Mixed reality headset in vitreoretinal surgical teaching: a newly defined tele-mentoring model.

Abstract

PURPOSE: To report the benefits of a newly defined tele-mentoring surgical model in vitreoretinal surgery based on a mixed reality headset (MRH) to enhance ophthalmic surgical education. METHODS: A two-step approach was used to define and test the efficacy of the tele-mentoring model designed for surgical teaching. First, the application of the innovative MRH in intraocular surgery was validated for safety and efficacy by an expert surgeon. Secondly, a board of vitreoretinal surgeons designed the tele-mentoring model for surgical teaching, entailing a pre-operative training and the execution of vitreoretinal procedures by a fellow supervised by the mentor through the connection offered by the device. Intraoperative parameters and a satisfaction questionnaire were used to assess surgical safety, efficacy and level of satisfaction for the tele-mentoring teaching method. Outcomes in the model validation were: Surgical safety, defined by (i) the absence of intraoperative complications (ii) the absence of early and (iii) late post-operative complications and surgical efficacy. In addition, in the model application MRH wearability and practicability, the all in one system, impact in the procedure and safety and confidence were investigated. In all cases, time lag and surgery duration were measured. RESULTS: A total of 40 vitreoretinal surgical procedures were performed by an experienced vitreoretinal surgeon with the aid of the MRH. No intraoperative nor early or late postoperative complications were recorded, and time lag and surgical duration were acceptable. A total of 40 surgical procedures were successfully performed by a fellow with the MRH, with no recorded complications and acceptable time-lag and intraoperative time. The tele-mentoring experience was found to be safe and effective, with overall fellows satisfaction in the surgical teaching method. CONCLUSIONS: Reshaping the mentor-fellow relation in a tele-mentoring dimension boosts the fellow self-confidence and training, preserving patient safety and surgical efficacy and representing a promising tool for surgical education in ophthalmology.