designed to distract burn patients from their pain." Research shows that people who play this game during treatment experience up to 50% less pain. Other research indicates that playing this game shows changes in the patients' brains, indicating they experience less pain.

The VR game SnowWorld, developed by Hoffman, is currently being tested in four locations in the United States and in two other countries. Although VR should not be seen as a replacement for pain management, the developers believe that combining medication and VR can be highly effective. In the Netherlands, too, there is extensive experimentation with pain relief through VR. Medical organisations such as Radboudumc and the burn centre of the Martini Hospital use VR glasses and conduct research into the application of VR in pain management during endoscopic examinations and procedures. Initial indications from this research show that less sedation is indeed needed for patients using VR glasses.

Virtual reality also helps patients struggling with balance and mobility issues as a result of a stroke or head injuries.

A new European consortium, led by the Sint Maartenskliniek, receives €2.4 million for the development of Virtual Reality (VR) applications in rehabilitation processes. The Interreg North-West Europe programme has awarded this to the so-called VR4REHAB project. Over the next three years, this project will bring together companies, universities, and rehabilitation clinics to develop and research applications that improve rehabilitation treatments and accelerate the recovery process.

Through VR, I can monitor everything happening around a patient and understand what influences their ability to change

Research shows that the use of VR in rehabilitation significantly accelerates the process. Patients regain their physical skills more quickly. The initial results are very positive. A study of people who have had a stroke showed that the use of VR led to better movement of the arm and hand after four weeks of therapy. After two months, these patients also showed better mobility. Other research on patients with cerebral palsy showed similarly better outcomes.

"The power of VR in therapy is that you really engage with how people see the world," says Keshner. "They learn how to respond. And after practising in the virtual world, they are much more confident and better able to do so in the real world."