ABSTRACT
The COVID-19 pandemic is having a significant impact on the provision of non-COVID-19 related clinical services. Early recommendations for head and neck reconstructive surgery were based on guidance from expert groups, advocating de-intensification of surgery. Since then, patient outcomes derived data has suggested that the continued practice of head and neck reconstructive surgery based upon pre-pandemic standard of care is safe if appropriate measures are in place for appropriate screening and segregation of care pathways for patients. In addition, adequate levels of personal protective equipment (PPE) are vital for both patients and the healthcare team. We present the current practice guidance within the UK National Health Service (NHS) for head and neck reconstructive surgery in the COVID-19 pandemic era in the following areas: COVID-19 testing/screening, care pathways for patients, the potential future role of immunisation against SARS-CoV-2, airway management, selection of the type of reconstruction, postoperative care and rehabilitation. The guidance produced reflect the evolving nature of the response of NHS to the COVID-19 pandemic, some of the suggested practice protocols could differ from local policies in various parts of the world however the principles which underlie these standards are the results of regular review of the needs of the patients and health service, balanced against the background of the ebb and flow of the prevalence of COVID-19 infection within the community and healthcare settings. © Frontiers of Oral and Maxillofacial Medicine. All rights reserved.
Subject(s)
Plastic Surgery Procedures , Skin Neoplasms , Ear, External , Humans , Skin Neoplasms/surgery , Skin Transplantation , Surgical FlapsABSTRACT
INTRODUCTION AND OBJECTIVE: COVID-19 has disrupted traditional training and education, requiring a shift to remote learning. Video conferencing has limitations in surgical education, but more immersive techniques, such as 360 virtual reality (360VR), may have a greater role in demonstrating surgical anatomy and techniques. In person cadaveric courses and online VR resources have independently been proven to be effective educational tools. By combining both elements, we ran the first live VR cadaveric course in Urology which aimed to bridge the current educational gaps. METHODS: A combination of lectures, live surgery and recordings were made of Urological operations using multiple cameras superimposed onto 360VR view. The candidates watch using headsets that hold their smartphones and adjust their view by turning their head. 4K videos could also be watched without VR. The course, run for regional trainees, covered procedures including ureteric reimplantation, glansectomy, perineal urostomy, penile fracture and open approach to bladder with SPC insertion. Videos were either pre-recorded and supplemented with step-by-step lectures or live streamed allowing simultaneous questions and answers. Feedback was sent to candidates via an online survey. RESULTS: 15 people attended, with 100% survey completion rate. Of the attendees, 72% had little or no prior VR experience, 100%thought VR was valuable with 91% saying it was very or extremely useful. 55% have attended postgraduate cadaveric courses, with 100% reporting it would be useful. 100% thought VR added to their learning experience and 100% would attend again. Qualitative feedback highlighted 70% benefited specifically from observing procedures that they would otherwise not experience. Improvements include obtaining higher quality VR headsets and more live stream sessions. CONCLUSIONS: Utilising VR technology in the context of live cadaveric teaching allows an immersive innovative experience which is easily accessible, low cost to participants and integrates the fundamentals of education. We are planning a national course with further live content later this year.
ABSTRACT
Introduction: COVID-19 has disrupted traditional training and education, requiring a shift to remote learning. Videoconferencing has limitations in surgical education, but more immersive techniques, such as 360 Virtual Reality (360VR), may have a greater role in demonstrating surgical anatomy and techniques. In person cadaveric courses and online VR resources have independently been proven to be effective educational tools. By combining both elements, we ran the first live VR cadaveric course in Urology which aimed to bridge the current educational gaps. Methods: Urological operations were recorded using multiple cameras superimposed onto 360VR view. The candidates watch using headsets that hold their smartphones. The course, run for regional trainees, covered procedures including ureteric reimplantation, glansectomy, penile fracture and open cystostomy. Feedback was sent to candidates via an online survey. Results: 15 people attended, with 100% survey completion rate. Of the attendees, 72% had little or no prior VR experience, 100% thought VR was valuable with 91% saying it was very or extremely useful. 55% have attended postgraduate cadaveric courses, with 100% reporting it would be useful. 100% would attend again. Qualitative feedback highlighted 70% benefited specifically from observing procedures that they would otherwise not experience. Improvements include obtaining higher quality VR headsets and more live stream sessions. Conclusion: Utilising VR technology in the context of live cadaveric teaching allows an innovative immersive experience which is easily accessible, low cost to participants and integrates the fundamentals of education. A national course with further live content is being planned for later this year.