A software-as-a-service platform that offers a low-cost and scalable simulation experience for trainee and qualified surgeons has been launched, combining VR with haptics.

According to the provider FundamentalVR, Fundamental Surgery creates an authentic environment allows users to experience and navigate the same visuals, sounds and feelings as they would during a real surgical procedure. This is said to be unlike some other medical training simulations which have made professionals feel like they have been through a game-like experience.

At the heart of the system is the Surgical Haptic Intelligence Engine (SHIE), which is calibrated to mimic the real-life sensations of many medical tools and tissue variants. Combining immersive haptic technology with low cost, off-the-shelf hardware, Fundamental Surgery is aimed at democratising surgical simulation through plug-and-play simplicity and a hitherto unachievable price point – less than a cost of one cadaver.

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Designed to improve patient outcomes while curbing the increasing cost of medical training that tops $15 billion a year in the US, Fundamental Surgery was created by a team of VR, haptic specialists and surgical training experts and has been extensively tested by over 500 surgeons.

Its initial US offering will focus on training packages within the orthopedic surgical disciplines. Current procedures supported include spinal pedicle screw placement, posterior hip replacement and total knee arthroplasty. Further orthopedic procedures will be added during Q4 2018 within other disciplines, including general surgery and cardiovascular planned for 2019.

Despite the massive advances in science and medical technology, the way surgeons are trained has remained largely unchanged for the past 150 years. Typically, this consists of classroom-based theory, theatre-style viewing of cadaver-based teaching, observation in the operating room (generally far removed from the actual procedure), hands-on cadaver practice (expensive, limited use), closely monitored live patient involvement and increasingly YouTube.

The introduction of simulations to supplement learning is a recent development. However, current solutions either require special, static machinery that costs $100K+ or provide a game-like experience with no sense of touch. This means only 0.5% of the world’s surgeons have access to simulations.

“Our missions is to democratise surgical training by placing safe, affordable and authentic simulations within arm’s reach of every surgeon in the world,” said Richard Vincent, founder and CEO of FundamentalVR. “With the help of some of the top minds in medicine, as well some of the most advanced VR and haptic programmers, we have created a solution that can be deployed anywhere – with limited investment – to allow surgeons to learn and hone their skills over and over again in a safe and controlled environment.”

For the cost of just one cadaver, hospitals and medical training facilities across the country can now offer realistic training experiences for surgeons to hone their skills anywhere at any time.

Fundamental Surgery eliminates the need for complex and expensive training systems. The software is hardware agnostic and works in conjunction with any modern PC or laptop, a standard VR headset and two haptic arm devices ¬– all of which are widely available for purchase.

While other simulations are limited to visual and audio interactions, Fundamental Surgery’s SHIE proprietary technology adds a realtime sense of touch. Users can feel the movement and interaction of tissue, muscle and bone as they would in an actual procedure within a submillimetre of accuracy of resistance.

SHIE contains a library of tools and tissue variants that mimic real life sensations that have been calibrated by a leading team of surgeons and key opinion leaders (KOLs). SHIE continually adapts with feedback and is designed to work with new haptic devices such as new arms and gloves as they become commercially available at low cost.

During each simulation, users will be able to assess and measure performances and receive realtime feedback on instrument use and techniques (including pedicle probe, x-ray and sagittal saw), procedural accuracy and patient impact. This information will also be able to be stored for both the user and the admin control, allowing changes in competency to be tracked, so progress and areas for refinement can be identified.

In addition, the system will be programmable to present users with branched outcomes – rare complications or scenarios that can happen during live procedures such as unexpected bleeding, abnormal anatomy or a change in a patient’s condition. Just as pilots train for bird strikes or engine failure, this capability better prepares the surgeon and facilitates better patient outcomes. This unique feature can be selected or randomised to reflect life’s events.