Mixed Reality in Complex Intracranial Surgery Fellowship

This “first of its kind” program offers advanced training in complex, minimally-invasive intracranial surgery and in the utilization of mixed reality in all aspects of the discipline from patient education, anatomic research and approach planning to intraoperative navigation.

Mixed reality – Virtual (VR) and augmented reality (AR) – is used for neurological surgery with increasing frequency. The technology makes procedures safer, more efficient, and better in preserving the patients’ quality of life. Mixed reality also has other applications in neurosurgery including education and simulation, surgical rehearsal and approach planning, as well as intraoperative guidance. Anatomic research can be conducted with VR models in place of cadavers, which lessens the cost and improves the accuracy. For all these reasons, LVHN have established a “first-of-its-kind” fellowship in mixed reality in intracranial surgery to teach neurosurgeons about this revolutionary technology and its application in complex brain and skull base procedures.

Details

The period of commitment is either 6 or 12 months depending on the fellow’s available start date. Stipend will be commensurate to the PGY-8 level, with additional research funding opportunities dependent on the fellow’s interest.  The fellowship is under the directorship of Chief of Neurological Surgery, Dr. Walter Jean. Dr. Jean is the creator of the textbook “Skull Base Surgery: Strategies,” and a leader in the field of AR and VR for Neurosurgery. He is the course director for the “Virtual and Augmented Reality in Neurosurgery” session at the upcoming meeting of the World Federation of Neurological Surgery (WFNS), as well as the lead topic editor for the August 2021 issue of Neurosurgical Focus, based on the same topic.

Learning Objectives

The fellow will be trained in the latest advanced techniques in complex, minimally-invasive intracranial surgery. S/he will gain proficiency in generating and manipulating VR models of patient-specific anatomy for the purposes of patient education, neurosurgical research and simulation, as well as surgical planning. In addition, the fellow will learn how to create surgical-guidance AR templates for intraoperative use to maximize the efficiency and safety of complex intracranial procedures.

A major role of the fellow is in technological innovation. VR will be applied throughout the fellowship for anatomic research, but additional goals include development of new paradigms for using VR/AR in teaching neurosurgeons, and new applications for surgical planning and navigation. Examples of recent academic publications by our faculty involving novel applications of VR/AR in neurosurgery include:

  • Jean WC, Yang Y, Srivastava A, Tai AX, Herur-Raman A, Kim HJ, Li D, Wu Z: Study of Comparative Surgical Exposure to the Petroclival Region Using Patient-Specific, Petroclival Meningioma Virtual Reality Models. Neurosurgical Focus, in press
  • Tai AX, Herur-Raman A, Jean WC: The Benefits of Progressive Occipital Condylectomy in Enhancing the Far Lateral Approach to the Foramen Magnum. World Neurosurgery, 2019. doi.org/10.1016/j.wneu.2019.09.152
  • Tai AX, Sack KD, Herur-Raman A, Jean WC:  The Benefits of Limited Orbitotomy on the Supraorbital Approach: an Anatomical and Morphometric Study in Virtual Reality. Operative Neurosurgery: Jul 2019. doi.org/10.1093/ons/opz201
  • Jean WC, Tai AX, Hogan E, Herur-Raman A, Felbaum DR, Leonardo J, Syed HR: An Anatomical Study of the Foramen of Monro: Implications in Management of Pineal Tumors Presenting with Hydrocephalus. Acta Neurochir 161: 975-983, 2019. doi.org/10.1007/s00701-019-03887-4 

Responsibilities

The fellow is a member of the Neurological Surgery staff of Lehigh Valley Health Network with an appointment as clinical instructor. In the clinic, s/he will utilize VR to educate patients about their disease and planned surgery. In the operating suite, the fellow will assist in complex cranial, AR-guided procedures for aneurysms, arteriovenous malformations, vestibular schwannomas, meningiomas and other lesions of the skull base. Overnight on-call duty will be part of the fellow’s responsibilities but will mainly involve a level-II trauma center.

Application Process

Candidates must be eligible for the examination of the American Board of Neurological Surgery, permitted to work within the US, and able to obtain Pennsylvania medical and DEA licenses.  Interested applicants should send a letter and CV to:

Walter Jean MD:  walter.jean@lvhn.org