The transition from virtual reality to real virtuality: advanced imaging and simulation in general surgery

Individual anatomical variations, involvement of organs in neoplastic lesions and consequent preoperative planning are some issues that surgeons have to face every day in their clinical activity. The use of dedicated softwares, together with tools for patient-tailored training, is likely to improve clinical outcomes and patients’ safety. We decided to review the literature to report the current role of virtual reality and simulation in general surgery. A search was systematically performed on Pubmed, EMbase, Cochrane Library and Up ToDate databases. The search was limited to articles written in English from January 2005 through June 2016. Altogether, 1,038 articles were found using this search strategy. All studies, case series and reports in the medical field pertaining to preoperative planning, VR and Augmented Reality (AR) application in general surgery that provided translational data were considered eligible to be included. Two authors independently screened the articles by title, abstract and keywords, and then selected 7 papers to be included in this review (4 for VR, 2 for AR and 1 for preoperative planning). Virtual reality training appears to decrease the operating time and improve the operative performance of surgical trainees with limited laparoscopic experience when compared with no training or with box-trainer training. The ability of virtual reality tools to guide surgeons during complex procedures represents a revolution for increased safety and overcoming minimally invasive surgery-related limitations.