Virtual Reality and Simulation for Progressive Treatments in Urology

Public Perceptions of Male Hormone Levels and Prostate Health: A Text Mining Analysis of South Korean Media and Online Communities

PURPOSE

The purpose of this study is to identify social perceptions and public concerns related to male hormone levels and prostate cancer. To do so, we analyzed news and community data from Naver, Daum, and Google, the three most active social media platforms in South Korea, to explore how male hormone levels and benign prostatic hyperplasia (BPH) are covered in the media and discussed within online communities.

METHODS

We analyzed three years of data from community discussions and news articles from July 2021 to June 2024. Text mining techniques were used to collect data with the keyword 'male hormone levels' to understand the portrayal of these issues in news and online communities as well as the public's social perceptions and concerns.

RESULTS

The analysis showed that news coverage of 'male hormone levels' initially drew public attention by highlighting information related to celebrities and events while discussion on 'prostate enlargement' largely focused on medical treatments and information. The online community served as a platform where news-triggered issues were rediscussed through personal experiences and opinions, thus influencing public perceptions. However, the community discussions leaned more towards sexual dysfunction rather than prostate enlargement. These findings suggest that while news and online communities shape public awareness in different way, they both contribute to shaping social understanding of male hormone level and BPH.

CONCLUSION

This study highlights the significant roles that news and online communities play in shaping social perceptions of male hormone levels and BPH. However, sensationalism in media coverage may lead to biased information and reinforce false stereotypes. Future studies can be done to incorporate data from diverse cultural contexts and extend the data collection period to further explore shifts in public perceptions and the evolution of social discussions surrounding male hormone levels and BPH.

Virtual reality intervention as a support method during wound care and rehabilitation after burns: A systematic review and meta-analysis

OBJECTIVE

This systematic review and meta-analysis aimed to analyze and synthesize the evidence on the effectiveness of virtual reality (VR) interventions in the prevention of pain, fear and anxiety during burn wound care procedures.

METHODS

In September and October 2021, PubMed, Scopus, Cochrane Library and Web of Science were searched for relevant randomized controlled and crossover studies. Two independent authors described the following inclusion criteria for the search: patients undergoing burn wound care with applied VR treatment compared to any other or non-VR intervention. From a total of 1171 records, 25 met the inclusion criteria. After full-text screening, seven publications were excluded. The risk of bias was assessed for 18 studies by two independent authors. RevMan 5.4 was used for the statistical analysis, meta-analysis and visual presentation of the results.

RESULTS

The meta-analysis showed a significant difference between VR treatment and standard care when analyzing pain outcome during wound care procedures (SMD = -0.49; 95% CI [-0.78, -0.15]; I2 = 41%) and in subgroup analysis when immersive VR was incorporated (SMD = -0.71; 95% CI [-1.07, -0.36]; I2 = 0%). No significant differences were found between VR treatment and standard care for range of motion outcome (SMD = 0.44; 95% CI [-0.23, 1.11]; I2 = 50%).

CONCLUSIONS

VR seems to be an effective therapeutic support in burn wound care procedures for reducing pain. However, this systematic review and meta-analysis highlights the need for more research into the use of VR as a distraction method. Studies on larger groups using similar conditions can provide unequivocal evidence of the effectiveness of VR and enable the inclusion of such intervention in standard medical procedures.

Panoramic Imaging Assessment of Different Bladder Phantoms - An Evaluation Study

OBJECTIVE

To evaluate "panoramic image stitching" for cystoscopy, a novel technique to augment a urologist's field of view transoperatively in real-time during a cystoscopic "keyhole" procedure, 3-D bladder phantoms provide a suitable setting. Thus, the objective is the evaluation of different 3-D printed bladder phantoms with respect to their ability to be used for extended experiments of panoramic cystoscopy.

MATERIALS AND METHODS

Five bladder phantoms with different geometries, surface textures, stiffness and materials were assessed with rigid 0- and 30-degree lenses and a video-cystoscope regarding suitability for image stitching. For panoramic image generation, we use an established real-time stitching approach successfully applied to retrospective cystoscopy image sequences from real clinical cases. For evaluation of the experiments two quality criteria were defined, namely 'completeness' (describing the internal area of the phantom that can be stitched), and 'extension' (how far does an acquired panorama extend beyond the assumed 'equator' of the phantom).

RESULTS

Panoramas of all phantom and endoscope combinations were computed. Using landmarks (south pole, north pole, equator) in the phantoms, maximum extension of the panoramas was assessed. The computed panoramas yield maximum extensions between 270^o (0-degree cystoscope) and 330^o (video cystoscope). Deformable phantoms yield larger panoramas than the rigid models.

CONCLUSION

In can be concluded that the stitching process works quite well with all evaluated phantoms. Nevertheless, a novel phantom would be needed, combing a deformable, elliptical geometry and real-type vascular texture in the inside, that can be filled with water.

The role of virtual reality in the changing landscape of surgical training

BACKGROUND

The current coronavirus disease 2019 pandemic has caused unprecedented challenges to surgical training across the world. With the widespread cancellations of clinical and academic activities, educators are looking to technological advancements to help 'bridge the gap' and continue medical education.

SOLUTIONS

Simulation-based training as the 'gold standard' for medical education has limitations that prevent widespread adoption outside suitably resourced centres. Virtual reality has the potential to surmount these barriers, whilst fulfilling the fundamental aim of simulation-based training to provide a safe, effective and realistic learning environment.

CURRENT LIMITATIONS AND INSIGHTS FOR FUTURE

The main limitations of virtual reality technology include comfort and the restrictive power of mobile processors. There exists a clear developmental path to address these restrictions. Continued developments of the hardware and software set to deepen immersion and widen the possibilities within surgical education.

CONCLUSION

In the post coronavirus disease 2019 educational landscape, virtual, augmented and mixed reality technology may prove invaluable in the training of the next generation of surgeons.

3D-printed models and virtual reality as new tools for image-guided robot-assisted nephron-sparing surgery: a systematic review of the newest evidences

PURPOSE OF REVIEW

Nowadays, kidney cancer surgery has been focusing on a patient-tailored management, expanding the indication to nephron-sparing surgery (NSS). Starting from computer tomography images, 3D models can be created, allowing a never experienced before understanding of surgical anatomy. Once obtained the models can be printed or virtually visualized with the aid to assist the surgeon in preoperative planning and simulation or intraoperative navigation. The aim of this systematic review is to assess the preoperative and intraoperative impact of 3D printed and virtual imaging for robotic NSS.

RECENT FINDINGS

Ten articles were found to meet the inclusion criteria and reviewed. An 'intermediate' score was assessed to the overall articles' quality. A moderate/high risk of bias was recorded for all the studies.

SUMMARY

3D-printed models were considered to be more useful during both preoperative simulations and patients' counseling. These models guaranteed a better comprehension of anatomical structures and surgical procedure. Costs and quality of the materials available represent the two main limits of this developing technology.Instead, in a virtual reality setting the preoperative planning was enhanced by using 3D virtual models in a mixed reality environment. Intraoperatively, the possibility to overlap the 3D model to real anatomy allowed augmented reality procedures. This technology is still a 'newborn' and is constantly evolving, expanding day by day the range of its potential applications.

Augmented and Virtual Reality in Anatomical Education - A Systematic Review

Learning anatomy traditionally has depended on traditional techniques like human cadaveric dissection and the use of textbooks. As technology advances at an ever-rapid speed, there are revolutionary ways to learn anatomy. A number of technologies, techniques and methodologies are utilised in anatomical education, but ones specifically receiving a lot of interest and traction is that of augmented reality and virtual reality. Although there has been a surge in interest in the use of these technologies, the literature is sparse in terms of its evaluation as to the effectiveness of such tools. Therefore, the purpose of this study is to examine in greater detail the literature specifically to see what the best practice in this field could be. By undertaking a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched for articles in both Web of Science and PubMed. Using the terms "augmented reality and teaching anatomy" yielded 88 articles. We then used "virtual reality and teaching anatomy" which resulted in 200 articles. We examined these articles, including that on augmented reality and virtual reality used to teach anatomy to undergraduate and postgraduate students, residents, dentistry, nursing and veterinary students. Articles were excluded if they were systematic reviews, literature reviews, review articles, news articles, articles not written in English and any literature that presented how a virtual model was created without the evidence of students testing it. The inclusion and exclusion criteria for virtual reality were the same as augmented reality. In addition, we examined the articles to identify if they contained data which was quantitative, qualitative or both. The articles were further separated into those which were pro, neutral or against for the use of these digital technologies. Of the 288 articles, duplicate articles totalling 67 were removed and 134 articles were excluded according to our exclusion criteria. Of the 31 articles related to augmented reality, 30 were pro, one neutral and no articles against the use of this technology. Fifty-six articles related to virtual reality were categorised resulted in 45 pro, eight neutral and three against the use of this technology. Overall, the results indicate most articles identified related to both virtual and augmented reality were for the use of those technologies, than neutral or against. This systemic review highlights the recent advances of both augmented reality and virtual reality to implementing the technology into the anatomy course.

Creating a low-cost virtual reality surgical simulation to increase surgical oncology capacity and capability

Worldwide, more than 80% of people with cancer will require surgery during their disease course, but less than 25% have access to safe, affordable and timely surgery. Among the barriers to increasing surgical capacity are the time and costs required to train novices. Virtual reality (VR) surgical simulations can reduce the time required for novices to reach surgical proficiency, though their costs may exceed USD $100,000. The goal of this study was to determine if a low-cost system, using commercially available technology designed for in-home computer gaming, could be used to create a realistic VR surgical oncology simulation. Standard commercially available VR software and Oculus Rift hardware have been used to provide high-quality visuals and believable surgeon hand interactions. Near identical VR reproduction of an operating room using 1:1 scale matching of real-world elements, including equipment, instruments, supplies and sounds, maintaining frame rate greater than 60 fps to maintain visual fidelity has been created. Internal anatomy was designed as VR replica of human female pelvic anatomy, including organs, veins and other vessels, peritoneum and connective tissue. Internal anatomy was designed to run at 120 fps and to allow for a realistic abdominal radical hysterectomy simulation. Surgical hands were modelled to scale for those with large and small hands. Multiple hand positions were simulated using Oculus touch hardware. Reconstructing the virtual environment to simulate reality as accurately as possible was done to immerse users in the simulator so that they focus on learning and practise without distractions. Training modules were co-designed by experts in learning sciences, human behaviour, VR and gynaecologic oncology. We have successfully created a low-cost VR simulation to help prepare novice surgeons to perform a radical abdominal hysterectomy surgery procedure. The simulation can be used with commercially available computer gaming hardware that currently costs less than USD $1,500. Low-cost VR simulation has the potential to reduce the time and cost to train surgeons to perform surgical oncology procedures, as well as both improve and audit quality. If effective in real-world clinical trials, such simulations have relevance to multiple surgical procedures and applicability in both resource-limited and high-income settings.