Virtual Reality: Game Changer in Complex Surgery Education

Understanding liver anatomy and planning resections are crucial yet complex skills for surgeons, requiring precise spatial awareness and knowledge of intricate anatomical structures. Traditional two-dimensional (2D) imaging and three dimensional (3D) static models often fail to provide the depth and realism needed for trainees to fully comprehend these complexities.1 As a result, there is a gap in traditional training methods to prepare surgeons for making critical decisions confidently in the operating room. To enhance training and improve surgical outcomes, a more immersive, interactive and accessible educational tool is needed.1 We collaborated with biomedical communication specialists to develop an immersive virtual reality (VR) tool featuring a 3D liver model in a shared, multiuser environment. The models were designed using the Unity game engine to ensure anatomical accuracy and offer a visually rich platform. Optimized for the Oculus Quest 2 headset, the tool allows users to manipulate the 3D model with controllers—enabling rotation, scaling and transparency adjustments. These features enhance depth perception and spatial understanding, making complex anatomical structures more intuitive to explore. The multiuser setup fosters collaborative space where trainees can engage with peers and mentors in real-time, facilitating immediate discussions on surgical techniques, anatomical nuances and procedural strategies. During development phase, we collected feedback from trainees and surgeons through Likert scale surveys and open-ended questionnaires. Additionally, we obtained insights from direct observations and one-on-one discussions during usability testing to ensure the final product effectively addressed the educational needs of diverse users. The feedback from participants has been overwhelmingly positive. They praised the intuitive design, ease of navigation and the realistic correlation between 2D scans and the interactive 3D model. The multiuser functionality, in particular, was highly valued, significantly enriching the overall learning experience. This depth of engagement fosters a more comprehensive understanding than traditional 2D imaging or static 3D models, effectively bridging the gap between theoretical knowledge and practical application. Beyond enhancing individual proficiency, the multiuser approach also prepares learners to perform as cohesive, efficient surgical teams, cultivating teamwork, problem-solving and effective communication—critical skills for high-pressure surgical scenarios. The development of the 3D models took us a year, progressing from initial conceptualization to the final prototype through an iterative, collaborative process. This effort involved a modest financial investment to cover the costs of headsets and specialist fees. However, the long-term benefits of these models position them as scalable and valuable assets in surgical education. Once created, these models can be seamlessly integrated into any training environment using a VR headset and internet connectivity, democratizing high-quality education for a broader audience. By eliminating geographical barriers, teams can learn together remotely, ensuring that advanced training remains accessible and consistent. While our study focuses on liver pathology—an area known for its complexity—the success of VR-based training could have far-reaching implications for other specialties that require high spatial awareness and precision. It sets a precedent for integrating innovative technologies into training, fostering a collaborative and inclusive learning environment for future surgeons and ultimately improving patient outcomes. Prachikumari Patel: Conceptualization; investigation; writing – original draft; methodology; visualization; writing – review and editing; formal analysis; project administration. Remi Gao: Conceptualization; visualization; project administration; software. Albert Fung: Conceptualization; visualization; software; project administration. Chaya Shwaartz: Supervision; conceptualization; investigation; writing – original draft; methodology; validation; writing – review and editing; project administration. The authors have no conflicts of interest. The University Health Network (UHN) Research Ethics Board reviewed and approved this project (CAPCR ID#22-5740). The data that support the findings of this study are available from the corresponding author upon reasonable request.