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Commercial Virtual reality uses

Commercial use might include games and entertainment, medicine, aviation, travel, information exchange, & all manner of training...

Nintendo surgery

Physicians are "flying" through colons to detect cancerous polyps. Military surgeons are simulating the repair of gunshots to the legs and arms of virtual patients. Robots are taking over during hip replacement surgeries. Physicians with the equivalent of Superman's "X-ray" vision are zapping tumors without making a single incision in the skin. Most of these technologies, though not quite virtual yet, are no less revolutionary. They bring together elements of medical technology that were previously separated endoscopic surgery, computer imaging, electronic databases and communications networks into one spot: a physician's computer workstation.
"The computer has become a new instrument in the operating room," says neurosurgeon Richard Bucholz, editor of Computer Assisted Surgery and developer of an imaging technology used in brain surgery. And surgeons have expanded their operating teams from the usual anesthesiologist and nurses to include radiologists, electronics engineers, bioengineers, computer engineers, programmers and technicians.
The techniques being developed today often referred to as "Nintendo medicine" soon will make current hands-in/open-body surgery look as old-fashioned as sitting in a barber's chair for a tooth extraction without anesthesia, a common practice a hundred years ago.

The first step on the road to virtual reality surgery began in earnest in 1989, with the development of endoscopic surgery. The new surgery was done through three small holes in the abdomen. One was for the endoscope a tiny camera that sent video of the patient's insides through a thin cable to a screen in the operating room. One was for the surgical instruments, such as a scalpel. And one was for a third instrument, often a clamp to hold tissue out of the way or close off blood vessels.

The first major endoscopic surgery was gallbladder removal. Operations that once required a long incision through the abdominal wall, a week's stay in the hospital, and six weeks recovery at home turned into outpatient procedures in which the patient was back at work in a few days. Endoscopic gallbladder surgery spread like wildfire. Today, in the United States, 600,000 gallbladder operations are performed annually, 95 percent of them endoscopically. Although the high-tech process has been applied to other types of operations, none have been as successful. However, new technological developments making news this year are likely to change the entire complexion of most surgical procedures done today.

The push to develop more advanced surgical technologies came from the Advanced Research Projects Agency of the U.S. Defense Department (DARPA), famed for bringing the Internet to the world. Col. Richard Satava, then a surgeon at the Walter Reed Army Medical Center and program manager of DARPA's Advanced Biomedical Technology Program, saw virtual reality surgery as a way to save lives on battlefields. "Soon we'll be able to put a surgeon in every foxhole," he told as many people as would listen.

In the area of surgical simulation systems to train physicians, nurses and technicians so they don't have to practice on cadavers or live humans the list of companies seems endless Medical Education Technology Inc. in Sarasota, Fl., sells anesthesia and critical care simulators. Eagle Simulation in Binghamton, N.Y., has developed a gallbladder surgery simulator. In Sweden, Prosolvia is making a simulator for arthroscopic shoulder operations. Lockheed Martin is developing systems for sinus and pituitary gland surgeries. There's DentSim for dentists. And Nu-Vision for ophthalmologists.
But it's inconvenient for physicians, technicians and nurses to travel to Sweden, Israel or Binghamton to practice. And it's costly to put a surgical simulator in every medical school.
That's what neurosurgeon Jack Kushner thought, so he started Futuristic Instruments, a company based in Annapolis, Md., that develops software to put these simulators on the Internet. As soon as next year, physicians in Thailand or nurses in South Africa can rehearse procedures to make available procedures that would otherwise never exist in their communities. And because it's the Internet, these simulators might open up a new form of entertainment. Anyone who's got the hourly fee (perhaps as low as $50) can learn how to sew up blood vessels, too.

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