Virtual reality (VR) reconstruction allows immersive experience and enables visualization of vascular/ complex anatomy. In this prospective study we analyzed usefulness of VR in pediatric urology.

All patients who underwent VR reconstruction in our department over the last one year (2023-24) were included. Contrast enhanced CT scan/ MRI images were obtained at 1mm thickness. A VR model and a 3D environment were created (Immersive view5.0; Immersive Touch Inc. 910). The usefulness was assessed by three independent physicians on a Likert scale (1-5) on the following headings: anatomical delineation, haptic tools, pre-surgical planning, student teaching and patient counseling. Inter class correlation (ICC) analysis was performed using SPSS.

Among 275 patients managed, 20 cases underwent VR reconstruction in view of the complex anatomy/ combination of anomalies. The diagnoses were bilateral Wilms Tumor 1; pelvic kidney UPJO 1; horse shoe kidney 1; malrotated UPJO 1, duplication anomalies 8, recto urethral fistula 1; exstrophy variants 3, complex urolithiasis 2, bladder diverticulum 1 and renal trauma with urinoma 1. Among the study population 18/20 underwent surgical treatment; two were managed conservatively (renal trauma-1; pseudo exstrophy -1). The mean usefulness score was: anatomical delineation 3.9, haptic tools 3.1, surgical planning 3.6, student training 4.1 and patient counseling 4.2. ICC for indivudal measures was 0.893 (95% CI 0.792-0.952; p<0.001)

VR application is most useful for patient counseling/ student education followed by anatomical delineation and presurgical planning. Selection of ideal cases for VR will make this novel tool cost-effective.