Benjamin Miles W, Sabri Omar
Trauma and Orthopaedics, St George's University Hospitals NHS Foundation Trust, London, GBR.
Cureus. 2021 Sep 27;13(9):e18315. doi: 10.7759/cureus.18315. eCollection 2021 Sep.
Background Bone drilling is a procedure that demands a high level of dexterity, fine motor skills and spatial awareness from the operating surgeon. An important consideration when drilling bone is minimising soft tissue damage. There are numerous causes of drilling associated soft tissue injury, of which most concerning is drilling into the tissue beyond the far cortex as unseen injury can occur. This is known as plunging. Objectives The objective of this study was to evaluate the impact of haptic feedback in virtual reality (VR) simulation-based training. The acquisition of drilling skill was assessed by changes to their drill plunge depth. Study Design & Methods The participants in the study were medical students, doctors and biomedical scientists. Participants were randomly allocated into two groups. One group had simulation with haptic feedback as part of their VR simulated learning, whereas the second group undertook the same VR simulation but did not receive haptic feedback during the simulation. Following completion of the simulated bone drilling protocol, a bone drilling exercise took place. Each participant was allowed to drill a synthetic tibia bone five times and then the plunge depth was measured. We quantified outcome in the form of plunge depth. Results There were four participants in each group. The average plunge distance in the group who were able to practice with haptic assisted VR simulation was 46mm (range: 37-56mm), the average plunge distance in the non-haptic group was 79mm (range: 44-136mm). Results showed an average reduction of 33mm in plunge depth from users in the haptic group compared to the non-haptic group. Conclusion Bone drilling simulation with haptic feedback may be an effective simulator of the motor skills that would be required to perform this action on a live patient. The study results suggest that there could be a reduction in soft tissue damage for users trained in VR simulations with haptic feedback.
骨钻孔手术要求外科医生具备高水平的灵活性、精细运动技能和空间感知能力。钻孔时的一个重要考虑因素是将软组织损伤降至最低。钻孔相关软组织损伤有多种原因，其中最令人担忧的是钻穿远侧皮质之外的组织，因为可能会发生不可见的损伤。这被称为“穿透”。
本研究的目的是评估虚拟现实（VR）模拟训练中触觉反馈的影响。通过钻孔穿透深度的变化来评估钻孔技能的习得情况。
研究参与者为医学生、医生和生物医学科学家。参与者被随机分为两组。一组在其VR模拟学习中使用带有触觉反馈的模拟，而另一组进行相同的VR模拟，但在模拟过程中不接受触觉反馈。完成模拟骨钻孔方案后，进行骨钻孔练习。每个参与者被允许对一块合成胫骨进行五次钻孔，然后测量穿透深度。我们以穿透深度的形式对结果进行量化。
每组有四名参与者。能够使用触觉辅助VR模拟进行练习的组的平均穿透距离为46毫米（范围：37 - 56毫米），非触觉组的平均穿透距离为79毫米（范围：44 - 136毫米）。结果显示，与非触觉组相比，触觉组用户的穿透深度平均减少了33毫米。
带有触觉反馈的骨钻孔模拟可能是对活体患者进行该操作所需运动技能的有效模拟器。研究结果表明，接受触觉反馈的VR模拟训练的用户可能会减少软组织损伤。
