Beyond Gaming: How Osso VR is Already Transforming Surgical Training

Featured on MedGadget by Scott Jung.

In a nondescript office building in downtown Palo Alto, I enter a conference room with the furnishings of a typical Silicon Valley tech company. Suddenly, my view changes, and I am transported to the inside of a brightly lit operating room, myself fully gowned and staring down at the exposed knee of an anesthetized patient. I turn my head to the right, pick up an orthopedic insertion handle, and slowly step toward the patient.

So begins my meeting with our own Medgadget editor, Dr. Justin Barad, who is co-founder and CEO of Osso VR, a company that is seeking to modernize surgical training through the use of virtual reality (VR).

But what about surgical training that is in need of technological disruption?

According to Dr. Barad, the typical training process for surgeons (at least the orthopedic specialty) largely consists of low-tech instruction manuals and videos, and often involves traveling to one-day surgical training courses. On occasion, there might be a single brief training procedure on a cadaver. It is often many months later that the surgeon is thrown into the operating room to perform the newly learned technique on real patients without having had any real practice. It’s no wonder that residents can become so uneasy during their first live surgeries, and patients consequently can be averse to being operated on in teaching hospitals or treated with new surgical techniques.

With Osso VR, orthopedic surgeons can not only freely look and move around their environment with a VR headset, but the hand controllers allow them to hold and manipulate tools and devices in the right sequence and “operate” on a patient’s leg with accurate and precise movements. And while it might at first sound a little like a more serious version of the Surgeon Simulator 2013 game we wrote about in 2013, Osso VR makes the experience as accurate as possible and grades your performance based on time, accuracy, and other metrics that surgeons are typically evaluated on.

One of the benefits of this is that orthopedic surgeons can train for procedures on their own time before operating on real patients. Osso VR could even be given to first-year medical students (or heaven forbid, armchair surgeons like yours truly) to jumpstart their training.

Like the majority of VR-based experiences, haptic feedback was limited to soft taps and vibrations when drilling and hammering. I asked Dr. Barad if a lack of realistic tactile feedback was ever a point of concern. He replied that, surprisingly, the VR experience is so immersive that the brain tends to create its own haptic feedback when it thinks the hand is supposed to be touching or grasping something, and the user doesn’t even realize it. He even shared that the first time he played with Intuitive Surgical‘s da Vinci Surgical Robot, he remarked how great the tactile feedback was, even though there wasn’t any!

I also asked Dr. Barad a bit about the quality of the graphics. While Osso VR is built on the popular Unity game engine, you probably wouldn’t consider the graphics to be super photorealistic. Dr. Barad shared that the purpose of Osso VR isn’t to train with minute precision; it’s to get users comfortable with the sequence of events in a surgical procedure and to train them how to use the different tools and devices. As users continues to train with the software, these steps eventually become muscle memory, allowing them to focus more on precision and technique when it comes time to operate on live patients. Dr. Barad also surmised that overly-realistic graphics could have unintended negative consequences with the "uncanny valley" phenomenon, so Osso VR’s were intentionally stylized.

While Osso VR is only a little over a year old, they’ve been hugely successful as of late. They recently raised $2 million in funding and won awards from MedTech Innovator and the U.S. Department of Education. Most proudly, Dr. Barad shared, was that a recent UCLA study showed that a group of first-year medical students who trained to perform a tibial nail placement procedure using Osso VR outperformed a control group of first year medical students who performed the procedure without training, based on evaluations from a blinded observer. Their scores were comparable to the skill level of a 2nd or 3rd year surgical resident!

And Osso VR is only getting started. Dr. Barad shared that in addition to medical schools, Osso VR is already working with several major orthopedic medical device manufacturers to develop training for using and implanting their devices.

I’ve always thought virtual reality to be just another novelty technology with limited utility. But after demoing Osso VR’s realistic and immersive experience being the head and hands of an orthopedic surgeon, I’m beginning to think there might be a place for VR outside of the gaming and technology industry. A brief escape into the virtual world certainly isn’t a bad thing if it’s helping to improve real lives.

The Medgadget team is honored that Justin has been a valuable part of the family for over a decade and are excited to see what surgical training programs he’s ready to disrupt!

To see how the Osso VR works click here.

For more information on Osso VR click here.