BACKGROUND: Surgical education often relies on costly task trainers or two-dimensional surgical videos. Photogrammetry, the process of constructing three-dimensional (3D) models from two-dimensional (2D) images, offers a cost-savings solution while providing a customizable 3D surgical experience. This technique for building photogrammetry-based 3D models allows for the creation of virtual teaching modules and aimed to enhance options for surgical education. While photogrammetry has been used to build models for teaching anatomy, its application in procedural simulation remains limited. Additionally, open carpal tunnel release (OCTR) achieves outcomes comparable to the endoscopic approach, yet virtual reality (VR) training simulations for this open technique have not been explored. This study introduces a low-cost VR OCTR surgical teaching module using photogrammetry to explore production feasibility and educational value across surgical disciplines.

METHODS: A VR OCTR module was created using photogrammetry to generate virtual hand and wrist models from intraoperative cadaveric dissections. Filming was conducted in an academic anatomy lab, demonstrating a five-step OCTR procedure on cadaveric right arms. Serial photographs were captured from multiple angles using a Nikon Z8 camera, with drapes placed to minimize visual distractions. 3D models were rendered via photogrammetry software and refined with open-source tools. The models were viewed through a Meta Quest 3 headset and the teaching module was narrated by a hand surgeon using the MedicalHolodeck Surgical and Anatomical VR application. Surgical trainees and faculty from plastic surgery, orthopedics, and neurosurgery provided feedback for further model development.

RESULTS: This VR module was built using accessible tools and software. High resolution photographs resulted in the anatomically accurate 3D models used to highlight essential anatomy and surgical landmarks in the teaching module. The seven-minute module was noted to be conceptually clear and appropriately concise. Feedback emphasized its usefulness in reinforcing anatomical knowledge, visualizing operative steps, and noting structures to avoid during surgery. In-house development of the modules highlights its customizability for institutional specific learning goals, cost-effectiveness and feasibility for broader institutional adoption, compared to commercial subspecialty specific private platforms for VR surgical training. These findings support the educational potential of photogrammetry-based VR and guide further pilot studies, expansion to medical students and an upcoming randomized trial comparing VR to standard 2D training.

CONCLUSION: Photogrammetry can produce low-cost 3D models for virtual reality teaching modules in surgical education and training. By leveraging accessible technology and cadaveric dissections, this method enhances educational access and sets the stage for wider implementation and outcomes-based research.