Inspiration

Using various technologies and taking to heart the advice from a Pediatric Psychologist from Shands Children’s Hospital, Dr. Rao, our team has built a project aiming to be able to help kids deal with and overcome their fear of surgery. Our Virtual Reality Experience, built for the Oculus Rift and Samsung Gear VR, is a virtual representation of a hospital (based on Shands Hospital) that includes the pre-operation and operation rooms, along with the child’s transitioning between the two. These rooms include all of the people a child would encounter before, during, and after surgery, including nurses, technicians, surgeons, and an anesthesiologist.

Surgery can induce severe anxiety in children, which according to the National Center for Biotechnology Research,

“Severe anxiety can cause unpleasant symptoms and stress. Typical symptoms include a pounding heart, a racing heart (fast pulse), irregular heartbeat, nausea, a nervous stomach, shortness of breath and sleep problems. These anxiety-related symptoms can be particularly worrying for people who have pain due to a heart condition. Anxiety can make pain worse, as well as making it harder to cope with the pain.”

Dr. Rao noted that as a child gets more nervous and shows the above problems, more anesthetic is needed for the child during the surgery and more pain medication is needed after, which is something that should be aimed to be avoided if possible.

What it does

Our VR program allows for the child to be able to get a representation of what they are about to experience. This would allow them to ask their nurse questions about the equipment that is in the room and also allows them to know the identities of all the hospital staff that will help them throughout the process. This also gives the nurses’ and all those that work with the patients an easier time with their job, as they don’t have to worry about calming or even restraining the patients. According to various studies, including those by K Bekelis et. al, J Gold et. al, V Leibovici et. al and all of the other studies in our references, VR has high potential in reducing stress and could prevent trauma from the experience.

How we built it

  • Built using Blender, Unity, Unity Collaborate, Googling/Binging
  • Coding language was C#, native to Unity
  • A mix of assets created by us in Blender or found in Unity Asset Store/TurboSquid
  • Keyframing tools for animations
  • Expert advice from a pediatric psychologist

Challenges we ran into

  • The installation process of the Oculus Rift software was a huge time waste as the software did not want to install across different laptops.
  • Getting information about the hospital and the procedures of the operation.
    • Many reference photos had to be used to create a decent representation of the Shands hospitals.
    • We were visited many times by Dr. Rao to review and confirm the accuracy of our representations and vision for design.
  • 3d modeling was time-consuming and tedious.

Accomplishments that we're proud of

  • Successfully built an experience that takes patients through the process of going from Pre-Operation Room to Operation Room.
  • Hand-made models in Blender, hand-made animations in Unity.
  • Real-life based sizings of rooms and inclusion of objects within hospital pre-operation and operation rooms.This took more work than expected getting FOV right, as well as the size of the equipment and patient, for a more realistic VR experience.

What we learned

  • Not to use Oculus anymore when working on this type of project as it implements OpenVR standards poorly compared to HTC Vive. It is also difficult to initiate proprietary software. It has Poor driver support: required many re-installs of both driver software and proprietary software.

What's next for Dream Team SurgeryU

  • Possible transition to Unreal Engine 4 to provide graphical improvement.
  • Moving the product into the hospital environment to test patient, family, and doctor’s reactions and adjust the product accordingly.
  • Planning to work with Senior Designers in UF’s Art School that can help with providing higher quality (free/low cost) modeling and animation.
  • Expanding the experience to include post-operation procedures to create a more complete surgical experience.

[References]

  • What can help relieve anxiety before surgery? (2018, February 08). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK279557/
  • Bekelis, K., Calnan, D., Simmons, N., MacKenzie, T. A., & Kakoulides, G. (2017). Effect of an immersive preoperative virtual reality experience on patient reported outcomes: a randomized controlled trial. Annals of surgery, 265(6), 1068-1073. Retrieved from https://oce.ovid.com/article/00000658-201706000-00008/HTML
  • Piskorz, Joanna, and Marcin Czub. "Effectiveness of a virtual reality intervention to minimize pediatric stress and pain intensity during venipuncture." Journal for Specialists in Pediatric Nursing 23.1 (2018): e12201. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/jspn.12201
  • Gold, J. I., Kim, S. H., Kant, A. J., Joseph, M. H., & Rizzo, A. S. (2006). Effectiveness of virtual reality for pediatric pain distraction during IV placement. CyberPsychology & Behavior, 9(2), 207-212. https://www.liebertpub.com/doi/abs/10.1089/cpb.2006.9.207 Positive reactions from children, parents, and nurses when using Street Luge VR distraction http://www.5dt.com/downloads/5dtsw/VRPDSDataSheet.pdf
  • Leibovici, V., Magora, F., Cohen, S., & Ingber, A. (2009). Effects of virtual reality immersion and audiovisual distraction techniques for patients with pruritus. Pain Research and Management, 14(4), 283-286. https://www.hindawi.com/journals/prm/2009/178751/abs/ “Virtual Reality Immersion can help distract from pain and stress from certain conditions, could imply distraction from trauma”
  • Piskorz, Joanna, and Marcin Czub. "Effectiveness of a virtual reality intervention to minimize pediatric stress and pain intensity during venipuncture." Journal for Specialists in Pediatric Nursing 23.1 (2018): e12201. https://onlinelibrary.wiley.com/doi/abs/10.1111/jspn.12201 “VR can be as an effective tool to minimize pediatric pain and stress due to venipuncture”
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