Dr. Steinberg & Virtual Reality

Categories: Research

Medical Advisory Board Member Dr. Gary Steinberg Pioneers Use of Virtual Reality for Surgical Planning and Patient/Doctor Education.

Once a novelty, virtual reality technology is increasingly being used by all types of industries, from aviation to tourism. Now, this sophisticated technology, which enables users to don a headset and “travel” through a virtual world in three-dimensions, is being used in the surgical arena, an application that is transforming surgery.

A national leader in the use of virtual reality in surgery is neurosurgeon and Brain Aneurysm Foundation Medical Advisory Board member Gary K. Steinberg, MD, PhD, of Stanford University in California. Dr. Steinberg has practiced neurosurgery at Stanford for more than 29 years. He is the Bernard and Ronni Lacroute-William Randolph Hearst Professor of Neurosurgery and the Neurosciences and Professor of Neurology at Stanford. He also serves as Chair of Neurosurgery. Among many other accomplishments, Dr. Steinberg has pioneered microsurgical techniques to repair intracranial vascular malformations and certain aneurysms that were previously considered untreatable.

Realizing the great potential of virtual reality (VR) in surgery, in 2016 Dr. Steinberg established the Stanford Neurological Simulation and Virtual Reality Center with colleague and program director Malie Collins, MS. What is happening there is transforming surgical planning, surgical precision and safety in the operating room, and the education of both patients and doctors.

To create 3-D images of a patient’s anatomy, scientists fuse two-dimensional images from MRI, CT scans, and angiography from individual patients using advanced computer programs. With VR headsets, surgeons can then “fly” through the brain on screen — getting a close-up look at the brain tissue and vessels without opening the skull.

Before and during surgery
One important use of VR is surgical planning. By immersing themselves in 3D views of their patient’s specific anatomy, doctors can more effectively plan surgical procedures. Surgeons practice the procedure using images of the actual patient, rather than generic anatomy, allowing them to map out the exact path they will take during the surgery ahead of time. “When we get to the actual surgery, it’s as if we’ve been there before,” says Dr. Steinberg.

The VR system also helps surgeons in the operating room, guiding them in a 3D space. Surgeons can correlate the 3D images with the real-time microscopic surgical view, giving them much more detail then they would have otherwise. The 3D aspect of the imagery improves accuracy during the surgery, leading to safer procedures.

Training and education
Stanford doctors are also using VR technology as an education and training tool. The system allows instructors to highlight different components of the brain, such as arteries to show an aneurysm, while rotating the view to illustrate how an aneurysm appears from different angles. Neurosurgeons in training can explore complex cases together in VR and progress, as avatars, through the steps of repairing an aneurysm, starting outside the skull.

Patient education and care
For patients being treated at Stanford, a mobile unit complete with VR headset can be rolled into an examination or hospital room. Being able to visualize the problem in three dimensions can help reassure patients, and is especially useful for young patients or those who do not understand English well. Imagery can also be downloaded onto a thumb drive and given to the patient, which can be shared with family members.

“Traditionally, doctors can show their patient a standard physical model of the brain and say, ‘On this model, imagine your aneurysm is located here,’” says Ms. Collins. “But with VR, we are able to immerse patients in their own anatomy so they can very clearly get a sense of what’s going on.”

VR technology certainly helped Dr. Steinberg’s patient Sandi Rodoni of Watsonville, California, who thought she understood everything about the procedure as she had undergone two previous aneurysm surgeries. Prior to her third surgery, Ms. Rodoni took a VR trip inside her own brain. Knowing where her aneurysm was and how Dr. Steinberg would treat it helped reassure her as she faced her third brain operation. “I knew that Dr. Steinberg wasn’t going to run into any surprises,” she says. Indeed, Ms. Rodoni’s operation went smoothly and she was discharged from the hospital within two days.