The Novel Application of Photogrammetry in Building Virtual Reality Modules for Multidisciplinary Surgical Education and Procedural Training

Background: Virtual reality (VR) is an emerging tool in surgical education, offering immersive, repeatable experiences and opportunities for preoperative planning. While prior models have used CT or MRI imaging to build VR simulations, these methods present financial and access barriers, especially in resource-limited settings. VR training for open procedures like open carpal tunnel release (OCTR) remains underdeveloped, constrained by 2D formats and limited transparency in content creation. Photogrammetry, the process of constructing 3D models from 2D images, offers a low-cost, replicable alternative. Though previously used in anatomy education, its application in procedural training is limited. This study introduces a transparent method for using photogrammetry to develop a VR OCTR module and assesses its feasibility for multidisciplinary surgical education. 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 across multiple sessions (<2 hours each), using five-step OCTR procedures on cadaveric right arms. Serial photographs were taken from various angles using both phone and Nikon cameras, with drapes minimizing background noise. 3D models were rendered via photogrammetry software and refined with free, open-source tools. The models were viewed through a Meta Quest 3 headset and the teaching module was narrated by a hand surgeon using MedicalHolodeck. Surgical trainees and faculty across target specialties provided usability feedback. Results: The VR module was successfully developed using accessible tools and no-cost software. Nikon images produced higher-resolution, anatomically accurate models than phone images or video stills. The final module illustrated key anatomy, surgical landmarks, and procedural steps. Pilot users found the module appropriately brief (~7 minutes) and conceptually clear. They emphasized its usefulness in reinforcing anatomical knowledge, visualizing operative steps, and noting structures to avoid intraoperative complications. Users also noted its cost-effectiveness compared to commercial VR platforms, making it feasible for broader institutional adoption. These findings support the educational potential of photogrammetry-based VR and inform planned expansion to medical students and an upcoming randomized trial comparing VR to standard 2D training across plastic surgery, orthopedics, and neurosurgery. Conclusion: This study presents a scalable, cost-effective model for developing VR surgical training using photogrammetry. Leveraging accessible technology and cadaveric dissections, this method enhances educational access and supports surgical anatomy comprehension. Early feedback confirms its feasibility, cost efficiency, and educational value, setting the stage for wider implementation and outcome-based research.