Pan Jun J, Ahn Woojin, Dargar Saurabh, Halic Tansel, Li Bai C, Sankaranarayanan Ganesh, Roberts Kurt, Schwaitzberg Steven, De Suvranu
State Key Laboratory of Virtual Reality Technology and Systems, Beihang University, Beijing, China; Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, USA.
Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, USA.
J Biomed Inform. 2016 Apr;60:410-21. doi: 10.1016/j.jbi.2016.03.005. Epub 2016 Mar 12.
Natural Orifice Transluminal Endoscopic Surgery (NOTES) provides an emerging surgical technique which usually needs a long learning curve for surgeons. Virtual reality (VR) medical simulators with vision and haptic feedback can usually offer an efficient and cost-effective alternative without risk to the traditional training approaches. Under this motivation, we developed the first virtual reality simulator for transvaginal cholecystectomy in NOTES (VTEST™).
This VR-based surgical simulator aims to simulate the hybrid NOTES of cholecystectomy. We use a 6DOF haptic device and a tracking sensor to construct the core hardware component of simulator. For software, an innovative approach based on the inner-spheres is presented to deform the organs in real time. To handle the frequent collision between soft tissue and surgical instruments, an adaptive collision detection method based on GPU is designed and implemented. To give a realistic visual performance of gallbladder fat tissue removal by cautery hook, a multi-layer hexahedral model is presented to simulate the electric dissection of fat tissue.
From the experimental results, trainees can operate in real time with high degree of stability and fidelity. A preliminary study was also performed to evaluate the realism and the usefulness of this hybrid NOTES simulator.
This prototyped simulation system has been verified by surgeons through a pilot study. Some items of its visual performance and the utility were rated fairly high by the participants during testing. It exhibits the potential to improve the surgical skills of trainee and effectively shorten their learning curve.
自然腔道内镜手术（NOTES）提供了一种新兴的手术技术，外科医生通常需要较长的学习曲线。具有视觉和触觉反馈的虚拟现实（VR）医学模拟器通常可以提供一种高效且经济高效的替代方案，而无需承担传统训练方法的风险。在此动机下，我们开发了首个用于NOTES经阴道胆囊切除术的虚拟现实模拟器（VTEST™）。
这个基于VR的手术模拟器旨在模拟胆囊切除术的混合NOTES。我们使用一个6自由度触觉设备和一个跟踪传感器来构建模拟器的核心硬件组件。对于软件，提出了一种基于内球体的创新方法来实时使器官变形。为了处理软组织与手术器械之间频繁的碰撞，设计并实现了一种基于GPU的自适应碰撞检测方法。为了通过电灼钩去除胆囊脂肪组织给出逼真的视觉效果，提出了一种多层六面体模型来模拟脂肪组织的电切。
从实验结果来看，学员能够以高度的稳定性和逼真度进行实时操作。还进行了一项初步研究以评估这种混合NOTES模拟器的逼真度和实用性。
这个原型模拟系统已通过一项初步研究得到外科医生的验证。在测试期间，参与者对其视觉性能和实用性的一些项目给予了相当高的评价。它展现出提高学员手术技能并有效缩短其学习曲线的潜力。
