Transforming the Surgical Experience for Young Patients
At the Hong Kong Children’s Hospital, a groundbreaking initiative is helping children like eight-year-old Aidan face their medical procedures with less fear and more confidence. Using virtual reality (VR) technology, the hospital is creating a fun and engaging environment that eases the anxiety of young patients before surgery.
Aidan was initially terrified about undergoing an operation at the hospital in 2024. However, once he put on a VR headset, his fears began to fade. The VR program, guided by a friendly panda character, allowed him to explore the hospital’s corridors and operating theatre. He could even choose the colors of the medical staff’s gowns and the flavor of the anaesthetic gas used to help him sleep.
The experience was not just educational but also entertaining. A “giggle doctor,” a trained entertainer, performed magic tricks before Aidan “drove” himself to surgery in a miniature electric car of his choice. After the procedure, Aidan said, “The whole thing is fun! There is no need to be scared of surgery at all.” When he woke up, he thought, “Was that all?”
His mother recalled that Aidan was so engrossed in the experience that he didn’t even look back to say goodbye when entering the operating room in his sports car.
Addressing Anxiety Through Innovation
This innovative approach was developed by the Hong Kong Children’s Hospital to help young patients manage stress and anxiety before an operation. The hospital aims to reduce traumatic memories and maintain children’s trust in medical staff by making the surgical process a positive experience.
Dr. Vansie Kwok, deputy chief of service of the hospital’s department of anaesthesiology and perioperative medicine, explained that the VR game was designed to alleviate patients’ anxiety by addressing the uncertainty and unfamiliarity they felt before an operation.
“Children are often scared, but they are unable to express clearly what they are scared of … sometimes, they are simply scared of fear, but not pain,” she said. Based on previous studies, the hospital found that fear came from the unfamiliarity surrounding the environment, what the doctors would do to their bodies, and what would happen after they woke up, whether they would be in pain, among other things.
Kwok warned that if a child underwent an operation in a state of anxiety, it could affect their recovery and lead to post-anaesthesia confusion and delirium. Some might even have nightmares, become excessively clingy to parents, or develop a fear of medical staff.
Collaborative Efforts to Improve Patient Care
To implement this initiative, the hospital worked with Polytechnic University, City University, and local NGO Playright. They developed a prototype of the VR tour in 2023 and completed a clinical study a year later to assess its effectiveness.
The study, which covered 70 children and parents, found that children who used the VR tool were 20 per cent less anxious than those who did not. The tool was most effective among children aged five to eight.
In December 2025, the hospital started offering the VR tour as a regular service, with each session lasting 15 minutes. Most children would go on the VR tour before the operation, unless they were too young or physically unable to wear the headset, but they could still be seen by “giggle doctors” and hospital play specialists to ease their anxieties.
Mok Yi-tan, a department operations manager, shared cases where parents did not properly brief their child about an operation, leaving them feeling deceived or betrayed afterwards. Such children lost trust in their parents and medical staff and struggled during post-operative care.
“The long-term impact of traumatic memory from surgery should not be underestimated, because that could impact the children’s acceptance of surgery when they grow up,” she said.
Enhancing the Experience with Play and Entertainment
The “driving” experience was meant to give children a sense of agency instead of staring helplessly at the ceiling as they were wheeled into the operating room. The hospital also worked with Playright to bring in play specialists, who would explain medical procedures with toys and help children express their anxieties and reduce stress.
On the day of the procedure, the “giggle doctor” from another NGO, Theodora Foundation, would accompany the children to the operating theatre while performing magic tricks on the way to amuse them, Mok said. The hospital also offered anaesthetic gases in different flavors, such as chocolate and strawberry.
Mok said the hospital would allow parents to enter the operating theatre so the patient would feel more secure, although such reassurance is deemed not necessary for very young or older children. But if the surgery was complicated, parents would not be allowed entry to prevent their anxiety from being transferred onto their children.
