Pilot Assessment of Immersive Virtual-Reality Renal Models as an Educational and Preoperative Planning Tool for Percutaneous Nephrolithotomy

This project was the brainchild of Dr. Shoaib Safiullah, who was at UC Irvine for a year as one of two Leadership and Innovation Fellowship Training medical students, and his colleague Ryan James at the University of Washington. The concept of using immersive VR rapidly grew to include patient education as well as surgeon experience. For both groups, it proved to be of significant value. In the former with regard to relieving preoperative anxiety and increasing understanding of their impending surgery while in the latter it improved the understanding of the renal anatomy in relation to the kidney stone leading to less blood loss, less fluoroscopy time and a trend toward fewer access tracts and higher stone-free rates (retrospective matched controls).

Subsequently, we have found iVR to be of value also in the planning and execution of laparoscopic/robotic partial nephrectomy and in donor nephrectomy. What has been most striking is that the viewing of the iVR immediately prior to surgery has resulted in the surgeon altering the operative approach in 40-65% of cases! The next step is to further test the hypothesis that iVR is beneficial prior to surgery via a prospective randomized study for patients scheduled for percutaneous stone removal, partial nephrectomy, or donor nephrectomy. Simultaneously we are working with computer scientists at UCI to develop a method to make the conversion of CT or MR images into an interactive, immersive VR experience less time consuming as it currently requires 1-2 hours to accomplish.

Written by: Ralph V. Clayman, M.D. Professor, Department of Urology Dean – emeritus, University of California, Irvine, Department of Urology, Orange, CA

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