Tele-consent using mixed reality glasses (NREAL) in pediatric inguinal herniorrhaphy: a preliminary study

Won-Gun Yun,Dayoung Ko,Hyun-Jin Joo,Hyun-Young Kim,Inhwa Yeom,Hyoun-Joong Kong,Joong Kee Youn

doi:10.1038/s41598-022-06653-2

Won-Gun Yun, Dayoung Ko + Show 5 more

Open Access

https://doi.org/10.1038/s41598-022-06653-2

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Abstract

There is an increasing demand and need for patients and caregivers to actively participate in the treatment process. However, when there are unexpected findings during pediatrics surgery, access restrictions in the operating room may lead to a lack of understanding of the medical condition, as the caregivers are forced to indirectly hear about it. To overcome this, we designed a tele-consent system that operates through a specially constructed mixed reality (MR) environment during surgery. We enrolled 11 patients with unilateral inguinal hernia and their caregivers among the patients undergoing laparoscopic inguinal herniorrhaphy between January through February 2021. The caregivers were informed of the intraoperative findings in real-time through MR glasses outside the operating room. After surgery, we conducted questionnaire surveys to evaluate the satisfaction and usefulness of tele-consent. We identified contralateral patent processus vaginalis in seven out of 11 patients, and then additionally performed surgery on the contralateral side with tele-consent from their caregivers. Most caregivers and surgeons answered positively about the satisfaction and usefulness of tele-consent. This study found that tele-consent with caregivers using MR glasses not only increased the satisfaction of caregivers and surgeons, but also helped to accommodate real-time findings by adapting surgical plan through the tele-consent.

Highlights

There is an increasing demand and need for patients and caregivers to actively participate in the treatment process
Inguinal hernia can be diagnosed by confirming groin protrusion under high abdominal pressure, and the etiology of pediatric inguinal hernia is almost always patent processus vaginalis (PPV)[2]
Asymptomatic PPV develops into subsequent inguinal hernia later in only 10%; laparoscopic inguinal herniorrhaphy is associated with major complications such as nerve damage or infertility[3]

Summary

Introduction

There is an increasing demand and need for patients and caregivers to actively participate in the treatment process. This study found that tele-consent with caregivers using MR glasses increased the satisfaction of caregivers and surgeons, and helped to accommodate real-time findings by adapting surgical plan through the tele-consent. When pediatric patients undergo surgery, some intraoperative findings may require giving explanations to and obtaining consent from caregivers. This situation occurs more often in pediatric surgeries than in adult surgeries; this is likely because pediatric surgery encompasses a large variety of disease groups, with most of them being benign diseases, so it is important to preserve the organs as much as possible during s urgery[1].

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