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Early-stage innovation report
Virtual reality experience for in utero fetal surgery: a new era of patient counselling and medical education
  1. Yair J Blumenfeld1,
  2. David M Axelrod2,
  3. David Sarno3,
  4. Susan R Hintz4,
  5. Karl G Sylvester5,
  6. Gerald A Grant6,
  7. Michael A Belfort7,
  8. Alireza A Shamshirsaz7,
  9. Yasser Y El-Sayed1
  1. 1 Obstetrics & Gynecology, Stanford University School of Medicine, Stanford, California, USA
  2. 2 Cardiology, Stanford University School of Medicine, Stanford, California, USA
  3. 3 Lighthaus, Inc, San Francisco, California, USA
  4. 4 Pediatrics, Stanford University School of Medicine, Stanford, California, USA
  5. 5 Surgery, Stanford University School of Medicine, Stanford, California, USA
  6. 6 Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
  7. 7 Obstetrics & Gynecology, Baylor College of Medicine, Houston, Texas, USA
  1. Correspondence to Dr Yair J Blumenfeld, Obstetrics & Gynecology, Stanford University School of Medicine, Stanford, CA 94304, USA; yairb{at}stanford.edu

https://doi.org/10.1136/bmjinnov-2021-000799

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    Summary box

    What are the new findings?

    • A fetal virtual reality (VR) programme was created for twin-to-twin transfusion syndrome and fetal spina bifida.

    • The programme allows the user to immerse himself/herself in the intrauterine environment and to between understand the pathophysiology of disease, ramifications for the developing fetus, and the proposed intervention.

    How might it impact on healthcare in the future?

    • The fetal VR programme can be used as an adjunct tool for patient counselling.

    • The fetal VR programme can be used as an adjunct tool for medical education.

    • Using this approach, additional fetal VR programmes can be developed for other fetal conditions.

    Introduction

    Fetal anomalies complicate approximately 3%–4% of all pregnancies. Counselling expectant parents facing a diagnosis of a fetal structural anomaly or obstetrical complication is challenging. Following image acquisition (usually via prenatal ultrasound (US)), medical providers are tasked with conveying the finding, the pathophysiology of the anomaly, the spectrum of possible outcomes and (when appropriate) a proposed in utero therapy to treat severe fetal conditions. Unfortunately, patients’ limited ability to interpret prenatal US and adjunct MRI studies, and sometimes a limited health literacy, can compromise patient understanding and important decision making. In order to assist with patient education, physicians often use premade illustrations and real-time drawings to represent the difference between normal fetal development and the fetal anomaly. Optimising patient medical understanding is particularly important in cases where fetal surgery is offered as a management option, as patients need to decide whether or not to undertake significant operative risk in order to optimise fetal outcome.

    Virtual reality (VR) is increasingly being applied to a variety of healthcare settings both for patient counselling and medical trainee education.1–3 Specifically, trainees at all levels of medical and surgical training have described a greater mastery of complex anatomy and favoured the addition of VR to routine education using a lectures and textbooks.4 5 Recently, members of our …

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    Footnotes

    • Contributors All authors participated in the study design and manuscript writing of this submission. YJB conceived the idea, developed the VR platform and contributed to the manuscript writing; DMA developed the VR platform and contributed to manuscript writing; DS developed the VR platform and contributed to the manuscript writing; SRH helped to develop the idea, assisted with VR platform development and contributed to the manuscript writing; KGS assisted with VR platform development and contributed to the manuscript writing; GAG assisted with VR platform development and contributed to the manuscript writing; MAB assisted with VR platform development and contributed to the manuscript writing; AAS assisted with VR platform development and contributed to the manuscript writing; YYE-S helped to develop the idea, assisted with VR platform development and contributed to the manuscript writing.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests DS is the founder and CEO of LightHaus, the developer of the VR platform.

    • Provenance and peer review Not commissioned; externally peer reviewed.