Over the last 10 years, healthcare has seen a rapid increase in the use of technology, but the pandemic has pushed that usage faster than ever before. The use of technology has drastically changed medicine by providing doctors with better information with which they can collaborate, diagnose, develop treatments, and plan surgeries. According to adilblogger,com, “In the medical industry, there are more than 500,000 technological devices and [pieces of] equipment available [for use] in hospitals and other healthcare departments.” In orthopedics, this new technology is vastly enhancing patient outcomes.
Cory Calendine, M.D. is a board-certified orthopedic surgeon specializing in anterior hip replacement, robotic joint replacement, and partial and total knee replacement. He has recently joined the medical advisory board for Osso VR. Dr. Calendine is helping Osso VR develop virtual reality enhanced training for orthopedic surgery. He also has expertise in Mako SmartRobotics robotic-arm assisted surgery and is one of only eight surgeons chosen to serve on the international Mako Champions faculty. He serves as an examiner with the American Board of Orthopaedic Surgeons – our nation’s credentialing body for orthopedic surgeons – to define best practices. Dr. Calendine currently serves as Chief of the Division of Orthopaedic Surgery for Williamson Medical Center, where he often hosts national and international visiting surgeons who come to learn about the latest techniques and advancements in orthopedic surgery.
Williamson Source: Virtual reality (VR) only came about in the mid-1980s, but it has grown vastly in the last 40 years. What got you interested in delving into the cutting edge of medicinal technology, including robotics and VR?
Dr. Cory Calendine: Once you get the anatomy down and the basics of the practice, the question is what next? What can you do to improve your training and your techniques to enhance your skills and better serve your patient? This is where robotics and VR come into play.
WS: You do robot-assisted joint replacement surgery, what is it like for you when you are doing the surgery? What does it mean for a patient?
Dr. Cory Calendine: Robots are all about precision. Think about all of the places we now see robots, like in the car plant at Nissan. They bring a level of precision that is more detailed than the human eye and hand can do.
We begin with a CT scan that provides us with a detailed 3D model of the patient. This allows us to customize the surgical procedure to the patient because everyone’s anatomy is different. From this model, a detailed surgical plan is created and the robotic arm allows us to execute the plan to perfection.
The whole goal is more precise surgery. When surgery is very precise there is less dissection of surrounding tissue. The robot just cuts the bone that it is programmed to cut. This means a faster recovery time for the patient and less chance of issues like infection.
WS: You are now getting into the use of VR as a tool for training medical students and surgical residents to practice before their first surgery. How does it work?
Dr. Cory Calendine: Previous to VR, practicing surgeons who want to adopt robotics had to complete two full replacements on a cadaver before they were certified. This requires the surgeon to come to me or I go to them. So, there are travel costs. Time is expensive. And then cadavers are gold because there is more demand than availability. There are so many other things that we can learn from cadavers, we honor and respect those who have donated their bodies to science, so we want to make sure their gift is employed in the best possible way.
With VR a surgeon can learn or enhance their skills without using a cadaver, which allows it to be used in a more fruitful manner to enhance medical knowledge.
When training using VR, the trainee need not be in the same city as me. They can learn in their home or office. I can be here in Tennessee and the surgeon I am training can be in California or on the other side of the world, yet I can be there with them virtually as they are doing the surgery on a virtual person in a virtual operating room with all of the tools, technologies, and staff that would be in a real operating room.
WS: What does this mean to medical training?
Dr. Cory Calendine: It allows for the sharing of information and the democratization of surgery training in the United States and internationally. The latest surgery technologies and techniques will be able to be shared from Canada to Saudi Arabia without any travel involved. It opens up a lot of opportunities.
We also want the virtual world to be as close as possible to the real world of the operating room. Surgeon input is important to developing that reality in the VR world.
WS: Where do you see VR going from here?
Dr. Cory Calendine: Any time you can use VR to preserve resources, that is a good thing. And also, when it can be used to make us better doctors. It allows us to be better prepared for all scenarios; to deal with the unexpected; to see how event A leads to event B, and B to C, and C to D; to teach us to be prepared for any and all eventualities.
Once you know the framework, it is about seeing how the patterns play out and being prepared for contingencies.
WS: Where do you see medical technology, especially VR, going from here?
Dr. Cory Calendine: With regard to VR, I see it as a means for medical students and doctors to train, adopt innovation and repeat cases without real patients being involved. It can also be a means to train an entire surgical team – the nurses, and the surgical assistants – in advance of surgery.
It can also be used for patient education. A patient will be able to see in a virtual space what is going to happen during their surgery, or what is happening to their bodies and why they need surgery.
It can be used to help physical therapists understand surgery better, which will help them better plan their rehab strategies.
It can be used to create new techniques and procedures. Anything can be tried without risk to a patient. VR will certainly speed innovation in and of itself.
Best of all, it can be used for collaboration. Multiple surgical experts can come together from all over the world virtually to work on a difficult case or to work together on new ways to do things. I can’t wait for the collaborative mode to be developed further.
To learn more about Dr. Calendine or to schedule an appointment, please call 615-791-2630 or click here to make an appointment online.
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