Abdominal SurgeryVR-RECOVERNCT07493499
Effect of AI-Personalized Virtual Reality on Postoperative Recovery After Major Abdominal Surgery
A study testing Immersive Virtual Reality (VR) and Standard Perioperative Care and Enhanced Recovery Protocol in people with Abdominal Surgery and Postoperative Recovery, run by Alexandria University at 1 site in Egypt.
Trial summary
Major abdominal surgery is frequently associated with postoperative pain, anxiety, delayed recovery, and prolonged hospitalization. This study aims to evaluate the effectiveness of an AI-personalized virtual reality (VR) intervention as an adjunct to routine postoperative care in improving recovery outcomes among… Read more about this study
- Who is it for?
- Ages 18 to 60 years
- Conditions the study is for
- Abdominal Surgery, Postoperative Recovery, Postoperative Pain
- What is being tested?
- Immersive Virtual Reality (VR) and Standard Perioperative Care and Enhanced Recovery Protocol
- Type of treatment
- Pill or oral medicine, Injection or infusion, Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 84 participants
- Where
- 1 siteEgypt
- Study dates
- 28 Mar 2026to 30 Jun 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 60 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Adult patients aged 18 to 60 years.
- Scheduled for elective major abdominal surgery (e.g., colorectal, gastric, or hepatobiliary procedures).
- Physical and cognitive ability to provide informed consent.
- Ability to use and interact with Virtual Reality (VR) equipment (head-mounted display).
- Followed the standardized Enhanced Recovery After Surgery (ERAS) protocol at the hospital.
Who cannot join
- Patients with a history of epilepsy or photosensitive seizures.
- Significant cognitive impairment or diagnosed psychiatric disorders that may interfere with study participation.
- Severe visual or auditory impairments that prevent effective interaction with VR content.
- Patients with pre-existing motion sickness or severe vertigo.
- Presence of open wounds or infections in the head or face area that prevent wearing the VR headset.
Trial locations and contacts
1 site in 1 country.
Egypt1 site
Alexandria University Hospital, Faculty of Nursing
Alexandria, Alexandria Governorate, 21511
About this study
Official title: Effect of Adaptive AI-based Virtual Reality on Quality of Recovery and Hospital Stay After Major Abdominal Surgery
Major abdominal surgery is frequently associated with postoperative pain, anxiety, delayed recovery, and prolonged hospitalization. This study aims to evaluate the effectiveness of an AI-personalized virtual reality (VR) intervention as an adjunct to routine postoperative care in improving recovery outcomes among patients undergoing major abdominal surgery.
Participants assigned to the intervention group receive immersive VR sessions delivered through a smartphone-based head-mounted display integrated with an AI-assisted personalization system. The system combines patient-reported pain and anxiety levels, postoperative recovery status, emotional state estimates obtained through facial emotion recognition technology, and previous session feedback to personalize VR content and enhance patient engagement.
Read more
VR sessions are initiated on the first postoperative day and administered twice daily until hospital discharge. The primary outcome is postoperative quality of recovery measured using the Quality of Recovery-15 (QoR-15) questionnaire. Secondary outcomes include pain intensity, anxiety, recovery milestones, opioid requirements, simulator sickness, and length of hospital stay.
The study compares AI-personalized VR plus routine postoperative care with routine postoperative care alone. Findings from this trial will help determine whether AI-enhanced VR is a feasible, safe, and effective strategy for improving postoperative recovery and reducing hospital stay following major abdominal surgery.
- Being tested
- Immersive Virtual Reality (VR), Standard Perioperative Care and Enhanced Recovery Protocol
- Keywords
- Virtual Reality, VR Therapy, Distraction Therapy, ERAS (Enhanced Recovery After Surgery), Perioperative Care, Non-pharmacological Pain Management
- Medical subject headings
- Pain, Postoperative
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Immersive Virtual Reality (VR)Device
Session Protocol:
- Preoperative session: One session of 15 minutes on the evening before surgery for familiarization with the VR equipment and content.
- Postoperative sessions: daily on Postoperative Days 1, 2, and 3, each session lasting 15 to 20 minutes.
- Total VR exposure: approximately 90 to 120 minutes per patient.
VR Content:
- Nature immersion simulations
- Guided relaxation environments
- Breathing exercises
- Mindfulness-based stress reduction modules
Safety Measures:
- VR-related adverse effects monitored after each session using an adapted Simulator Sickness Questionnaire (SSQ).
- Sessions are discontinued immediately if the patient reports Moderate or Severe symptoms.
- All VR equipment is disinfected between uses according to hospital infection control protocols.
Standard Perioperative Care and Enhanced Recovery ProtocolOther
Preoperative Phase:
- Patient education and counseling regarding the surgical procedure and postoperative recovery expectations.
- Administration of carbohydrate-rich drinks before surgery to reduce metabolic stress.
Intraoperative Phase:
- Propofol-based total intravenous anaesthesia or balanced anaesthesia.
- Opioid-sparing multimodal analgesia.
- Optimized intraoperative fluid management.
- Standardized neuromuscular blockade reversal.
- Intraoperative opioid dosing recorded for all patients.
Postoperative Phase:
- Standardized multimodal pharmacological pain management.
- Early mobilization encouraged within 6 hours after surgery.
- Early oral nutrition initiated as soon as clinically appropriate.
- Patient-controlled analgesia (PCA) available if indicated.
No Virtual Reality sessions or any form of distraction therapy will be provided to this group.
| Study group | Role | What they receive |
|---|---|---|
| AI-Personalized Virtual Reality (VR) Group | Experimental | Participants received routine postoperative care plus an AI-personalized virtual reality intervention delivered through a smartphone-based head-mounted display. The intervention used facial emotion recognition, pain and anxiety assessments, postoperative status, and previous session feedback to personalize VR content. Sessions were administered twice daily from postoperative day 1 until hospital discharge. Receives: Device: Immersive Virtual Reality (VR) |
| Control Group | Active comparator | Patients in this group will receive only the standard perioperative care according to the established Enhanced Recovery After Surgery (ERAS) protocol, without any VR exposure or distraction therapy. Receives: Other: Standard Perioperative Care and Enhanced Recovery Protocol |
What is being measured
The primary outcome is the main question the study is designed to answer.
Quality of Postoperative Recovery (QoR-15)
Description: A validated 15-item patient-reported outcome measure assessing five dimensions of postoperative recovery: pain, physical comfort, emotional state, psychological support, and functional independence. Each item is scored from 0 to 10, with a total score ranging from 0 (poorest recovery) to 150 (excellent recovery). A minimum clinically important difference of 8 points between groups is considered significant
Measured: Time Frame: Baseline (day before surgery), postoperative day 1 (POD1), postoperative day 3 (POD3), at hospital discharge, and on postoperative day 7 follow-up.
Length of Hospital Stay (LOS)
The total number of days from the date of surgery until the patient meets standardized clinical discharge criteria based on the Enhanced Recovery After Surgery protocol, including tolerance of oral intake, adequate pain control on oral analgesia, independent mobilization, and absence of surgical complications.
Measured: Time Frame: From date of surgery until hospital discharge (up to 30 days).
Secondary outcomes (5)
Postoperative Pain Intensity (NRS)
Description: Pain intensity assessed using the Numeric Rating Scale (NRS), an 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain). Scores are recorded daily from the nursing file and additionally before and after each VR session to capture the immediate analgesic effect of VR.
Measured: Baseline (day before surgery), postoperative day 1 (POD1), postoperative day 3 (POD3), at hospital discharge, and on postoperative day 7 follow-up.
Clinical Recovery Milestones
Description: Objective recovery indicators collected from the medical record including: time to first ambulation (hours after surgery), time to first liquid intake (hours after surgery), time to first soft diet intake (hours after surgery), and time to IV fluid discontinuation (hours after surgery).
Measured: Time Frame: Recorded once at hospital discharge.
VR-Related Adverse Effects Simulator Sickness Questionnaire
Description: VR tolerability assessed after each session using an adapted version of the Simulator Sickness Questionnaire (Kennedy et al., 1993), modified to include the four most clinically relevant symptoms in the postoperative setting: nausea, dizziness, headache, and eye strain. Each symptom is rated on a four-point scale: None / Slight / Moderate / Severe. Sessions are discontinued if Moderate or Severe symptoms are reported.
Measured: Time Frame: Immediately after each VR session from the evening before surgery through Postoperative Day 3.
Postoperative Anxiety
Postoperative anxiety will be assessed as a secondary exploratory outcome using a single-item Numeric Rating Scale for Anxiety (NRS-A). Patients will rate their current level of anxiety on a scale from 0 (no anxiety) to 10 (extreme anxiety).
Measured: Immediately before and after each VR session Baseline (day before surgery), postoperative day 1 (POD1), postoperative day 3 (POD3), at hospital discharge, and on postoperative day 7 follow-up.
qualitative strand
using semi-structured interviews to evaluate and explain the trial results. In order to provide a comprehensive understanding of the intervention outcomes
Measured: at the end of the intervention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 Mar 2026
- Study start28 Mar 2026
- Primary completion10 May 2026
- Study completion30 Jun 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Abdominal SurgeryStudies of the same condition, open and under way.
- More trials run by Alexandria UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- A parallel-group, two-arm randomized controlled trial with an explanatory sequential mixed-methods design was conducted to evaluate the effect of an AI-personalized virtual reality (VR) intervention on postoperative recovery after major abdominal surgery. Participants were randomly assigned to either routine postoperative care alone or routine care plus AI-personalized VR. The intervention was delivered through a smartphone-based head-mounted display and incorporated a pre-trained facial emotion recognition model and a decision-support personalization engine. Before each session, pain, anxiety, postoperative status, demographic characteristics, emotional state estimates, and previous session feedback were used to personalize immersive VR content. Sessions began on postoperative day 1, were administered twice daily until discharge, and lasted approximately 15 minutes. Outcomes included quality of recovery (QoR-15), pain, anxiety, recovery milestones, opioid requirements, simulator sickn
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 84 participants (actual)
Sponsor and investigators
- Lead sponsor
- Alexandria University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Mohamed Fakhry Ahmed Salem, Alexandria University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07493499
- Sponsor's protocol ID
- AU-20-10-457
- Acronym
- VR-RECOVER
- Status last verified
- Mar 2026
- First submitted
- 20 Mar 2026
- Last updated
- 11 Aug 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 11 Aug 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Adaptive AI-based Virtual Reality on Quality of Recovery and Hospital Stay After Major Abdominal Surgery
- ClinicalTrials.gov ID
- NCT07493499
- Acronym / sponsor ID
- VR-RECOVER / AU-20-10-457
- Keywords
- Virtual Reality, VR Therapy, Distraction Therapy, ERAS (Enhanced Recovery After Surgery), Perioperative Care, Non-pharmacological Pain Management
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 84 participants (actual)
- Lead sponsor
- Alexandria UniversityUniversity, hospital or other
- Study start
- 28 Mar 2026 (actual)
- Primary completion
- 10 May 2026 (actual)
- Study completion
- 30 Jun 2026 (actual)
- First posted
- 25 Mar 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Major abdominal surgery is frequently associated with postoperative pain, anxiety, delayed recovery, and prolonged hospitalization. This study aims to evaluate the effectiveness of an AI-personalized virtual reality (VR) intervention as an adjunct to routine postoperative care in improving recovery outcomes among patients undergoing major abdominal surgery.
Participants assigned to the intervention group receive immersive VR sessions delivered through a smartphone-based head-mounted display integrated with an AI-assisted personalization system. The system combines patient-reported pain and anxiety levels, postoperative recovery status, emotional state estimates obtained through facial emotion recognition technology, and previous session feedback to personalize VR content and enhance patient engagement.
VR sessions are initiated on the first postoperative day and administered twice daily until hospital discharge. The primary outcome is postoperative quality of recovery measured using the Quality of Recovery-15 (QoR-15) questionnaire. Secondary outcomes include pain intensity, anxiety, recovery milestones, opioid requirements, simulator sickness, and length of hospital stay.
The study compares AI-personalized VR plus routine postoperative care with routine postoperative care alone. Findings from this trial will help determine whether AI-enhanced VR is a feasible, safe, and effective strategy for improving postoperative recovery and reducing hospital stay following major abdominal surgery.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- A parallel-group, two-arm randomized controlled trial with an explanatory sequential mixed-methods design was conducted to evaluate the effect of an AI-personalized virtual reality (VR) intervention on postoperative recovery after major abdominal surgery. Participants were randomly assigned to either routine postoperative care alone or routine care plus AI-personalized VR. The intervention was delivered through a smartphone-based head-mounted display and incorporated a pre-trained facial emotion recognition model and a decision-support personalization engine. Before each session, pain, anxiety, postoperative status, demographic characteristics, emotional state estimates, and previous session feedback were used to personalize immersive VR content. Sessions began on postoperative day 1, were administered twice daily until discharge, and lasted approximately 15 minutes. Outcomes included quality of recovery (QoR-15), pain, anxiety, recovery milestones, opioid requirements, simulator sickn
| Arm | Type | Receives |
|---|---|---|
| AI-Personalized Virtual Reality (VR) Group | Experimental | Device: Immersive Virtual Reality (VR)Participants received routine postoperative care plus an AI-personalized virtual reality intervention delivered through a smartphone-based head-mounted display. The intervention used facial emotion recognition, pain and anxiety assessments, postoperative status, and previous session feedback to personalize VR content. Sessions were administered twice daily from postoperative day 1 until hospital discharge. |
| Control Group | Active comparator | Other: Standard Perioperative Care and Enhanced Recovery ProtocolPatients in this group will receive only the standard perioperative care according to the established Enhanced Recovery After Surgery (ERAS) protocol, without any VR exposure or distraction therapy. |
Who may qualify
- Ages
- 18 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- Adult patients aged 18 to 60 years.
- Scheduled for elective major abdominal surgery (e.g., colorectal, gastric, or hepatobiliary procedures).
- Physical and cognitive ability to provide informed consent.
- Ability to use and interact with Virtual Reality (VR) equipment (head-mounted display).
- Followed the standardized Enhanced Recovery After Surgery (ERAS) protocol at the hospital.
Key exclusion criteria (5 listed)
- Patients with a history of epilepsy or photosensitive seizures.
- Significant cognitive impairment or diagnosed psychiatric disorders that may interfere with study participation.
- Severe visual or auditory impairments that prevent effective interaction with VR content.
- Patients with pre-existing motion sickness or severe vertigo.
- Presence of open wounds or infections in the head or face area that prevent wearing the VR headset.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Immersive Virtual Reality (VR)Session Protocol: * Preoperative session: One session of 15 minutes on the evening before surgery for familiarization with the VR equipment and content. * Postoperative sessions: daily on Postoperative Days 1, 2, and 3, each session lasting 15 to 20 minutes. * Total VR exposure: approximately 90 to 120 minutes per patient. VR Content: * Nature immersion simulations * Guided relaxation environments * Breathing exercises * Mindfulness-based stress reduction modules Safety Measures: * VR-related adverse effects monitored after each session using an adapted Simulator Sickness Questionnaire (SSQ). * Sessions are discontinued immediately if the patient reports Moderate or Severe symptoms. * All VR equipment is disinfected between uses according to hospital infection control protocols. | Device | AI-Personalized Virtual Reality (VR) Group |
| Standard Perioperative Care and Enhanced Recovery ProtocolPreoperative Phase: * Patient education and counseling regarding the surgical procedure and postoperative recovery expectations. * Administration of carbohydrate-rich drinks before surgery to reduce metabolic stress. Intraoperative Phase: * Propofol-based total intravenous anaesthesia or balanced anaesthesia. * Opioid-sparing multimodal analgesia. * Optimized intraoperative fluid management. * Standardized neuromuscular blockade reversal. * Intraoperative opioid dosing recorded for all patients. Postoperative Phase: * Standardized multimodal pharmacological pain management. * Early mobilization encouraged within 6 hours after surgery. * Early oral nutrition initiated as soon as clinically appropriate. * Patient-controlled analgesia (PCA) available if indicated. No Virtual Reality sessions or any form of distraction therapy will be provided to this group. | Other | Control Group |
Primary outcome
Quality of Postoperative Recovery (QoR-15)
Time frame: Time Frame: Baseline (day before surgery), postoperative day 1 (POD1), postoperative day 3 (POD3), at hospital discharge, and on postoperative day 7 follow-up.
Description: A validated 15-item patient-reported outcome measure assessing five dimensions of postoperative recovery: pain, physical comfort, emotional state, psychological support, and functional independence. Each item is scored from 0 to 10, with a total score ranging from 0 (poorest recovery) to 150 (excellent recovery). A minimum clinically important difference of 8 points between groups is considered significant
Length of Hospital Stay (LOS)
Time frame: Time Frame: From date of surgery until hospital discharge (up to 30 days).
The total number of days from the date of surgery until the patient meets standardized clinical discharge criteria based on the Enhanced Recovery After Surgery protocol, including tolerance of oral intake, adequate pain control on oral analgesia, independent mobilization, and absence of surgical complications.
5 secondary outcomes
Postoperative Pain Intensity (NRS)
Time frame: Baseline (day before surgery), postoperative day 1 (POD1), postoperative day 3 (POD3), at hospital discharge, and on postoperative day 7 follow-up.
Clinical Recovery Milestones
Time frame: Time Frame: Recorded once at hospital discharge.
VR-Related Adverse Effects Simulator Sickness Questionnaire
Time frame: Time Frame: Immediately after each VR session from the evening before surgery through Postoperative Day 3.
Postoperative Anxiety
Time frame: Immediately before and after each VR session Baseline (day before surgery), postoperative day 1 (POD1), postoperative day 3 (POD3), at hospital discharge, and on postoperative day 7 follow-up.
qualitative strand
Time frame: at the end of the intervention
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Aug 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Immersive Virtual Reality (VR) and Standard Perioperative Care and Enhanced Recovery Protocol in people with Abdominal Surgery and Postoperative Recovery, run by Alexandria University at 1 site in Egypt.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 11 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Quality of Postoperative Recovery (QoR-15) (time frame: Time Frame: Baseline (day before surgery), postoperative day 1 (POD1), postoperative day 3 (POD3), at hospital discharge, and on postoperative day 7 follow-up.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Aug 2026.