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Fighter pilots invented a revolutionary way for surgeons to peer inside people's skulls

Hoag virtual reality surgeryHoagDr. Christopher Duma of the Hoag Institute uses the SNAP technology prior to brain surgery.

Fighter pilots and brain surgeons have a lot in common.

With limited time and a high degree of risk, they must zero in on a dangerous target with the intent to destroy, making sure to minimise any collateral damage.

Perhaps no one understands that relationship better than Alon Geri and Moty Avisar, veterans of the Israeli Air Force and co-founders of Surgical Theatre, an Ohio-based company that brings state-of-the-art virtual reality to brain surgeons.

Physicians in thick black goggles can step inside a patient’s skull, explore the malformed region, craft a strategy for entry, elimination, and exit, and even do dry runs of the surgery itself. When it comes time to make the first incision, there are fewer surprises.

The technology, which Surgical Theatre calls SNAP (Surgical Navigation Advanced Platform) uses existing MRI scans to create 3D models, which are compatible with virtual reality. Geri and Avisar, both engineers, developed SNAP after working extensively on flight simulation. They realised in the early 2000s that the problems facing brain surgeons were nearly identical to those of their fellow pilots.

“You do it wrong the first time, and it’s either game over or you spend the rest of the surgery putting out fires,” Geri tells Tech Insider.

Virtual reality surgery hoagHoagDr. Duma uses SNAP to explore a patient’s brain.

Beginning in 2005, the pair spent three years crafting the solution to flat, colorless MRI scans. In 2013, their technology received FDA clearance. Now, with the explosive growth of VR, doctors can walk their patients through full-colour 3D renderings.

“It’s like the difference between a flip book and 4K,” Dr. Robert Louis, program director of the Skull Base and Pituitary Tumour Program at Hoag Neurosciences Institute in Newport Beach, CA, says of the difference between MRI and SNAP. “They’re not even close to the same level.”

Hoag has been using SNAP since December of 2015. In that seven-month period, Louis and his team have used the technology on every patient they have seen. “It’s really making a big impact on the way we do things,” he says.

A great deal of research explains why. When patients take an active role in their procedure, they feel more comfortable, in-control, and satisfied with the outcomes. With SNAP, doctors can put the VR goggles on their patients so they can see their own brains before they go under.

The surgeries are also more successful, Louis says. Patients recover faster since SNAP allows doctors to avoid making any unnecessary incisions.

Virtual reality surgeryHoagDr. Robert Louis zooms in on the vascular structures of the brain.

SNAP is being used in nine locations so far, including Stanford, UCLA, and New York’s Mount Sinai Hospital. A tenth location will adopt the technology later this year, Geri says. Doctors have performed about 900 surgeries using SNAP to date.

Over time, Louis suspects the technology will provide even more detail.

Already he’s seen a jump from last December. Initially, he could just see anatomical structures. Now SNAP lets him look at functional pathways in the 3D model. In excising a tumour, for example, he can more easily avoid nearby structures that govern things like speech or movement. Without SNAP, that wouldn’t be possible. “You can’t see those with your naked eye or even with the microscope,” Louis says.

Both he and Geri agree that virtual reality is poised to become a mainstay in the operating room. For Louis, the most rewarding element of the technology is how it helps patients understand their disorders and illnesses. For Geri, SNAP’s success holds an even deeper significance.

“The first time I was in the operating room, it was very emotional for me,” he says. “I remember thinking about how I transitioned from flying war machines to developing life-saving machines.”

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