Misra Sarthak, Ramesh K T, Okamura Allison M
Department of Mechanical Engineering, The Johns Hopkins University.
Presence (Camb). 2008 Oct 1;17(5):463. doi: 10.1162/pres.17.5.463.
Surgical simulators present a safe and potentially effective method for surgical training, and can also be used in robot-assisted surgery for pre- and intra-operative planning. Accurate modeling of the interaction between surgical instruments and organs has been recognized as a key requirement in the development of high-fidelity surgical simulators. Researchers have attempted to model tool-tissue interactions in a wide variety of ways, which can be broadly classified as (1) linear elasticity-based, (2) nonlinear (hyperelastic) elasticity-based finite element (FE) methods, and (3) other techniques that not based on FE methods or continuum mechanics. Realistic modeling of organ deformation requires populating the model with real tissue data (which are difficult to acquire in vivo) and simulating organ response in real time (which is computationally expensive). Further, it is challenging to account for connective tissue supporting the organ, friction, and topological changes resulting from tool-tissue interactions during invasive surgical procedures. Overcoming such obstacles will not only help us to model tool-tissue interactions in real time, but also enable realistic force feedback to the user during surgical simulation. This review paper classifies the existing research on tool-tissue interactions for surgical simulators specifically based on the modeling techniques employed and the kind of surgical operation being simulated, in order to inform and motivate future research on improved tool-tissue interaction models.
手术模拟器为手术训练提供了一种安全且可能有效的方法，还可用于机器人辅助手术的术前和术中规划。手术器械与器官之间相互作用的精确建模已被视为高保真手术模拟器开发中的一项关键要求。研究人员已尝试以多种方式对工具-组织相互作用进行建模，大致可分为：（1）基于线性弹性的方法；（2）基于非线性（超弹性）弹性的有限元（FE）方法；以及（3）其他不基于有限元方法或连续介质力学的技术。对器官变形进行逼真建模需要用真实组织数据填充模型（这在体内很难获取）并实时模拟器官反应（这在计算上很昂贵）。此外，在侵入性手术过程中，考虑支撑器官的结缔组织、摩擦力以及工具-组织相互作用导致的拓扑变化具有挑战性。克服这些障碍不仅将帮助我们实时模拟工具-组织相互作用，还能在手术模拟期间为用户提供逼真的力反馈。本文综述专门根据所采用的建模技术和所模拟的手术操作类型，对手术模拟器中工具-组织相互作用的现有研究进行分类，以便为改进工具-组织相互作用模型的未来研究提供信息并激发其灵感。
