Global survey on perioperative immersive virtual reality for patient distraction in hand surgery

Immersive virtual reality (VR) has emerged as a promising tool to reduce anxiety and to improve the perioperative experience, particularly during procedures performed under local anaesthesia. This application was initially used in burn care and is also employed in various other medical fields such as dialysis, chemotherapy and dentistry. Currently, its use within hand surgery remains insufficiently reported in the literature.

To evaluate the current global adoption of VR for perioperative patient distraction in hand surgery and to identify the hand surgeon's (users and non-users) perceptions, barriers and challenges.

In this descriptive pilot study, a self-developed online questionnaire was distributed worldwide between February and June 2025, promoted through social media and WhatsApp groups. This two-stage survey included the analysis of 17 questions.

Among 230 respondents from 37 countries, 80.36% reported not using VR due to the high cost (19%), lack of awareness (16%), and institutional resistance (16%). More than 75% of the non-users expressed interest in future implementation. Among current users, the technology received an average usability and patient experience score of approximately 3.7 out of 5 on a Likert scale. Additionally, 57% of this group reported achieving a profit as surgeons while patients were immersed during surgery and an equal part reported that they found it effective but time-consuming. Notably, 68% of all respondents supported integrating VR into standard anaesthetic care and a stepwise integration plan was suggested.

By 2025, immersive VR is used sparingly in hand surgery for patient distraction. Though it shows promise in easing anxiety, its broader adoption demands more research into cost-effectiveness and cross-setting applicability. Successful integration calls for a critically open mindset and readiness to tackle practical challenges.