Transforming Surgery with XR: Dr. Omar Jibrel, Journey from the OR to Medical Innovation

Ever wondered how a traditional surgeon transitions into a tech-savvy innovator? Join us as Dr. Omar Jibrel, a renowned surgeon turned entrepreneur, unfolds his transformative journey from the operating room to the frontier of extended reality (XR) technologies. His early days in Sweden sparked a passion for immersive simulation, leading him to harness augmented, virtual, and mixed reality to revolutionize surgical training. Dr. Jibrel shares the pivotal moments that inspired his shift and the profound impact this technology can have on improving performance and patient safety.

From a startup pivoting from gastroenterology to securing a prestigious SBIR SBPR grant, this episode captures the excitement and challenges of pioneering XR solutions in healthcare. Join our discussion on the future of medical training, where Dr. Jibrel advocates for integrating simulation into daily practice, even beyond traditional settings. We explore the potential of a virtual skills university, providing global access to top-tier medical training, especially for remote and underserved areas. Tune in for a compelling conversation about the future of simulation and innovation in healthcare.

Website: https://endoxr.com/

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Transcript

Disclaimer/ Innovative Sim Solutiuons/ intro: 0:00

The views and opinions expressed in this program are those of the speakers and do not necessarily reflect the opinions or positions of anyone at Innovative Sim Solutions or our sponsors. This week's podcast is sponsored by Innovative Sim Solutions. Are you interested in the journey of simulation accreditation? Do you plan to design a new simulation center or expand your existing center? What about taking your program to the next level? Give Deb Tauber from Innovative Sim Solutions a call to support you in all your simulation needs. With years of experience, Deb can coach your team to make your simulation dreams become reality. Learn more at www. innovativesimsolutions. com or just reach out to Deb Contact today. Welcome to The Sim Cafe, a podcast produced by the team at Innovative Sim Solutions, edited by Shelly Houser. Join our host, Deb Tauber, as she sits down with subject matter experts from across the globe to reimagine clinical education and the use of simulation. So pour yourself a cup of relaxation. Sit back, tune in and learn something new from The Sim Cafe. Tune in and learn something new from The Si m Cafe.

Deb Tauber: 1:28

Welcome to another episode of The Sim Cafe, and today we're going to have Ferooz as our co-host, Fe rooz Sekandepoor. So thank you Ferooz , for joining us today.

Ferroz Sakandepoor: 1:41

Thank you. Thank you for having me once again to host this great podcast. So hello to our audience.

Deb Tauber: 1:48

Thank you. And today we have Dr Omar Jibral and he is going to be opportunity to host me on the podcast today. It's a wonderful experience surgical coach.

Omar Jibrel: 2:02

I'm doing entrepreneurship along with a company called EnderXR. It's a startup.

Ferroz Sakandepoor: 2:06

It runs on the axis of simulation and innovation involving augmented reality, virtual reality and AI and at the same time, I'm deeply involved and in love with simulation because I see a unique value. Great, thank you very much, Dr Jibrel. And before I know, you talked about simulation and innovation, but you're a surgeon, so what inspired you to pursue the surgery first and how that transitioned later on to simulation?

Omar Jibrel: 3:08

That's a good question. Thank you so much. My grandfather passed away in 2000 from an advanced colon cancer that was spreading in the body and that made me realize and appreciate that the healthcare system, people who are working in it, really are doing a great job and have a lot of burden on their shoulders. Also, I realized from my father's work was at that time transitioning between jobs that becoming a doctor or a physician has a unique mission in terms of fulfilling the humanitarian touch and care for the patients and the society. My aunt also was head of neonatology, nursing in a hospital. She also encouraged me to pursue a career in healthcare. Encouraged me to pursue a career in healthcare. I embarked on my residency back in my home country.

Deb Tauber: 4:13

Omar, and that was the beginning of my journey in surgery, Dr Jibral, when did you actually start your first simulation experience?

Omar Jibrel: 4:28

Well, my first simulation experience was back in 2018. I was invited and participated in a conference in endovascular, trauma and vascular surgeries in Sweden, in Uribe. It's in the west part of Sweden, a lovely town, and there I got some hands-on experience of how simulation can bring real-life experience in an immersive, controlled way In a patient safety, de-risk environment. I started to love the concept that you can not only train. You can not only train but transition your cognitive skills and abilities to think and learn outside the box.

Omar Jibrel: 5:12

Till that moment, I used to, as most of the surgeons before, realize that training this skills aspect is about apprenticeship. So from there I started to appreciate the value and the unique preposition it brings of being involved in simulations. I mean, before that, I read some articles and some friends of mine told me about simulation in aerospace industry as pilots or mechanical engineers involved in repairing airplanes, and I saw once a documentary about it, about a simulation center in Canada, near Montreal, that works on such skills. So it turns out to be it can be mimicked for any skills-driven procedures that you combine as much as real scenarios as possible to a controlled environment, which is a fantastic thing.

Ferroz Sakandepoor: 6:13

That is a great story. So, Dr. Jibrel, I think in the healthcare there's a lot of physicians and clinicians who are involved in simulation every day and none of them become entrepreneurs. They are just going to be academic and just sort of continue with that and teaching, which they love. And so can you tell me what triggered you or what transition you made to use those technologies and these things that you just described, reading about the articles and being exposed to these things and just becoming an entrepreneur out of it? So how did you choose this? Did you have any background in entrepreneurship or business or anything like that?

Omar Jibrel: 6:59

There is an exciting short story I'll tell you about. The pandemic happened. It hit everybody worldwide and I had a hard time trying to figure out how can we have some CMEs and hands-on training workshops in a simulated way, or even in as much as possible, maybe on, maybe on pigs or something, but it's in the end, a simulation setting. So I realized there is none and this triggered me to think about, to think even in an unorthodox way. How can we bring something that brings the core concept of simulation in a continuous innovative way? So we brainstorm simulation in a continuous innovative way. So we brainstormed with a friend of mine he's on the technology side that maybe XR is the solution. XR is extended reality, XR xr is the umbrella of augmented reality, virtual reality and mixed reality, and he also told me about it. So I dig deep and we started a concept of simulation, not necessarily restricted for simulation centers, which would be a fantastic situation. But you know what happened during the pandemic? Everybody had sometimes curfew or limited access to simulation centers and facilities. So we brainstormed the idea of bringing the head-mounted devices alongside online access so that you can have immersive experience in a controlled way that will enhance your performance Now, training those skills and enhancement of performance complete and synchronize each other. So the concept is you do simulation on daily basis before your operation or procedure and once you do it, if you wear the glasses, you have some data collection and that can be implemented in the virtual reality, which is 100% digitalized growth, compared to an augmented reality, which is a real life on the background of some digitalized aspects of it, which can be implemented for real life's real patients practice. So you get training on patients virtually in a safe way, again de-risking it, which is the beauty of simulation. You have that aspect of the simulation and you can then take it and practice it on the patients in the augmented reality one. So you have multiple and this is the beauty of XR extended reality.

Omar Jibrel: 9:45

Whatever you choose from it, it always brings the value of simulation. So it's like an ecosystem that each part of it brings it, like a ring completing each other to bring the best outside of you. And there is a lot of data and a lot of clinical trials that have proven worldwide the value of using extended reality in all of its forms to increase confidence of the person who is performing it, whether the nurses, the firefighters, the airplane pilots and definitely, of course, surgeons, and we're not only serving surgeons in our sort of company called Endo XR. We're serving also nurses, healthcare professionals, paramedics, people who are doing interventional medical procedures such as interventional radiology, pulmonology, etc. And we see the value being extended across the board because stimulation is gaining more and more momentum.

Omar Jibrel: 10:52

So we get students, even normal people who are outside the healthcare world. One of my patients that day he said well, do you use your glasses or do you go to center that you use in a simulated way that can make you always safe for your patient? Is that part of your training? So even outside our community as healthcare professionals in the society it's becoming more and more popular, especially after the release of the. You know the hype of the Apple Vision Pro and worldwide momentum of technology being advanced. It's just mind-blowing how it goes day by day.

Deb Tauber: 11:31

Now, Dr Jibrel, I have a question. So first of all, where are you physically located? What country are you in?

Omar Jibrel: 11:38

I'm physically located in Bahrain. I work in Bahrain. It's a country based in the Gulf region in the Middle East.

Deb Tauber: 11:46

And so I think what I heard you said was, before you do a surgery, you actually get into the goggles and go through the surgery before you actually do any surgery.

Omar Jibrel: 11:58

In our concept as enhancements of performance. We believe it's a continuum. So prior to the surgery, before the surgery, pre-operation, you can have the basic settings there. Maybe you don't catch, for example, the vital signs such as the blood pressure or some stuff which we use during the surgery, because maybe the patient is not there. But the beauty of it you can, for example, take the images, you can spread it from its stacked format and examine where's the disease and how to it by.

Omar Jibrel: 12:36

We created a 3D rendering of that image in the form of 3D animation, where you can pick it, play with it in a high fidelity, game-like environment and that can make visualization of the organ and the adjacent surrounding organ, give insights about which approach to do, which instruments to be picked, how to tackle this patient. Are there some considerations for the anesthesia, the nurses, all these aspects you don't want to bump, even if you're well-prepared for a scenario that's storming you in a disastrous way. You panic, you keep running, then the mistakes happen. So the idea is from the beginning to make things as well-prepared as possible. Then you have the part of it when you are using it during the surgery or during the procedure. Part of it when you are using it during the surgery or during the procedure. You wear the glasses, then you sync with the monitors. You have on the top the vital signs of the lab data. Then you have below it, on the right, you'll have the images where you can spread it beautifully, pick it it's like Minority Report of Tom Cruise in some way, but it's in the healthcare sector Then those images of the diseased organs, we can create a 3D animation of it where the surgeon or even the assistant this is also one of the beauty of it where you coordinate the work with your nurse, with your resident, with your fellow colleague, to try to understand what you're trying to do. And that's very crucial when you're working in a multidisciplinary or in a teamwork, because every person has to be well-synced into the system and into the procedure.

Omar Jibrel: 14:26

And on the left, we're working on making AI tips, spurts, tricks of the technical aspects. For example, use this approach or this device or this maneuver instead of that, based upon a panel of experts and machine learning from data and analysis. Those are the core principles for use Now you have post-operatively, now, after the procedure, you'll have some insights about what are the stuff to be done to minimize as much as possible the incidence of having some complications and, at the same time, improve the patient's outcome and, of course, the procedure. And to make it clear that it's about collecting the data from the patient and from the person who's performing it, and hopefully maybe we can use it for, for example, ai and data collection, so that you're always seeking that enhancement of performance on all the levels your team, yourself as a person who's performing a procedure, or even the patient themselves. This can benefit the healthcare institutions and the society, hopefully.

Ferroz Sakandepoor: 15:42

That's great. Well, Dr Jabil, as you were talking, I was thinking, so I'm always, and I think the technology is out there and just for clinicians and surgeons to create their, you know, take their ideas and make it into a business or a model that it could be profitable, and in this case, yours, the company. So what is the biggest challenges for you while you established this VR company? And once again remind me of the name it was Endo.

Omar Jibrel: 16:14

EndoXR.

Ferroz Sakandepoor: 16:15

EndoXR.

Omar Jibrel: 16:17

Yeah, Endo. Actually we pivoted. We wanted to start in gastroenterology. Definitely R&D is one of the challenges, but we got lucky to be preliminary selected for an SBIR SBPR grant for R&D and innovation with the University of New Orleans, texas. We'll embark on August 2nd for that. We're excited to bring and patent one of the new concepts, which is I love combining technologies together so that you're always having unique value prepositions, always bringing that cutting edge technology for the people who are doing it. So we will reach to a level where in XR we will plateau. So it's XR, but if you bring something with the XR, that's the smart way to move forward. And making simulation engaging that's one of the aspects that make people click. You don't want people to say, well, this center is boring because I use that type of simulator or technology and you know it's not clicking, it's not making me more enthusiastic to be engaged. We want people to have it in a fun, user-friendly way and always looking forward to use it, actually being sort of in a good way addicted to it.

Ferroz Sakandepoor: 17:35

Yeah, love to test it out. I've got quite a number of headsets with me here, so love to pick it up at some point. Yeah, I think there's just. I know Dev has another question for you, but I just want a question on a technology. Are you guys fixed on a? Any hardware, like you know, oculus, or or you? Just? Your platform is open to all the other headsets, such HTC and other headsets we're open to the hardware tier that supports virtual reality, augmented reality and mixed reality so for instance, if you take, I have nothing against this company.

Omar Jibrel: 18:16

It's a very fantastic company, but their gear is targeting augmented reality audience and companies and software builders, which is magically. They're really innovative. They're fantastic, they're based in Florida, but you have other companies, for example Meta, or you have the Apple Vision Pro. These are just just examples and we're sector agnostic when it comes to hardware. So we take anything, but you have to keep in mind that your affiliated partners maybe don't have that budget to bring, for example, some hardware of thousands of dollars for the audience, while it can be done for a couple of hundred bucks for for the same value. Especially when you are a sort of company.

Omar Jibrel: 19:03

Sometimes you have to put the to put these considerations at the forefront while you are embarking on your journey, and the main idea is to have a good display with a visualization. It doesn't have to be mind-blowing, crystal clear thing, but you have to have it in a good way. You have to have the flow, it doesn't have some hiccups, it has the technical support, whether on a cloud or a server, and the hardware. What's very important about it is that it has to have the good amount of power supply or energy that keeps you running off. You don't have to always be teetered and connected and you're worrying about that At the same time. Data privacy is important. The software display and collection of data is important. So these are the main areas.

Ferroz Sakandepoor: 19:57

Sounds like currently, your software or your VR simulator is compatible with HTC, Oculus and Pico. Is that the three right now?

Omar Jibrel: 20:09

Actually, it's compatible with Pico, with Meta, with HTC, with Apple Vision Pro or Apple system. So we're again. And for the AR, we are also compatible with Magic Leap. We're not trying to put ourselves in the corner and picking only one company.

Ferroz Sakandepoor: 20:27

That is a great strategy, definitely yeah.

Omar Jibrel: 20:30

We're open for everything out there and even we tell our customers and our partners and universities we have no preference as long as it delivers the same message, the same software, the same experience.

Ferroz Sakandepoor: 20:45

That's great, thank you. Thank you, that's great, good to know.

Deb Tauber: 20:49

How did people in the operating room respond when the first time that you said we're going to do this virtual reality? I like to hear that.

Omar Jibrel: 20:56

I have a funny story, if I may share it with you please. I was assisting in an operation and there was once an incident where I was in between the operations and they prepped the other patients to bring them inside. So I saw a hand on my shoulder. I was wearing the glasses and trying to record for iterations and helping my tech developers tweaking some stuff because it's an ongoing process, making that software interesting and that head on my shoulder was telling me what on earth are you doing? And it was my dad and he told me well, it must be something really interesting because you seem so engaged in it. And I told him would you like to try? And he tried it. And the next day there was another colleague trying it. And each person tells me we never had experienced something like this. It's like a sci-fi movie where in reality that before something maybe like 20 years, not even long ago, it was almost impossible to imagine that you're reproducing the results, you're making things precise, good and you're doing something really beautiful and unique, that it's like you're loving it or engaged. The experience is really I don't have the words to explain how engaging people are when they wear the glasses. They feel they're transformed into another area where they can achieve, they can do it, and that's the essence of simulation, so it's not only a game.

Omar Jibrel: 22:43

I always think that simulation shouldn't be strictly labeled or directed to a simulation center. We open at 8, we close at 4. You just take your cup of coffee, you grab your coffee, you chat with some people and you have some stations in a routine way and you know you have some stations in a routine way and you go home. So maybe the practice of it is not more than maximum maybe 40 percent in the best centers maybe it's 50 percent, maybe it's 100 percent. But if you can't take those glasses to your home, you go on a vacation, you're in a quiet atmosphere and you're relaxed and you see how you perform or how you will perform, or you are in the operation and you're wearing those glasses.

Omar Jibrel: 23:24

You will see a real shift in your perception, cognitive skills, immersed experience that can bring value for your hand movements, your decision-making, and I can go for months talking about how beautiful it is. I wished it was in my residency, for example. Maybe I had changed a lot of things in my life because of the experience it brings. Definitely, again, simulation synchronizes with XR and these glasses, and I think people should reconsider the definition of simulation as strictly going to a simulation center a couple of times a year and that's it, just for a senior certificate or an experience on one device or another device. It should be a lifestyle, an engaging, a daily activity. It should be a lifestyle, an engaging, a daily activity. People should love going to do simulation because that's the future for training, education of skills and the go-to for these related industries.

Ferroz Sakandepoor: 24:28

I totally agree. I just come from ASPE Conference Association of Standardized Patient Conference in Vancouver and I presented there and my presentation was about the past, present and future of AR and VR and XR, which was great to see the audience reaction as well. And one thing that I've also seen that this simulation, especially VR and AR, especially with the phones and all of these devices, and how affordable it becomes at some point, I think this should be a part of. I see it's like sort of a textbook. You know, if you're a resident, you should bring your textbook home to read and study. I think you should be able to also bring some of this VR experience and then try it at home. You don't need to be at the simulation center as well. I mean you could be in a simulation center for specific things that are directed by a faculty and help you on those things, but some experiences like orientation of OR, procedural and to see how you can engage in those environments orientation of OR, procedural and to see how you can engage in those environments. You know you could be. If I'm a student, a resident, I should be able to bring that at home and augmented reality, just put some things in my own chair and to see how I visit a patient.

Ferroz Sakandepoor: 25:46

I think one of the technologies I think GigaXAR is one of the technologies that you can allow you to do that and just between even connecting between your fellows, you know, like fellow students, so we can all connect and just group teamwork and that's what I see. I hope that's going to be the future of this technology, to allow better accessibilities and allowing the students and learners to have further access to these learning environments. So these are great. I love to hear this. So I know we are close to the end of our time, but what I was asking is can you tell us how, right now, what stage your technology is? Is it as a beta, the beta testing, or is it launched, and how people get access to that if they wanted to, if they're right now some of our listeners are universities or hospitals that they wanted to give it a trial or test it. Is there any of these opportunities available within your system?

Omar Jibrel: 26:47

Each startup has some challenges. We're trying to overcome them at one time at another. The major challenge would be always finance. So if you don't have, for instance, letters of interest, or you have some fraction or deals, you're still lagging behind. This is the sad thing about startups. Sometimes innovations die because they don't get enough support, unfortunately, but we're working on that. Startups, sometimes innovations die because they don't get enough support, unfortunately, but we're working on that. We have some good talks about it and some exciting, interesting projects about creating a virtual skills university.

Omar Jibrel: 27:24

So you don't need to move from India or China or any other country outside your home country, especially if you are, for some reason, working in rural areas or difficult areas, in the military, in combat area. You're working in a humanitarian way, saving some people in Africa, but you want to improve your skills in a simulated environment using XR. We believe there is a go-to and it can be online learning. In the beginning, such as the guys in Udemy, idex or Coursera the famous one. It was something like a fantasy a couple of years ago, like, why should I train or, for example, take some knowledge online? Well, what's the big value of it? Well, it turns out to be when we had the pandemic. You couldn't go anywhere or you don't have the time. You can't quit your job, especially in our times. You know the financial situation, economy. You can't just ditch your job just to take, for example, a fancy course here and there or attend the university, while it can be done online and it's this concept is gaining more momentum.

Omar Jibrel: 28:40

So the problem was in medicine always whether for nurses. But nurses were lucky because they focus and a big salute and shout out to them because in their schools and faculties they focus always on the skills as well as the knowledge. So skills knowledge, it's not the knowledge and the skills and unfortunately, in surgery and in medicine in general, we focus on knowledge. You get tested in your birth certification while you have your examination on the knowledge, your birth certification while you have your examination on the knowledge. Maybe you never did an operation and maybe you did rarely that operation. You're an assistant. I saw some cases. People became attending physicians and their hand skills are really, really, really disastrous and it's. The problem is not that surgeon is actually patient who will be lying on the table undergoing that surgery and he doesn't know if that surgeon is good or not. We're not terrifying people. These are rare cases, but sometimes it's a scenario that we have to rethink that.

Omar Jibrel: 29:47

To put it as a must, skills is always the top priority, definitely with knowledge, but to address the skills in a simulated way, innovative way and, by the way, it's cost efficient to have an XR in a simulation center or a university or in any way Our project would be really interesting to people so that, wherever you are, whenever you want to, you can use these type of courses and you'll have something like a dedicated 24-7 bot. And also from different aspects of the world. Maybe people are awake in Korea while you're at night, for example, in London, and you want some feedback. You'll get it, so that would be an interesting thing.

Omar Jibrel: 30:35

Going back to your question, we think that the future that lies ahead for healthcare innovation and digital transformation is just really amazing. Each day, even each hour, there's new developments going on and we should rethink how we teach people in the medical schools, the nursing schools and any skills-driven procedure how they should perceive simulation. Some people have no clue, unfortunately, around the world. What is simulation around the world? What is simulation? Simulation is a mindset. Simulation is not only going to simulation centers, but it's a life-changing experience that gets you engaged, the more you are involved in it, which is the beauty of it. That produces a safe, consistent, incremental change that positively impacts society.

Ferroz Sakandepoor: 31:33

So how people can get hold of your technology if they wanted to try it, oh, I didn't answer that.

Omar Jibrel: 31:41

What stage you are right now to get access, and maybe is it just testing for the testing you require at this stage or when it's being where we're working on beta testing, one of our prototypes now, and this experience about the prototype beta testing would really benefit us for from the regulatory aspect for the hipaa, fda approval and being certified in that way. At the same time, we want the feedback from people, because if you have a software theoretically in a simulated way, it's totally different than if you have it on an animal or on a patient. Definitely it would be safe. But we want to receive the feedback from the technical aspect and also the human aspect, or, let's say, the people who will be engaged and using it. They can reach out to us the our website would be endoxr. com or they can find my profile on linkedin and reach out to us through schedule. At demo, we can share the link and we would be glad to partner and collaborate with healthcare systems that would want to be part of positively impacting and changing the world for the better.

Ferroz Sakandepoor: 32:58

Well, definitely we will just indoexar. com. That's the website. We will put that in the notes, as well as your contact as well, for people to reach out Deb. Any follow-up questions?

Deb Tauber: 33:11

No, this has really been very interesting and I appreciate your time and contributions to simulation, Dr Jibral.

Omar Jibrel: 33:18

Thank you so much, Deb yeah.

Ferroz Sakandepoor: 33:20

Thank you, Sure. Well, hopefully we have a follow-up and next time we'll see how many. I mean, you're not at the beta testing at that time, so we're just deploying it and we're going to ask which universities using it and look forward to more of these. That's fantastic. Thank you very much for your time, Dr J .

Deb Tauber: 33:39

Thank you so much and happy simulating.

Omar Jibrel: 33:43

Thank you so much.

Disclaimer/ Innovative Sim Solutiuons/ intro: 33:45

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