The metaverse describes a graphically rich virtual space where humans can interact. The idea is not new but its manifestation is contingent upon the evolution of multiple technological strands.
High speed internet is fundamental, providing ubiquitous connectivity which transcends geographical boundaries. Tools that allow people to interface meaningfully with the metaverse are also key. Initial internet interactions were limited to typing commands via a keyboard. The mouse, touchscreen technology, and more contemporary gesture interface tools are improvements.
The output from the metaverse is currently a key rate-limiting factor. Receiving realistic haptic feedback and moving from 2D to 3D visual feedback is a crucial to achieving any degree of verisimilitude with the real world. Gaming leads the way in many senses here, providing immersive interactive online 3D arenas. Virtual reality platforms are yet to fulfil their promise but will be a key aspect of the metaverse.
Whilst it will take time for the concept to mature, it is worth considering surgical applications now. The conflict in Ukraine highlighted how even the relatively crude interactions afforded by Zoom (a metaverse prelude technology) could help local surgeons respond to the challenges of the war. Medicine sans Frontier do similar, using online teleconferencing for training, supervision, and consultations. The fidelity of these platforms will be enhanced as the metaverse matures. Growing centralisation of subspecialty practise means some trainees are not exposed to certain cases. Telemedicine and downstream metaverse iterations could allow units to cooperate and remove this barrier. For example, Proximie combines AI, machine learning, and augmented reality to allow distant clinicians to interact during a live surgical procedure or assessment. Particularly relevant to surgery is how surgical robots will interface with the metaverse. There are already examples of surgeons in distant locations controlling surgical robots to perform procedures, including the placement of a deep brain stimulation electrode for Parkinson’s disease.
Humans evolved in the context of face to face interactions and human touch - and it is hard to contemplate a future without this. However, we already exist in a hybrid reality. Development of the metaverse will change our day to day reality as well as surgical training and surgical delivery.
Consultant Neurosurgeon and Honorary Senior Lecturer, Edinburgh