Progress in Virtual Reality Aiding Accurate Surgery

"It [deep brain stimulation surgery] makes a remarkable difference in a patient's quality of life."
"That is why this virtual reality environment is so helpful, because it actually allows us to turn it [visual brain mapping] into an intuitive, visual three-dimensional experience that can be used to more accurately place the electrode, as opposed to looking at the top of the skull and closing your eyes and trying to think, 'Where am I'?"
"We are talking about a refinement of millimetres. But millimetres matter."
"In deep brain stimulation surgery, because the target is very small and in the middle of the brain this leaves the surgeon with the problem of how to visualize the person’s brain to understand the area and where to put the electrode."
"This is really exciting. The deep brain stimulation electrodes will be more precisely placed because we’ll be able to integrate accurate images from the patient’s anatomy and visualize it in three dimensions."
Dr. Adam Sachs, director of neuro-modulation and functional neurosurgery, The Ottawa Hospital

"[Although virtual reality has been used for patients], doctors wearing the headsets instead of patients is fairly limited, largely because technology wasn't there in the past."
"We’re excited about working with the Sachs Lab because it is a perfect clinical example of using 3-D visualization to better understand a spatial problem."
"In this case, actually seeing a target for deep brain stimulation removes the burden on the surgeons of trying to create a 3-D model in their head."
"As far as we know, no one else is pursuing this type of thing, and it could have a global impact."
Dr. Justin Sutherland, medical physicist, radiation oncology department, The Ottawa Hospital

Dr. Adam Sachs virtually pokes around inside a virtual human brain at The Ottawa Hospital’s General campus Monday, March 18, 2019 with the help of new virtual reality technology. The 3D Virtual Reality Lab at the hospital has innovated technology scheduled to be rolled out this year that is the first of its kind, allowing neurosurgeons to increase their accuracy during deep brain stimulation for patients. Julie Oliver / Postmedia

The virtual reality laboratory at The Ottawa Hospital is still in the developmental phase of creating the cutting-edge technique whereby neurosurgeons are enabled to virtually 'step within' a patient's brain to achieve a close-up view of where an electrode will be ideally placed during deep brain stimulation surgery. Dr. Sachs, a researcher with the Ottawa Hospital Research Institute, anticipates he will be using this new high-tech tool within a few months in his hospital operating rooms.

For the past few years virtual reality has been a medical tool assisting in the training of physicians, and as well a tool useful in guiding patients with their rehabilitation, PTSD or other medical issues. Never before has virtual reality, however, been utilized in the way this direction is taking it as a technique developed for the purpose of improving the accuracy of surgery for patients with Parkinson's and other neurological diseases.

The medical physicist Justin Sutherland, on the left, explains the virtual reality technology as Dr. Adam Sachs neurosurgery pots almost inside someone's brain at the Ottawa Hospital general campus Monday, March 18, 2019   Julie Oliver

The goal of the surgery is to help in the reduction of tremors, slowness, stiffness and walking problems that Parkinson's and other neurological diseases cause to the sufferer. The expectation is that not only will mobility be improved, but the procedure can conceivably end up with a decreased reliance on medications whose side effects are decidedly unwanted. The issue is the implantation of a microelectrode no thicker than a human hair, through the skull and into a specific brain area; highly technical, precision-work.

Currently, surgeons make use of MRIs and brain atlases (visual brain mapping) to achieve a mental diagram of how the patient's brain appears. Negatively, the brain atlases are two-dimensional, produced from a compilation of many patients' brains. The use of virtual reality will aid in improving precision since surgeons can make use of accurate images from the patient's own brain in three dimensions, using MRIs and CT scans. Precision is key, critical in achieving the goal of deep brain stimulation.