A surgeon, cancer specialist, and co-founder of virtual and augmented reality firm Medical Realities, Dr. Shafi Ahmed performed an important surgery last April at The Royal London Hospital. It was the first surgery live-streamed to the world in virtual reality—an experience Dr. Ahmed wants to repeat in order to train thousands of medical students at the same time.
ME e-mag: Can you explain to us the preparation involved?
Dr. Shafi Ahmed: We used a camera rig with six lenses, which was suspended just above the operating table, hanging from the lights. That [rig] was creating a 360-degree video, [which was] stitched together immediately and then streamed live. We also had an app called VR in OR (Virtual Reality in the Operating Room), that people could download on iOS, Android and on Medical Realities’ website. They could click it and be directly immersed to the live scene, using VR headsets to watch the operation. So basically with a smartphone, a free app, and cardboard—a cheap device—they could be immersed into the operating room. It was a low-cost approach.
To me, it was like a normal operation. The only difference was that I was talking and teaching in front of the world with the pressure of TV cameras close by and also making sure that we were appropriate. Because 65,000 people watched on live the operation, in 140 countries, in 4,000 cities, and we reached 4.5 million people on Twitter and 150,000 views on YouTube. So it was a big event.
ME e-mag: You did a similar thing two years ago?
Dr. Shafi Ahmed: Yes, with the Google Glass. It was a live retransmission of an operation, and at that point we taught in front of 14,000 students and trainees across the globe. They were interacting with me using text messages on the Google Glass, for example, and that went really well. We had a good experience.
But then virtual reality came in, a new technology, a new way of doing things. So the natural extension for that was to do the same thing in VR, which would give a much more immersing environment. With the Google Glass, it was only one aspect, one point of view—the things that I was seeing through the glasses. What we want now is to create a greater immersion, watching how the team behaves, what’s going on around, the different noises. It would be much more an educational tool.
ME e-mag: Why did you run the video a minute behind the surgery?
Dr. Shafi Ahmed: We talked about all the risks that could happen during the operation. We talked about the patient, the safety, the security. Safety was the biggest concern. When you’re operating in front of the world you can feel a lot of pressure, so we thought that it would be better to run the video a minute behind so if anything went wrong we could just stop the streaming. That would be better for the patient. But for training, it would be actually better if students could see the complications because it’s part of what we do.
ME e-mag: The primary purpose of this VR surgery is education?
Dr. Shafi Ahmed: Yes, because healthcare around the world is not fair. According to the paper that came out last year in Lancet, 5 billion people around the world—out of 7 billion—have no access to safe and affordable surgery. If we need, like the paper suggests, about 2.2 million extra surgeons and we need another 150 million operations, we have to think about how to train people on a bigger scale.
The next step is to create a virtual surgeon. It would be a perfect simulation tool, with the creation of videos and educational content.
So my idea is that having trained 10,000 people at the same time could be a solution. You only need an Internet connection with a smartphone. It’s about using cheap and smart technology to make it work. Last month we had viewers from Africa, Asia, South America. So we could penetrate every single country.
Last month, it was only a demonstration of the project and the technology. We wanted to demystify surgery, which is often seen as secretive. We also wanted to inspire school kids and the young generations to study medicine. But in the future we will do it more secretly—it will be part of training, and we can have partnerships with medical schools to train surgeons on a more targeted basis.
ME e-mag: Will students be able to interact with you next time?
Dr. Shafi Ahmed: We’re not quite sure. There is no way to do this interaction in a VR environment. That’s the next level and we’re working on that. Also, the next step is to create a virtual surgeon. It would be a perfect simulation tool, with the creation of videos and educational content—you make it interactive with the possibility of touch control and haptic feedback. It would be actual virtual reality where you could see a virtual body, which is not real, and you would be able to make a cut, feel the gloves, etc.