Virtual reality training helps Malaga’s junior doctors master complex surgery

JUNIOR doctors in Malaga are using virtual reality (VR) technology to master one of the most complex and high-risk procedures in digestive medicine.

A group of 16 third and fourth-year residents from across Malaga and Cadiz took part in a pioneering course at the Hospital Clínico, specialising in endoscopic retrograde cholangiopancreatography (ERCP).

The procedure is used to treat diseases of the biliary tract and pancreas. Due to the precision required and the high risk of complications - including pancreatitis and haemorrhaging - it traditionally carries a long and difficult learning curve.

By using headsets developed by Malaga tech firm mSurgery, residents were able to "enter" the operating theatre virtually. The technology bypasses the physical capacity limits of a surgery room, allowing a larger number of students to witness the procedure in high-definition without compromising patient safety.

"It is a difficult technique," said Dr Guillermo Alcaín, head of the Digestive System Unit at the Clínico. "Virtual reality glasses help the residents see exactly what is happening in the operating theatre in an immersive way."

While ERCP was originally a diagnostic tool, it is now primarily used as a treatment. It allows specialists to drain bile ducts and extract stones, often replacing the need for invasive traditional surgery.

Head of the digestive system unit at Clínico Dr Guillermo Alcaín says: "It is a difficult technique and we use a lot of resources in the training of resident doctors."

The course that the attendees have completed consists of two parts: theoretical lectures and live cases broadcast from the operating theatre using image, sound and an immersive image system with virtual reality glasses, "which helps them see what is happening in the operating theatre".

"This technique has been performed in the hospital since it opened," Dr Alcaín says. Due to its complexity, only a "few specialists" are skilled to perform it, although "it is of great benefit because it solves problems of the bile duct and pancreas".

ERCP was initially a diagnostic technique, but it now functions almost always as a treatment, because "it allows drainage of the bile duct, placement of prostheses, extraction of stones and other procedures that avoid and replace surgery in most cases", as Dr Alcaín says.

Hospital Clínico performs an average of 16,000 endoscopies of all types per year. The endoscopy unit mainly performs colonoscopies, but also gastroscopies and special techniques such as the treatment of achalasia - a disease of the oesophagus that makes swallowing difficult.

Dr Isabel Lavín from the endoscopy unit stands firmly behind the importance of ERCP, which cannot be learnt just from reading textbooks. "You learn from attending, but it is very important that residents know about it, know about its complications and its indications. I think it is the first training we have done in Malaga aimed at residents," she says.

The platform, developed by Malaga-based mSurgery, is now entering its commercial phase after four years of development.

CEO Michel Velázquez explained: "We have developed a platform that allows many surgeons to connect from anywhere to the operating theatre and feel like they are actually there."

The Hospital Clínico remains a regional leader in the field, performing an average of 16,000 endoscopies annually. While the majority are routine colonoscopies and gastroscopies, the unit is increasingly focused on specialised techniques, including the treatment of achalasia.