“The opportunity is enormous”: CIO attendees experience thyroid ablation case in virtual reality

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CIO attendees using the VR headsets

The 11th Symposium on Clinical Interventional Oncology (CIO; 11–13 October, Miami, USA) hosted a virtual reality (VR) case presentation, where delegates placed their smartphones into a provided cardboard headset and watched Auh Whan Park (UVA Health, Charlottesville, USA) perform a pre-recorded thyroid ablation as though they were in the operating room. This case presentation followed a series of talks discussing state of the art thyroid intervention, versing the audience in the current mainstay of thyroid cancer treatment.

Speaking in his capacity of panel moderator, Ziv Haskal (UVA Health, Charlottesville, USA) introduced the live case: “I have had the great fortune and pleasure of being involved in this meeting for ten years, and they have tolerated a lot of the things I have done. There is a certain atmosphere here—maybe it is the Miami meeting or the southern Florida meeting that just makes it a cool and hip way to learn things—and I think, at least for me, things just stick better when you can meet faculty and talk to them and see things that might be defining. I will never forget the first time I saw a live EVAR [endovascular aortic repair] case at ISET [International Symposium on Endovascular Therapy] a few decades ago. No matter how many papers you had read beforehand, seeing that live was transforming. It was several years before I did my first case, so there is sort of an inertia, but [witnessing that live case is nevertheless] a marked event.

“What we are going to do here is try to give you a little bit of that cool by putting you in that intimate, close-up seat, in the room, where you can watch Dr Park do a thyroid ablation. The purpose is to take something that probably none of you have done, and show you that […] you can actually do this: this is something you can learn and put into your practices. The opportunity is enormous. This will happen in the USA; whether it is going to be interventional radiologists (we all have experience with ablation, after all), or endocrine surgeons [is to be decided]—it is going to be performed by whoever is going to bring it [to institutions], and whoever is going to do it well.”

Prior to the session, attendees downloaded a free application to their smartphones, and then used this to stream the case. By placing a smartphone into the cardboard headsets provided, attendees were transported to Park’s operating room, where they watched a 15-minute thyroid ablation case. Haskal provided commentary throughout, describing operator decisions and drawing the audience’s attention to certain technical aspects of the case. Turning around whilst wearing the VR headset, session participants could see a presentation slide outlining the procedural steps.

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Ziv Haskal at CIO 2019

The case

The patient was a woman with two benign nodules in the right thyroid lobe, which had been growing for two years prior to the procedure. Her pre-procedural thyroid function tests were normal. The patient had opted for radiofrequency ablation (RFA) over a thyroidectomy to preserve her singing voice.

The procedure was a success, with Park reporting: “She [the patient] is now really happy. She sent me a thank you letter to say that she had an invitation to perform at a concert, she is a jazz singer, so she is really happy and grateful.”


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