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2017 Virtual Reality Show

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The Virtual Hospital

The FreeHand team were at the London 2017 Virtual Reality (VR) show where a medical seminar was held to discuss the potential impact that virtual reality could have on the healthcare industry. Alongside the conference there were presentations from key technology providers including Microsoft, with their new HoloLens product, and an array of content developers that make use of this growing platform.

Microsoft with their HoloLens headset is not alone in the market place, the likes of Facebook (Oculus Rift), Sony (PlayStation VR), Samsung, LG and Google all having entered the fray offering a mixture of consumer and commercially focused products.

The Microsoft offering positions itself at the top end of the market in terms of sophistication, cost and breadth of development platform. In addition, they promise to open the door to the world of useful Augmented Reality (AR) sometimes referred to as Mixed Reality. AR has important differences to full VR. For example whilst VR envelops the user into a fully computerised world, AR allows the user to continue to operate in the real world whilst overlaying digital objects and information. This concept was explored in a simplistic way with (the now withdrawn) Google Glasses. However, Microsoft has advanced this platform by developing a technology that can “digitise” the real world in real time to provide a smooth and natural feel interface between reality and virtual reality.

To illustrate this, imagine putting a virtual cup of coffee on a real desk, with the virtual object interacting in a life like manner with the real table, i.e. it sits on top of the table and stays where you put it. If it is left there for a week it will still be there - a concept known as “World Locking”.

In the Virtual Hospital, this technology has the potential to streamline the way that primary, secondary and tertiary care is delivered and how the challenges of providing sufficient post treatment care programmes in the community are addressed. This means that this technology could change patient interaction with GPs and Consultants, how surgical procedures are carried out and how recovery and rehabilitation is monitored.

Microsoft refers this developing area of technology as the “IoT Edge”. The Internet of Things (IoT) has started to link a huge variety of devices to the ‘Cloud’ thereby improving remote monitoring and communications. In the future, this technology will link these devices to Cloud based analytics, machine learning and even artificial intelligence.

Laparoscopic surgeons already work in an environment that is akin to a virtual world, being detached from direct tissue contact through the interface of laparoscopic tools and from what they observe in the image from the laparoscope.

Surgical robotic systems provide a more extreme step into virtual reality with the surgeon being remote from the patient with no physical connection at all other than via the console and robotic interface. Robotic systems and robotic assisted surgery offer the ability to increase the reliability and control of what a laparoscopic surgeon is seeing and the precision in the manipulation of laparoscopic tools.

The Virtual Hospital seminar highlighted the importance of minimally invasive surgery in the hospital of the future. The surgical panel’s vision was of an increasingly less invasive surgical environment. There are clear patient and economic benefits in increasing the number of surgical procedures being completed using these techniques. However, the seminar highlighted several key issues:
  • Full robotic surgical systems are expensive to buy, maintain and use.
  • There are significant cost pressures in many healthcare systems.
  • There is currently little evidence to say that robotic systems provide value for money over traditional laparoscopic procedures.
  • Nevertheless traditional laparoscopic surgery has its own issues:
  • There is currently little compulsory training in laparoscopic surgical procedures.
  • 90% of procedures are done using older 2D cameras and screen technology making hand-eye coordination and fine depth manipulation and coordination more difficult.
  • There is a very steep learning curve.
  • Training is usually limited to a mixture of 2 day courses to help gain hand-eye coordination and ‘on the job’ experience.
  • New techniques are slow to be adopted.
  • In summary, the following requirements were described as critical to increase the number of robotic and laparoscopic procedures:
  • Robotic procedures need to be considerably cheaper to be “universally” available and applicable.
  • Haptic feedback in robotic systems needs to be better and universally available.
  • Training needs to become easier and more accessible.
  • Visualisation technology needs to improve to provide better depth perception.
  • At Freehand we are developing systems and products to be applicable to a wide range of laparoscopic procedures, providing better visualisation and supporting the adoption of High Definition and 3D technologies. We believe that providing a stable, more predictable image can decrease the learning curve for surgeons looking to develop the necessary skills to perform laparoscopic procedures.

    The FreeHand system has a gesture based control system with the robotic arm’s mode of movement being selected through the surgeon’s head movement using technology similar to the sensors built into the current generation of VR headsets. The system maintains the direct contact between surgeon and patient as in traditional laparoscopic procedures and can be easily used with the new generation of robotic hand-held tools.

    Laparoscopic procedures are expected to grow at between 6-9% p.a. and Goldman Sachs research indicates that robot-assisted procedures will double in the next two years.

    VR and AR in the operating theatre are new technologies but ultimately will be developed to the point of providing better control interfaces for both accessing data and manipulating the real world through interfacing with robotic manipulators. The FreeHand system provides an accessible first step down this path.

    If you would like to find out more about our products and how they fit into this landscape please contact us for further information.

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