Qualitative analysis of the Innersight Labs 3D model at East Kent Hospitals University NHS Foundation Trust (EKHUFT)

Assessment of a patient’s surgical need typically includes a scan during the preoperative stage (Przedlacka et al., 2021). These scans provide flat images (“slices”) in shades of grey which provide horizontal and vertical dimensions (Muehlhauser, 2022). Three dimensional (3D) models, resembling a digital reconstruction of the patient’s organs, permit exploration from horizontal, vertical and sagittal dimensions prior to surgical intervention (DICOM Director, 2021). 

Funding was provided by Health Innovation Kent Surrey Sussex (KSS) for Unity Insights to conduct a qualitative analysis on the use of the Innersight Labs 3D model at East Kent Hospitals University NHS Foundation Trust (EKHUFT), within the colorectal major resections perioperative pathway (February 2023 – November 2023). The aim of this qualitative evaluation was to understand the clinical perception and potential benefits of the Innersight 3D model platform in the preoperative planning and the intraoperative process for colorectal major resections pathways at EKHUFT.  

Surveys were developed to understand the 3D model’s helpfulness across different perioperative activities such as planning and decision making within a multidisciplinary team, assistance required and surgical excision (preoperative planning and intraoperatively), hypothetically explaining patient outcomes (i.e., patients were not shown the models during this evaluation, but clinical opinion on helpfulness was explored) and understanding workforce impacts. The colorectal operating surgeon completed one survey after each surgery (n = 9) and an overall survey. Four clinical experts (a consultant surgeon, a colorectal surgical care practitioner, a gynaecology consultant, and a gynaecology surgical registrar) each completed an overall survey for all surgeries that they attended. 

Planning and decision making across a multidisciplinary team:  

• Findings suggest that the 3D models could be beneficial in the co-ordination of patient treatment and care across a multidisciplinary team. Additionally, there was the potential to use the model to assist with incision placement.   

• The 3D models could be perceived as more helpful during the preoperative planning phase for assistance required and surgical excisions. Intraoperatively, the 3D models could help if there is a change to the surgical plan. 

Explaining patient outcomes: 

• The operating surgeon indicated that the model aided in explaining surgery specifics and managing patient expectations.  

Avoiding complications: 

• The operating surgeon stated that the model “decreased [the] chance of post op infections” and by having additional staff/specialities to hand, the surgeon was “happy to continue with [the] radical procedure, thereby avoiding stoma and its frequent complications”.  

Workforce impacts: 

• All of the experts indicated that the models would be helpful with training new or more junior members of staff. Additional feedback indicated that “It [the 3D model] may also be helpful in planning surgical incision, by evaluating the position of major vessels. I think it would be also helpful in teaching and training.” 

• Overall, the operating surgeon recommended that the Trust implement Innersight as part of future surgical procedures. Additionally, the operating surgeon suggested that there may be some time efficiencies as there is “no waiting for other specialities to arrive”, but that this time efficiency is “difficult to quantify as [it] is [on a] case by case [basis]”.  

• The majority opinion of the experts was neutral when considering adoption of the model into current practice. A potential explanation for the neutral response may be the unclear application or evidence base of the 3D model to a specific speciality. For example, one expert stated that the “application in gynaecology should be looked [at] in depth with many cases”. Whilst the Innersight 3D model platform has been used in several NHS trusts across England (North Bristol NHS trust, Frimley Health NHS Foundation Trust, and Barts Health NHS Trust; Innersight Labs, 2024), the model’s perceived benefits may vary. Willingness to adopt the solution could be dependent on site and specialty specific evidence to facilitate clinical buy-in and uptake of the solution as part of standard operating procedure. 

This evaluation demonstrated the importance of gathering specialty-specific evidence to garner widespread clinical adoption. This should assist plans for spread of the solution.