350 cases of surgery proved VR-assisted surgery can reduce 24% of patients with pain

54-year-old Mexican surgeon José Luis Mosso Vazquez added VR-assisted surgery to more than 350 surgical procedures, reducing the patient’s pain by 24% and reducing the use of sedatives such as fentanyl and midazolam. The use of expensive drugs reduces the cost of surgery by 25% and also reduces the occurrence of complications.

VR acts as a tranquilizer

We used a small case to understand how Mosso used VR technology to assist surgery: Ana Maria, a 61-year-old man with a lipoma on the left side of the thigh, Mosso lying in his own private clinic. The surgeon doctor eliminated the poison on the left side of her left leg and injected the anesthetic drug.

During the entire operation, Ana was awake. When the surgeon began to move the knife, her blood pressure was 183/93, apparently high. Under normal circumstances, the patient was given a tranquilizer, but the doctor Mosso wore VR glasses to Ana Maria. In the virtual world, she was immersed in the beauty of Machu Picchu. She was the first time in her life.

At the same time, the doctor began to cut the first knife, and then the operation proceeded smoothly. From the monitoring apparatus, Ana's blood pressure dropped. In the 20-minute operation, she was immersed in her own world and she did not know that the surgery had been completed. She thanked the doctor after the operation.

As a surgeon at the Pan-American University in Mexico City, Mosso is 54 years old. He carefully observed Ana and prepared a calming drug ready for injection. The goal of his research was to bring VR into surgery to help the operation proceed smoothly. Under normal circumstances, these surgeries require potent painkillers and sedatives. Nowadays, only local anesthesia is needed, which not only reduces The pain of the patient also reduced the cost of surgery and decompressed Mexican medical finances.

Inspired from the game

In 2004, Mosso bought his son a VR game related to Spider-Man. His son was immersed in the game and he could not hear him eating. In general, the experience of the hose reaching into the stomach is extremely painful. The patient usually needs a sedative aid. Mosso then thinks about adding the game to the surgery and distracts the patient.

Mosso asked patients to score pain and anxiety during the surgery and presented their results at the 2006 "Medical Virtual Reality Technology" conference in California. The idea of ​​using VR to transfer patient's attention during surgery was first proposed by universities in Seattle and Washington. At that time cognitive psychologist Hunter Hoffman and his colleagues had developed a VR game called SnowWorld to help patients to endure. Severe burn wound care.

Researchers hope that patients are immersed in computer-generated three-dimensional scenes that can shift the patient's attention away from their real world. It is effective, and tests by Hoffman's team show that SnowWorld reduces the patient's painful feelings during trauma care, with an effective rate of 50%, and at the same time can reduce the activity of brain-related areas of pain.

However, at the time, VR applications were not used in other medical fields. At the 2006 conference, Mosso met Albert Rizzo, a psychologist at the University of Southern California. Rizzo did about 10 cases of surgery, but Rizzo showed Mosso an advanced head display, which made Mosso very shocked and allowed him to use part of the virtual environment developed by Brenda Wiederhold for patient pain relief. This helped Mosso's research process.

After Mosso returned home, he applied VR to postpartum recovery and heart surgery. However, although surgery can divert patients' attention, only some minor surgical procedures such as lipomas, cysts, and fistulas have been performed using VR. Lastly, Mosso mentioned that when re-election is a virtual scenario, it is not only necessary to shift the patient's attention, but also to avoid the game that makes the patient excited and avoid the increase in blood pressure.

Doctor Zhang Qiang's Exploration

Not only in Mexico, but also Chinese doctors are exploring this field. In December 2016, Dr. Zhang Qiang announced through personal microblog and WeChat that Dr. Zhang Qiang successfully performed VR-assisted varicose vein surgery under local anesthesia in Beijing. During the operation, the concentration of lidocaine (a kind of local anesthetic commonly used in clinical medicine) was reduced to 0.25%, which is 1/4 of the conventional concentration (1%), and the patient's heart rate and blood pressure were stable without obvious pain.

Dr. Zhang Qiang disclosed that after applying the VR to patients undergoing varicose vein surgery, Dr. Zhang Qiang's group allowed the patient to go home about one hour after the operation.

The VR scenario that Dr. Zhang Qiang's doctor group applied to the patient was designed based on Dr. Zhang Qiang’s dream. He was named “Smile's Dream” (Smile is Dr. Zhang Qiang’s English name):

People gliding in the air two or three meters from the ground, set off from the misty wilderness and enter the lush forest. Having seen the flowers of spring, I felt the coolness of the summer breeze, and I could see the fall of the fallen leaves. I could hear the silence of the winter snow. In this way, in the reincarnation of the four seasons of spring, summer, autumn and winter, we feel comfortable and comfortable with the beautiful nature.

These virtual screens are totally 360-degree three-dimensional dynamics. Falling leaves, flying butterflies, and mixing natural sounds into light music are all special, and even include how to overcome vertigo caused by VR. Zhang Qiang's team has done a lot of considerations. .

The virtual scene designed by Zhang Qiang is in fact similar to the scene used by Mosso. They all relax people's minds, avoid the increase of blood pressure, and effectively relieve pain and psychological anxiety of the patient's body.

Dr. Zhang Qiang said that he will continue to explore the application of new technologies in clinical medicine. For example, in addition to the “smile dream”, it is also possible to develop different scenarios based on user feedback and preferences, such as underwater world and space travel; in addition to varicose veins, it can also be applied to other disease treatment areas, such as depression, rehabilitation physiotherapy, emergency, etc. In addition to VR, AR products can also be developed to replace 3D printing in facial contouring surgery, removing the process of model building, reducing operating time and economic costs.

Use VR assistive devices to halve the dose of sedatives the patient requires and, in many cases, completely avoid the use of sedatives. This is a savings for Mosso's clinic: sedatives such as fentanyl and midazolam are very expensive. He predicted that this move could reduce the cost of surgery by about 25%.

At the same time, reducing drug doses can also reduce the risk of complications and reduce recovery time. Mosso also plans to further study. He said that if patients only receive local anesthesia, they can go home within an hour after surgery, but if it is general anesthesia, it will take one day to recover.