Training rural surgeons using virtual reality in surgery: An efficient cost-effective method

Dear Sir

The problem with facilitating high-quality cost-effective surgical services to rural areas is related to training. ¹ Typically, rural trainees are inundated with clinical cases, as the number of surgical patients per doctor is far higher in rural areas because of the shortage of medical staff. In addition, there is typically an acute lack of high-quality teaching and training consultants who would galvanize academic training in central academic complexes. ²

The Virtual reality training using 360° cameras, close-up view cameras, power point presentations and feeds from the monitors during laparoscopic surgeries gives an innovative method of training rural surgeons. ³

The 360° camera is placed in such a way that it gives the best possible position in the operating room for the virtual rural surgeon who can listen to the surgeon explain the various steps of the surgical procedure. In addition, he/she can have a look at the close-up view camera of the operating field that is overlaid or have a look at the pictures from the monitor just by turning the head when necessary. There is also the possibility of having a look at the Power Point presentation about the procedure.

Just looking at the pictures from the monitor is insufficient to learn laparoscopic surgery as important manoeuvres are necessary even to get the instruments into the field of view for which a simultaneous look at the monitor and outside view is important. The 360 video provides such opportunities. Close view of the operating field is not available to many despite being in the operating room with the surgeons. Virtual reality helps even remote surgeons have such a close view. It is possible to train many surgeons in rural areas with much less expense using this method.

The conventional teaching videos of the International Federation of Rural Surgeons [IFRS] are available on YouTube. ⁴ During the last 3 years, no one has written back saying that they started performing surgery after watching how to do it on the channel. However, recently they started Gas Insufflation Less Laparoscopic Surgeries at Kabale after watching the 360° - video on how to set up the device. ⁵ The Meru hospital in Kenya reported having performed over 40 procedures with the Laptop Cystoscope, according to a report from Kabale University. GILLS procedures were started in several hospitals in Kenya following the workshop.