Virtual Reality Head-Mounted Display (HMD) and Preoperative Patient-Specific Simulation: Impact on Decision-Making in Pediatric Urology: Preliminary Data

Author:

Lanfranchi Giulia1ORCID,Costanzo Sara1,Selvaggio Giorgio Giuseppe Orlando1,Gallotta Cristina2,Milani Paolo34,Rizzetto Francesco56ORCID,Musitelli Alessia1,Vertemati Maurizio23ORCID,Santaniello Tommaso34,Campari Alessandro7,Paraboschi Irene2ORCID,Camporesi Anna8ORCID,Marinaro Michela1,Calcaterra Valeria910ORCID,Pierucci Ugo Maria1ORCID,Pelizzo Gloria12

Affiliation:

1. Department of Pediatric Surgery, Children’s Hospital “Vittore Buzzi”, 20154 Milan, Italy

2. Department of Biomedical and Clinical Sciences “L Sacco”, University of Milano, 20157 Milan, Italy

3. CIMaINa (Interdisciplinary Centre for Nanostructured Materials and Interfaces), University of Milano, 20133 Milan, Italy

4. Department of Physics “Aldo Pontremoli”, University of Milano, 20133 Milan, Italy

5. Department of Radiology, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy

6. Postgraduate School of Diagnostic and Interventional Radiology, University of Milano, 20122 Milan, Italy

7. Pediatric Radiology and Neuroradiology Unit, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy

8. Pediatric Anesthesia and Intensive Care Unit, “Vittore Buzzi“ Children’s Hospital, 20154 Milan, Italy

9. Pediatrics and Adolescentology Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy

10. Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy

Abstract

Aim of the Study: To assess how virtual reality (VR) patient-specific simulations can support decision-making processes and improve care in pediatric urology, ultimately improving patient outcomes. Patients and Methods: Children diagnosed with urological conditions necessitating complex procedures were retrospectively reviewed and enrolled in the study. Patient-specific VR simulations were developed with medical imaging specialists and VR technology experts. Routine CT images were utilized to create a VR environment using advanced software platforms. The accuracy and fidelity of the VR simulations was validated through a multi-step process. This involved comparing the virtual anatomical models to the original medical imaging data and conducting feedback sessions with pediatric urology experts to assess VR simulations’ realism and clinical relevance. Results: A total of six pediatric patients were reviewed. The median age of the participants was 5.5 years (IQR: 3.5–8.5 years), with an equal distribution of males and females across both groups. A minimally invasive laparoscopic approach was performed for adrenal lesions (n = 3), Wilms’ tumor (n = 1), bilateral nephroblastomatosis (n = 1), and abdominal trauma in complex vascular and renal malformation (ptotic and hypoplastic kidney) (n = 1). Key benefits included enhanced visualization of the segmental arteries and the deep vascularization of the kidney and adrenal glands in all cases. The high depth perception and precision in the orientation of the arteries and veins to the parenchyma changed the intraoperative decision-making process in five patients. Preoperative VR patient-specific simulation did not offer accuracy in studying the pelvic and calyceal anatomy. Conclusions: VR patient-specific simulations represent an empowering tool in pediatric urology. By leveraging the immersive capabilities of VR technology, preoperative planning and intraoperative navigation can greatly impact surgical decision-making. As we continue to advance in medical simulation, VR holds promise in educational programs to include even surgical treatment of more complex urogenital malformations.

Publisher

MDPI AG

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