Fried Marvin P, Uribe José I, Sadoughi Babak
Department of Otorhinolaryngology - Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 10467, USA.
Curr Opin Otolaryngol Head Neck Surg. 2007 Jun;15(3):163-9. doi: 10.1097/MOO.0b013e32814b0802.
This article reviews the rationale, current status and future directions for the development and implementation of virtual reality surgical simulators as training tools.
The complexity of modern surgical techniques, which utilize advanced technology, presents a dilemma for surgical training. Hands-on patient experience - the traditional apprenticeship method for teaching operations - may not apply because of the learning curve for skill acquisition and patient safety expectation. The paranasal sinuses and temporal bone have intricate anatomy with a significant amount of vital structures either within the surgical field or in close proximity. The current standard of surgical care in these areas involves the use of endoscopes, cameras and microscopes, requiring additional hand-eye coordination, an accurate command of fine motor skills, and a thorough knowledge of the anatomy under magnified vision. A surgeon's disorientation or loss of perspective can lead to complications, often catastrophic and occasionally lethal. These considerations define the ideal environment for surgical simulation; not surprisingly, significant research and validation of simulators in these areas have occurred.
Virtual reality simulators are demonstrating validity as training and skills assessment tools. Future prototypes will find application for routine use in teaching, surgical planning and the development of new instruments and computer-assisted devices.
本文综述了将虚拟现实手术模拟器作为训练工具进行开发和应用的基本原理、现状及未来发展方向。
现代手术技术利用先进技术，其复杂性给手术训练带来了难题。亲身体验患者——传统的手术教学师徒制方法——可能并不适用，原因在于技能习得的学习曲线以及对患者安全的期望。鼻窦和颞骨解剖结构复杂，手术区域内或其附近有大量重要结构。这些领域当前的手术护理标准涉及使用内窥镜、摄像头和显微镜，这需要额外的手眼协调能力、对精细运动技能的精准掌握以及在放大视野下对解剖结构的透彻了解。外科医生的定向障碍或视角丧失可能导致并发症，这些并发症往往具有灾难性，有时甚至是致命的。这些因素确定了手术模拟的理想环境；不出所料，在这些领域已经开展了大量关于模拟器的研究和验证工作。
虚拟现实模拟器作为训练和技能评估工具正在展现出有效性。未来的原型将在教学、手术规划以及新器械和计算机辅助设备的开发中得到常规应用。
