Principles Of Virtual Reality In Surgical Training

Principles of Virtual Reality in Surgical Training and Practice Dr Sanjoy Sanyal MBBS, MS (Surgery), ADPHA, ADHRD Presented at 10 th National Medical Dental Conference in Seychelles, February 2007

Contents

Definition and classification

Technical aspects

Angled laparoscope simulation

Simulated cholecystectomy

Simulated gynecological surgery

Virtual endoscopy / angiography

Augmented reality imaging – Neurosurgery

Visible Human Project – NLM

Summary

References and URLs

Definition

VR 1 st coined by Jaron Lanier, head of VPL Research Inc. California

2 nd of 3 types of Cyberspace

System that provides realistic sense of being immersed in an environment.

Computer-generated visual , auditory and tactile multimedia experience.

Teledildonics : Virtual sex (or e-sex !!??)

Classification

Augmented reality systems

Technical aspects of VR

VR surrounds human body with artificial sensorium of sight, sound and touch.

Stereo headphones

‘ Eyephones ’: Head mounted stereo TV goggles – able to simulate 3-D

‘ Datagloves ’: Wired gauntlets

‘ Datasuits ’: Computerized clothing

NASA astronaut training in simulated (VR) environment

Technical aspects of VR in medicine

3-D computer graphics : Texture mapping

Interaction devices and trackers

Tactile feedback

Force (haptic) feedback : Reverse robotic units

Other sensory feedback : Auditory, olfactory etc

Angled laparoscope training simulator Spatial reasoning is required to focus objective lens in line with narrow cavity.

Angled laparoscope training simulator Virtual environment through a Virtual Laparoscopic Interface: All 4 corners of 6 targets have to be viewed in sequence.

Angled laparoscope training simulator After viewing all 4 corners of 1 st target, hit a button: Next object comes into view

Angled laparoscope training simulator Go through the whole sequence for all targets.

Angled laparoscope training simulator

Angled laparoscope training simulator Automatic timer records the time taken

Virtual cholecystectomy Occluding tissue is dissected

Virtual cholecystectomy Lateral traction is placed on gallbladder and cystic duct is clipped

Virtual cholecystectomy

Virtual cholecystectomy Cystic duct is successfully cut

Simulated gynecological surgery Endoscopic Surgery Simulation : Perform surgical tasks on elasto-dynamic objects in virtual surgery scene in real time; grasping , cutting and setting of clips

Simulated gynecological surgery Actively Deforming Objects (ADO) concept introduced for modeling organ motility

Simulated gynecological surgery © Dr. H. Cakmak, Institut für Angewandte Informatik, Forschungszentrum Karlsruhe Simulation of pulsatile bleeding, irrigation, suction, animation of coagulation smoke, causing steaming of endoscope lens…

Virtual endoscopy

Virtual bronchoscopy

Virtual colonoscopy

Virtual arthroscopy

Virtual angiography

Augmented reality imaging

Visible Human Project – NLM Visible Human Male Database Visible Human Female Database

Visible Human Project – NLM

Virtual scalpel incision Double click on icon to view video of virtual scalpel incision on a simulated knee model

Summary

VR is an immersive and interactive simulation of an environment

VR applications are playing a great role in teaching , training and testing of medical students and graduates

Computer simulated 3-D reconstruction of radiological c-sections are important diagnostic tools

Summary

Computer assisted pre-operative planning and outcome prediction are on the horizon

Integration of hybrid (real and imaginary) systems in augmented reality play a role in image-guided surgery

VR also plays a role in telemedine and telesurgery

References and URLs

Edelman V. Touch goes high-tech. http://cms.psychologytoday.com/articles/pto-19960101-000031.html

Boulos MNK. University of Plymouth. Virtual reality in medicine

Tendick F. University of California San Francisco. http://itsa.ucsf.edu/~frankt/vesta.html

Cakmak HK. Institut für Angewandte Informatik, Forschungszentrum Karlsruhe. http://www-kismet.iai.fzk.de/VRTRAIN/phD_main.html

References and URLs

The Visible Human Project, NLM, NIH: http:// www.nlm.nih.gov/research/visible/visible_human.html

University of Colorado, Center of Human Simulation: http:// www.uchsc.edu/sm/chs/browse/browse_m.html

http://www.uchsc.edu/sm/chs/browse/browse_f.html

NHSIA. Virtual Reality System Predicts Surgical Outcomes. http://www.informatics.nhs.uk/cgi-bin/item.cgi?id =1206 Feb-2005

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Principles Of Virtual Reality In Surgical Training

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