Cohen Alan R, Lohani Subash, Manjila Sunil, Natsupakpong Suriya, Brown Nathan, Cavusoglu M Cenk
Minimally Invasive Neurosurgery Laboratory, Department of Neurosurgery, Boston Children's Hospital, Boston, MA, USA.
Childs Nerv Syst. 2013 Aug;29(8):1235-44. doi: 10.1007/s00381-013-2139-z. Epub 2013 May 24.
Virtual reality simulation is a promising alternative to training surgical residents outside the operating room. It is also a useful aide to anatomic study, residency training, surgical rehearsal, credentialing, and recertification.
Surgical simulation is based on a virtual reality with varying degrees of immersion and realism. Simulators provide a no-risk environment for harmless and repeatable practice. Virtual reality has three main components of simulation: graphics/volume rendering, model behavior/tissue deformation, and haptic feedback. The challenge of accurately simulating the forces and tactile sensations experienced in neurosurgery limits the sophistication of a virtual simulator. The limited haptic feedback available in minimally invasive neurosurgery makes it a favorable subject for simulation.
Virtual simulators with realistic graphics and force feedback have been developed for ventriculostomy, intraventricular surgery, and transsphenoidal pituitary surgery, thus allowing preoperative study of the individual anatomy and increasing the safety of the procedure. The authors also present experiences with their own virtual simulation of endoscopic third ventriculostomy.
虚拟现实模拟是在手术室之外培训外科住院医师的一种很有前景的替代方法。它也是解剖学研究、住院医师培训、手术预演、资格认证和再认证的有用辅助工具。
手术模拟基于具有不同程度沉浸感和真实感的虚拟现实。模拟器为无害且可重复的练习提供了无风险环境。虚拟现实有模拟的三个主要组成部分：图形/体绘制、模型行为/组织变形和触觉反馈。准确模拟神经外科手术中所体验到的力和触觉感受的挑战限制了虚拟模拟器的复杂性。微创神经外科手术中可用的有限触觉反馈使其成为模拟的有利对象。
已经开发出具有逼真图形和力反馈的虚拟模拟器用于脑室造瘘术、脑室内手术和经蝶垂体手术，从而允许对个体解剖结构进行术前研究并提高手术的安全性。作者还介绍了他们自己对内镜下第三脑室造瘘术进行虚拟模拟的经验。
