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Virtual reality simulator hones eye surgery skills

Mar. 20, 2014, 8:54 AM

Laura Wayman, M.D., looks on as Ophthalmology resident Chris Estopinal, M.D., uses the Eyesi Surgical virtual reality simulator. (photo by Anne Rayner)

Virtual reality environments are a common feature used in the aviation industry to train pilots, and now they’re also proving to be a very effective tool in educating the next generation of ophthalmological surgeons at Vanderbilt University Medical Center.

Vanderbilt is one of a handful of programs in the country using the traditional hands-on teaching mechanism of the wet lab in addition to the newest surgical teaching devices, such as the Eyesi Surgical, a high-fidelity virtual reality simulator for intraocular surgery training.

“This is an impressive piece of equipment that will have a positive impact on our resident’s skills in the operating room,” said Laura Wayman, M.D., associate professor of Ophthalmology and Visual Sciences, vice chair of Education and director of Resident Education for the Vanderbilt Eye Institute (VEI).

“We have already been able to see that their microsurgical skills have much improved. And with 24/7 access, residents are able to utilize the system as much as they need, while getting detailed feedback from the computer about their surgical skills.”

The computerized training readies surgeons for cataract and retinal operations, with the goal of reducing complication rates and operative times to improve patient care, Wayman said.

The $250,000 Eyesi was purchased by the Veterans Affairs Tennessee Valley Healthcare System and is housed in their eye clinic for VEI residents and fellows, who also rotate at the VA.

“This was a benefit for not only our veterans, but also for the residents,” said Sam Sells, M.D., MPH, associate chief of staff for education at the VA. “We have the ability to train residents. They are able to practice their skills, become competent and progress on to the OR when they are proficient.

“This is really a neat tool. It’s as close to a live situation that you can get. But what is great is that the computer monitors the residents’ progress and skills and provides a very detailed report so that they know what specific details need work.”

Chris Estopinal, M.D., a second-year Ophthalmology resident, agrees that the computerized simulator has been a boost to the training regime.

Estopinal takes a seat at the head of his “patient.” He places his feet on the pedals below to operate the microscope and suction apparatus. Looking through the eye pieces of the microscope, used in surgical procedures, he enters into the virtual reality experience.

Eyesi gives him a specific task to complete to develop the necessary skills to perform microsurgery and cataract procedures. He begins the procedure, placing appropriate surgical tools into the eye of the patient. The screen adjacent to his work area shows a view of the patient’s eye during surgery.

“This is a new technology that is allowing me to get feedback in real time,” said Estopinal. “I am able to try different hand positions, use different instruments and perform various procedures at my own pace. It is allowing me to get comfortable with the surgical tasks so that I am able to bring those skills into the OR and be prepared.”

According to Wayman, surgical judgment and manual dexterity can be improved while practicing various simulations using the Eyesi. Residents are not only learning how to properly use the instruments, but to also work the pedals to control the microscope.

As they progress through the various levels, the residents will be asked to perform different steps of cataract surgery, Wayman said.

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