Principles of Principles of Virtual Reality in Virtual Reality in Surgical Training Surgical Training and Practiceand Practice

Dr Sanjoy Sanyal MBBS, MS (Surgery), ADPHA, ADHRD

Presented at 10th National Medical Dental Conference in Seychelles, February 2007

ContentsContentsDefinition and classificationTechnical aspectsAngled laparoscope simulationSimulated cholecystectomySimulated gynecological surgeryVirtual endoscopy / angiographyAugmented reality imaging – NeurosurgeryVisible Human Project – NLMSummaryReferences and URLs

DefinitionDefinition

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

2nd of 3 types of CyberspaceSystem that provides realistic sense of being

immersed in an environment.Computer-generated visual, auditory and

tactile multimedia experience.Teledildonics: Virtual sex (or e-sex!!??)

ClassificationClassification

Augmented reality systemsAugmented reality systems

Technical aspects of VRTechnical aspects of VRVR 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 Technical aspects of VR in medicinemedicine

3-D computer graphics: Texture mappingInteraction devices and trackersTactile feedbackForce (haptic) feedback: Reverse robotic

unitsOther sensory feedback: Auditory, olfactory

etc

Angled laparoscope training Angled laparoscope training simulatorsimulator

Spatial reasoning is required to focus objective lens in line with narrow cavity.

Angled laparoscope training Angled laparoscope training simulatorsimulator

Virtual environment through a Virtual Laparoscopic Interface:

All 4 corners of 6 targets have to be viewed in sequence.

After viewing all 4 corners of 1st target, hit a button:

Next object comes into view

Angled laparoscope training Angled laparoscope training simulatorsimulator

Go through the whole sequence for all targets.

Angled laparoscope training Angled laparoscope training simulatorsimulator

Angled laparoscope training Angled laparoscope training simulatorsimulator

Angled laparoscope training Angled laparoscope training simulatorsimulator

Automatic timer records the time taken

Angled laparoscope training Angled laparoscope training simulatorsimulator

Virtual cholecystectomyVirtual cholecystectomy

Occluding tissue is dissected

Lateral traction is placed on gallbladder and cystic duct is clipped

Virtual cholecystectomyVirtual cholecystectomy

Virtual cholecystectomyVirtual cholecystectomy

Cystic duct is successfully cut

Virtual cholecystectomyVirtual cholecystectomy

Simulated gynecological Simulated gynecological surgerysurgery

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 Simulated gynecological surgerysurgery

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

Simulated gynecological Simulated gynecological surgerysurgery

© 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 endoscopyVirtual endoscopy

Virtual bronchoscopyVirtual bronchoscopy

Virtual colonoscopyVirtual colonoscopy

Virtual arthroscopyVirtual arthroscopy

Virtual angiographyVirtual angiography

Augmented reality imagingAugmented reality imaging

Augmented reality imagingAugmented reality imaging

Augmented reality imagingAugmented reality imaging

Augmented reality imagingAugmented reality imaging

Visible Human Project – NLMVisible Human Project – NLM

Visible Human Male Database

Visible Human Female Database

Visible Human Project – NLMVisible Human Project – NLM

Visible Human Project – NLMVisible Human Project – NLM

Virtual scalpel incisionVirtual scalpel incision

Knecutsm.mpg

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

SummarySummaryVR 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

SummarySummaryComputer 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 URLsReferences and URLsEdelman 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 URLsReferences and URLsThe 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