Virtual Interactive Presence: An Operative Feasibility Study

Objective: We sought to 1) assess the process required to implement a virtual interactive presence (VIP) system into a standard operating room setting, 2) evaluate the technical performance of the device, and 3) determine the potential utility of the system for guidance of surgical procedures. Method: A feasibility study was conducted at a teaching hospital in 2011. Patients scheduled to undergo otolaryngology procedures were recruited for VIPAAR system (Birmingham, AL) usage to perform standardized exercises during the case. Setup time and observations regarding performance of the system were recorded. Surveys assessing satisfaction level were completed by the staff. Results: Following informed consent, the VIP system was implemented in 8 otolaryngology procedures requiring rigid nasal endoscopy (n = 6) or laryngeal microscopy (n = 2). Average setup time was 4.5 minutes at the outset with an additional 2.4 minutes intraoperatively. One hundred percent of OR staff surveyed (n = 24) agreed that the system was safe. Ninety-two percent disagreed that the system interfered with their duties. Surgeon responses (n = 8) were uniformly positive toward the system’s safety and its usefulness as a teaching tool. Strengths were noted in the system’s clarity of picture and portability. A weakness was identified in the crowding of a smaller OR space. Conclusion: Otolaryngology requires a highly technical skill set based on learned dexterity. Early intraoperative trials indicate VIP technology is a safe and potentially useful adjunct in providing monitored surgical experience to trainees. Potential barriers exist in smaller OR settings. Limitations of the study are sample size and a single surgeon’s experience.