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 minimize 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
Theater, 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 Theater 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 realized
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
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-color 3D renderings.
"It's like the difference between a flip book and 4K,"
Dr. Robert Louis, program director of the Skull Base and Pituitary Tumor 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've 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.
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 tumor, 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."