Usefulness of virtual reality application in pediatric urology

The utility of virtual reality (VR) in surgical planning, education and counselling has not been fully evaluated so far. The present study aims to address this gap in exploring usefulness of VR reconstruction in pediatric urology.

All patients who underwent VR reconstruction over the last one year (2023-24) were included. Contrast enhanced CT scan/ MRI images were obtained at 1-mm thickness. A VR model and a 3D environment were created (Immersive view5.0; Immersive Touch Inc. 910). The usefulness was assessed by three independent surgeons on a Likert scale (1-5) on the following headings: anatomical delineation, haptic tools, pre-surgical planning, student teaching and patient counselling. Inter class correlation (ICC) analysis was performed using SPSS.

Among 275 patients managed, 20 cases underwent VR reconstruction in view of the complex anatomy. The diagnoses were bilateral Wilms Tumor 1; pelvic kidney UPJO 1; horse shoe kidney 1; malrotated UPJO 1, duplication anomalies 8, recto urethral fistula 1; exstrophy variants 3, complex urolithiasis 2, vaginal atresia 1, and renal trauma with urinoma 1. Among the study population 18/20 underwent surgical treatment; two were managed conservatively (renal trauma-1; renal cyst - 1). The mean usefulness score was: anatomical delineation 3.9, haptic tools 3.1, surgical planning 3.6, student training 4.2 and patient counselling 4.1. ICC for individual measures was 0.893 (95% CI 0.792-0.952; p < 0.001).

VR reconstruction is as a valuable adjunct in enhancing anatomical understanding, and improving education and communication. Selection of ideal cases for VR will make this novel tool cost-effective.