Grants Funded

Abstract
Augmented reality technology allows remote yet “hands-on” education for overseas surgeons who seek to provide cleft lip repair. As a novel teaching modality, it has the potential to revolutionize the international transfer of surgical knowledge and skills, thereby expanding global access to quality cleft care. The proposed study builds on a proof-of-concept project by the Principal Investigator in which novel augmented reality technology enabled a remote surgeon (in the U.S.) to provide “hands on” virtual assistance during an ongoing overseas operation, effectively “scrubbing in” to guide and proctor an international surgeon. Using a 12-month longitudinal curriculum, the proposed project has three aims: measure the adoption of augmented reality technology by international surgeons, assess the ability of the technology to build overseas capacity and surgical autonomy, and evaluate its utility in complementary cleft services. These research aims test the central hypothesis that augmented reality technology is an effective new solution to build international capacity and sustainability for the surgical repair of a genetic deformity affecting 1 in 700 children worldwide. The project entails a partnership with Global Smile Foundation™, Peru's Universidad Privada Antenor Orrego, the Peruvian Ministry of Health's Social Security (EsSalud) Hospital System, and Boston-based technology start-up VITAAX, L.L.C. As part of the augmented reality curriculum, the Principal Investigator will provide in-person didactic and surgical training to selected surgeons in Trujillo, Peru, and will proctor cleft lip repair operations from Riverside, CA, using augmented reality technology. Periodic surveys and assessments by both international and remote surgeons will measure improvements in various components of cleft surgical proficiency as well as the ongoing safety, reliability and effectiveness of the technology platform. Objective gains in capacity and sustainability of regional cleft care will be measured over the study duration, as will metrics for operative efficiency. If successful, this technology and surgical curriculum can be replicated in additional international locations; the Principal Investigator has established partnerships in Ecuador, Guatemala, Lebanon, Ivory Coast, Senegal, and India. Also promising is the prospect of adapting the technology and teaching modality for use in a wider variety of reconstructive procedures – both in the U.S. and abroad.

Biography
Raj Vyas, M.D., is Director of Cleft Craniofacial and Pediatric Plastic Surgery, Chief of Plastic & Reconstructive Surgery, and Assistant Clinical Professor at the Division of Clinical Sciences of the University of California, Riverside. Dr. Vyas piloted augmented reality technology with Global Smile Foundation in 2014. He has served as Director of Global Research and Director of Community Outreach for Global Smile Foundation since 2009, has worked with Partners in Health (Rwanda), and has experience in international outreach at premier teaching institutions with active global health departments. Dr. Vyas brings his experience and expertise to this project of high importance to a globally underserved population.