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Watching surgery in VR isn't for the faint of heart

Engadget Engadget 15/04/2016 Nick Summers

© Provided by Engadget

Next month, my mom will retire as a theatre nurse. For almost forty years she's been walking into her hospital on a near daily basis, donning a fresh pair of scrubs and helping a surgical team save people's lives. I couldn't be prouder. But truth be told, I know little about her job and what actually happens when someone is wheeled inside the operating theatre. In my head, it's just a nightmarish blur of sedatives, scalpels and face masks.

That's why I leapt at the chance to watch some surgery at the Royal London Hospital. Not from inside the operation room -- oh no, I'm far too much of a scaredy-cat for that -- but through a VR headset. Doctor Shafi Ahmed, co-founder of AR and VR firm Medical Realities, made history as the first person to live stream surgery in virtual reality. You could watch it in a browser or using a smartphone with the VRinOR app for iOS and Android. I went with the latter, slipping my Moto X Pure Edition into a beaten up Google Cardboard that's been gathering dust on my desk.

The stream on my phone went live a little late, so I missed some of Ahmed's introduction explaining the intricacies of the operation. But here are the basics: a British patient in his 70s was suffering from bowel cancer. Ahmed and his team needed to perform laparoscopic or "keyhole" surgery to dig inside and cut loose a section of his intestine which contained the tumor. An incision would be made to remove it, followed by some delicate patch-up work. It was a routine operation and unlikely to cause complications, but they placed a one-minute delay on the broadcast anyway, just to be on the safe side.

The first 40 minutes were a flurry of hands and instruments. Looking down towards the end of the table, I could see Ahmed with a pair of cutting forceps, carefully picking at the patient's innards. A section of the torso was clearly visible, but the poor lighting and a slightly pixelated stream meant it was difficult to make out what, exactly, happening. That wasn't helped by the four or five other people huddled around Ahmed, holding additional forceps and the all-important "telescope" camera.

I was constantly squinting and craning my neck to see the nearest monitor, which was angled awkwardly in relation to the camera rig.

Everyone's eyes were fixed on two monitors showing the camera's perspective. That's where the action was happening. Here, you could see Ahmed expertly tugging and cutting to free the tumor from its surrounding tissue. Occasionally, he would request that someone adjust the camera or reposition their tongs. I felt sick but kept my eyes on the nearest screen, watching the team quietly work.

At this point in the procedure, watching everything unfold in VR seemed a little pointless. Here I was, starting at a video feed inside a video feed. I was constantly squinting and craning my neck to see the nearest monitor, which was angled awkwardly in relation to the camera rig. A simple live stream of the camera inside the patient's stomach would, in many ways, have been more insightful, provided it was supplemented with the chatter from the operating theatre.

A 360-degree video made by Medical Realities for training purposes.

Those feelings evaporated, however, as soon as the team started to extract the tumor, because everything was happening in plain sight. Ahmed performed the incision and the specimen was quickly on the table, clearly visible to everyone in the room, including myself. I didn't need to squint at a monitor anymore -- I could just watch the surgeons as they worked right in front of me. A few targeted snips and the infected colon was in a petri dish, ready to be whisked off to a laboratory. The team then took out scissors and thread, repairing and re-plumbing what was left of his intestines. It was fascinating to watch, and at this moment I noticed the theatre nurses coming into their own. Whatever Ahmed needed,they were two-steps ahead and ready with the correct utensil.

Watching the operation with Google Cardboard was a little finicky. My headset doesn't have a head strap, so it was tiring to hold it in position for a couple of hours. On a number of occasions I also noticed the headset's orientation beginning to drift. To look flat along the operating table, for instance, I would eventually find myself staring at the floor or up at the ceiling. Eventually the app would register the problem and reset, snapping my vision back into the proper position. These moments happened with such frequency, however, that I quickly became irritated. The image quality was also pretty poor -- I suspect, however, that this was because of the live stream, rather than my own connection or Cardboard headset.

Despite these technical niggles, I was enthralled by the experience. Afterwards, I Skyped my mom to ask some questions about the procedure, and for the first time, well, ever, we had a conversation about her work that went beyond 'it was a stressful day' or 'the operation had some complications.' For that alone, I'm glad I took the time to strap on a Cardboard and watch Ahmed work for a few hours. Even if it meant feeling queasy and rushing to the bathroom a couple of times.

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