Virtual reality (VR) is an artificially simulated environment that permits multiple
interactions. Augmented reality (AR) is an interactive experience of a real-world
environment where the objects are enhanced by computer-generated perceptual
information [1,2].
Enhanced versions of these concepts were being used in several clinical practices.
Virtual Interactive Presence (VIP) is a technology by which surgeons located
remotely can simultaneously view each other's visual field, allowing them to tele-
collaborate long distance surgeries [3]. Virtual interactive presence and augmented
reality (VIPAR) platform allows a surgeon from a remote location to deliver real-
time assistance to a local surgeon using a standard internet connection.
Pandemic typically led to a surge in demand for healthcare services overwhelming
usually local capabilities. The SARS-Cov-2 outbreak was a big challenge for both
patients and health practitioners. Surgical procedures were reserved only to most
critical cases. Long lockdown limited patients’ access to different health facilities.
Most of the savant societies recommended implementing telemedicine and
incorporating telemedicine as part of COVID-19 outbreak response systems [4].
Telemedicine involves not only consultation, radiodiagnosis and clinical follow up
but also surgical procedures and surgeon’s assisting guidance.
Telemedicine is no longer a futuristic tool. It becomes a need in the present
situation where human interaction has been made difficult by the pandemic. The
touch sense haptic technology and teledactyl were predicted since 1878. Nowadays
it may provide a more realistic and “physical” doctor- patient interaction remotely.
Since the first successful tele-laparoscopic cholecystectomy in 2001, telesurgery
allowed collaboration between different surgeons located distantly across world.
This Tele-collaboration contributed to complex wound repairs in war zones. The
same concept was useful in the management of some high-risk procedures such
as emergency surgeries in COVID-19 positive patients [5,6].
Telesurgery could revolutionize training concept as well. Real-time access to three‐
dimensional reconstructions in patient imaging and remote interaction with
colleagues may provide comprehensive high-quality skills transfer [7].
Before 2020, telesurgery was always an exciting technology but with unclear
endpoints. The limited access to tele-guided procedures was mostly explained by
the lack of patient’s trust and the high cost. The pandemic outbreak taught us a
lot about its safety and effectiveness. Nowadays, health care delivery is feasible
anytime in all restricted areas.
References
[1] Contreras CM, Metzger GA, Beane JD, Dedhia PH, Ejaz A, Pawlik TM. Telemedicine: Patient-provider clinical engagement
during the COVID-19 pandemic and beyond. J Gastrointest Surg. 2020; 24:1692-97.
[2] Mann DM, Chen J, Chunara R, Testa PA, Nov O. COVID-19 transforms health care through telemedicine: Evidence from
the field. J Am Med Inform Assoc. 2020; 27:1132-35.
[3] Mahajan V, Singh T, Azad C. Using telemedicine during the COVID-19 pandemic. Indian Pediatr. 2020; 57:652-57.
[4] Rockwell KL, Gilroy AS. Incorporating telemedicine as part of COVID-19 outbreak response systems. Am J Manag Care.
2020 Apr;26(4):147-148.
[5] Greenfield MJ, Luck J, Billingsley ML, Heyes R, Smith OJ, Mosahebi A, et al.Demonstration of the effectiveness of
augmented reality telesurgery in complex hand reconstruction in Gaza. Plast Reconstr Surg Glob Open. 2018;6: e1708
[6] AlMazeedi SM, AlHasan AJMS, AlSherif OM, Hachach-Haram N, Al-Youha SA, Al-Sabah SK. Employing augmented reality
telesurgery for COVID-19 positive surgical patients. Br J Surg. 2020;107: e386-87.
[7] Verhey JT, Haglin JM, Verhey EM, Hartigan DE. Virtual, augmented, and mixed reality applications in orthopedic surgery.
Int J Med Robot. 2020;16: e2067.
1: Department of Urology, Robotics and kidney
Transplant, Fortis Hospital, New Delhi, India
*Corresponding author
** Academic Editor
Correspondence to:
draamangupta@gmail.com
Publication data:
Submitted: August 2,2020
Accepted: September22,2020
Online: November 30,2020
This article was subject to full peer-review
This is an open access article distributed under the
terms of the Creative Commons Attribution Non-
Commercial License 4.0 (CCBY-NC) allowing to
share and adapt.
Share: copy and redistribute the material in any
medium or format.
Adapt: remix, transform, and build upon the
licensed material.
the work provided must be properly cited and
cannot be used for commercial purpose.