29 Sep Talking Virtual Reality with Dr. Cory Calendine – Facebook Live
Dr. Calendine, Tell Us A Little Bit About Yourself And What Specialties You See Here At Bone And Joint Institute:
Dr. Cory Calendine: I’m an orthopaedic guy here (at Bone and Joint Institute), I focus on hip and knee replacement. I joined the practice in 2007 back when we were under a different name. The Bone and Joint Institute had been in this area in Williamson County for years and years and years dating back to 1979 so that’s been cool to be in one community since I got out (of school) and I’ve been practicing since 2007.
Hip and knee is your specialty, and you’ve moved into the robotics realm with MAKO, correct?
Dr. Calendine: Technology is interesting, right? We were talking earlier before we hit play about the iPhone 6. I don’t think anybody has the iPhone 6 except this guy on the other side of the camera. But, you know, iPhone 6, we think “Oh, that’s old technology.” But the reality is the technology in the iPhone 6 is 120 million times better the computing capacity that NASA had when we put somebody on the moon. So it’s incredible what technology is doing and the improvements that we’re making. I think I’m on 13 now, maybe there’s a 14, I don’t know. But the reality is technology is advancing in every area of our lives, and why wouldn’t we use technology to help us with orthopaedics, right? What could be more important than serving our patients?
Lets talk about virtual reality. What is VR?
Dr. Calendine: Most people probably know Beat Saber or something like that. We know virtual reality from the gaming world. So the concept of virtual reality is you’re in a completely immersive environment – and there are movies about this like Ready Player One – but it’s actually very applicable to orthopaedics. What we’re talking about is using one of those headsets and we’re on Facebook, on Meta and Meta is Oculus where you’re actually closed off from the world around you. If you’ve ever been in one of those things, it’s a little bit bizarre because literally people will be right beside you and you kind of get lost in the virtual world. The whole concept of virtual reality is complete immersion into a virtual world.
So talk to us about VR and orthopaedics. How have you started to use VR in ortho?
Dr. Calendine: We’re talking about immersing into a virtual world, how does that apply to surgery? It’s because of the training side. We’ve already used these virtual reality programs to train residents. And that makes sense because if you have a surgeon doing an operation on you, you probably want them to have as much practice as possible both on other patients before they get to you and in the virtual world. But in the virtual world it allows you to, obviously without the involvement of an actual patient, go through the steps of a surgical procedure. We’ve been using virtual reality for surgical training for some time. We all know how COVID-19 limited how much access we had to care and the volumes of these training procedures went down. How did we supplement that? We supplemented that with virtual reality in surgical training. What you might not think about is, I’m old now, I’ve been here since 2007. There’s new technology always coming out, so the question is now becoming “How do we use virtual reality to teach the surgeons the new technical side of things?” We mentioned robotics earlier, what we’re doing is we used to train surgeons on the new robotic platform using cadavers, which is maybe kind of a gross thought for some of our viewers but kind of commonplace for how we train. It’s a safe environment, obviously, and we don’t have to worry about that patient’s outcome so it’s a good training environment. Well now you can do that training in the virtual world so you don’t have to utilize that important resource of cadavers. And again, you can do it anywhere, anytime. There are even these cool things, we call it the collaborative mode and I’ve done this frequently. I’ll be at my home in Brentwood, and I’ll drop in on a surgeon that’s physically in Australia, and he and I will both be in the same operating room in the virtual space exchanging tips and tricks, if you will. It’s a powerful tool to train not only residents as they start, but also new surgeons as new technology is coming out.
Have you seen this in other surgical specialties?
Dr. Calendine: Yes, it actually probably has its earliest roots in general surgery, but ortho has really blown up with it because we’re such a technical discipline and there’s so many manual things we do that are applicable immediately to the virtual space. But now we’re seeing even more in radiology, in vascular procedures, GI procedures, it really is expanding. The concept is “Any time you want to practice something, you can do that without a patient in the virtual world as many times as you want,” and that seems to be a good thing.
This is good not just for residents practicing, but for as new technology comes out for anyone to practice on:
Dr. Calendine: That’s exactly right. One of my other partners more advanced in age, shall we say – a brilliant surgeon who has a great practice in the robotic space – he was skeptical. He was like “Man, I’m going to put this thing on and get in the virtual world.” Well, he was in there about five minutes and loved it because it’s such a believable experience. But then, he’s finished, he goes to set the controllers down on the surgical table. Well, remember, he’s seeing the virtual world so he sets the controllers on the table that’s actually not there, he drops them to the floor, they break, we replaced them no problem but I make the point to say it’s much more realistic than you think. There are probably some people that are like “Well, virtual reality is for gamers” or what have you. It actually is quite convincing, and isn’t that what you want for your surgeon to be fully convinced? You want to simulate the actual procedure.
Where do you see the future of virtual reality going?
Dr. Calendine: I think it can only expand. Right now, we’re using it for training of residents and on new tech, and I think that’s going to expand, of course. This is a little bit of a fringe concept but the reality is within the virtual space, I can track every movement that the surgeon makes. So actually, we can test surgeon proficiencies either as they start the procedure or as they get older in life and maybe lose some of those technical skills. The reality is we could use it for the betterment of our patients. We could actually have real, objective, measured data about how well we’re doing as surgeons. I think there’s a huge education piece but I think it’s also how we can maintain our standards. Surgical disciplines are a little bit different. They take not only this knowledge of what you’re doing but this technical aspect as well, and that’s where virtual reality can really help.
How does the addition of technology help our patients with the best possible experience here at Bone and Joint Institute?
Dr. Calendine: Care is complex. The unique thing is you can know a lot about the books and all that, but everything has to be individualized for the single patient. Often times, what we do is we’ll see them in the urgent care to start with. Then we have sub-specialists. If you have hip and knee pain, you should call me. If you have shoulder pain, you probably shouldn’t listen to me (but you can call one of these shoulder surgeons here). We just have areas of sub-discipline and that is only to serve you. But it starts with how do you get here, then it’s how do we treat you? Hopefully with therapy, hopefully without surgery believe it or not. We have a lot of surgeons on staff but our goal is always to maximize things short of surgery. We want to make sure therapy is optimized so that’s why we’ve grown into that space. I think the ability for us to be a one-stop shop (is great). Surgeons can have control issues anyways, but in this scenario we’re trying to control the care for the patient good.
To watch the full segment with Dr. Calendine’s from Facebook Live, click here.
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