Virtual Reality Enhances Brain Surgery

UCSF Benioff Children’s Hospitals has been re-envisioning the entire pediatric health care experience with technology that most young patients can relate to—virtual reality (VR). At the hospital’s Oakland campus, patient and family anxiety levels are lowered prior to brain surgery with a VR tour of the surgical path to their tumor, guided by the child’s neurosurgeon. Meanwhile VR is used to educate medical staff more thoroughly and communicate clearly about an upcoming surgery.

Kurtis Auguste, MD, department of surgery chief at UCSF Benioff Children’s Hospital Oakland, uses VR technology to give patients and their families 3D “fly-through” tours of his patients’ brains, including up-close looks at tumors and the major nerves and blood vessels surrounding them. Auguste uses this technology to enhance his view of the problem area with exponentially more detail than can be provided by a standard MRI or CT scan.

“This technology is unlike any visual platform I’ve ever experienced—it is an actual immersive experience,” Auguste said. “I can use this to plan a surgery and determine the best roadmap to a target in a way I never could before.”

In a recent examination of a 10-year-old patient’s brain, the technology showed that a tumor was draped with nerve fibers serving the brain’s visual system, risking blindness for his patient if manipulated too aggressively. In addition, major veins blocked direct access to the tumor.

Wearing a headset and “standing inside” a 360-degree VR model of the patient’s brain, Auguste discovered an artery buried deep inside the child’s tumor—a feature that was not visible on standard 2-dimensional imaging and may not have otherwise been discovered until mid-surgery. Armed with this critical information, Auguste and his surgical team identified this vessel early during tumor removal and protected it throughout the procedure. The entire tumor was removed safely and the patient remained neurologically intact.

The patient, who suffered from migraines and seizures from the tumor, is now tumor- and seizure-free.

VR technology relieved much of the anxiety of their daughter’s brain surgery, the patient’s mother said. “We got to really ‘see’ the tumor and where the critical surrounding areas were,” she said. “I don’t think my husband, daughter or I would have been so calm without seeing those images.”

Parents say they benefit from an increased understanding of the neuroanatomy and surgical plan, and the VR-based patient consultation empowers their child, the patient. The result is a more comprehensive consult with the entire family and health care team.

Auguste successfully completed beta testing of VR technology created by Surgical Theater of Ohio at UCSF Benioff Children’s Hospital Oakland one year ago, and has now fully integrated VR into both pre-operative surgical planning and during procedures in the operating room. But the ability to conduct VR tours with families during shared VR patient engagement sessions is perhaps the most exciting development in his practice, he said.

“Nothing quite compares to having each participant ‘fly’ themselves alongside me as we explore the anatomy together. We are proud to be the first hospital in the country, children’s hospital or otherwise, to routinely perform shared VR experiences with our patients and families,” Auguste said.

Donors such as Eric Rudney of Alamo are kicking off a campaign to fund the expansion of this technology.

“When I learned about this VR program, I knew it would be cutting-edge technology that would deeply enhance the lives of children and the work that is performed at UCSF Benioff Children’s Hospital on a daily basis,” Rudney said. “The level of care that patients receive is unsurpassed, and this program is one of many that proves it!”