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基于虚拟现实的颅内动脉瘤手术开颅训练。

VR-based training of craniotomy for intracranial aneurysm surgery.

机构信息

Faculty of Computer Science, Otto-von-Guericke University Magdeburg, Universitätsplatz 2, 39106, Magdeburg, Germany.

University Hospital Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany.

出版信息

Int J Comput Assist Radiol Surg. 2022 Mar;17(3):449-456. doi: 10.1007/s11548-021-02538-3. Epub 2021 Dec 20.


DOI:10.1007/s11548-021-02538-3
PMID:34931299
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8873137/
Abstract

PURPOSE: Intracranial aneurysms can be treated micro-surgically. This procedure involves an appropriate head position of the patient and a proper craniotomy. These steps enable a proper access, facilitating the subsequent steps. To train the access planning process, we propose a VR-based training system. METHOD: We designed and implemented an immersive VR access simulation, where the user is surrounded by a virtual operating room, including medical equipment and virtual staff. The patient's head can be positioned via hand rotation and an arbitrary craniotomy contour can be drawn. The chosen access can be evaluated by exposing the aneurysm using a microscopic view. RESULTS: The evaluation of the simulation took place in three stages: testing the simulation using the think-aloud method, conducting a survey and examining the precision of drawing the contour. Although there are differences between the virtual interactions and their counterparts in reality, the participants liked the immersion and felt present in the operating room. The calculated surface dice similarity coefficient, Hausdorff distance and feedback of the participants show that the difficulty of drawing the craniotomy is appropriate. CONCLUSION: The presented training simulation for head positioning and access planning benefits from the immersive environment. Thus, it is an appropriate training for novice neurosurgeons and medical students with the goal to improve anatomical understanding and to become aware of the importance of the right craniotomy hole.

摘要

目的:颅内动脉瘤可以通过微创手术进行治疗。该手术过程需要患者保持适当的头部位置,并进行适当的开颅手术。这些步骤为正确的入路提供了便利,便于后续的操作。为了训练入路规划过程,我们提出了一种基于虚拟现实的培训系统。

方法:我们设计并实现了一种沉浸式 VR 入路模拟,用户被一个虚拟手术室所包围,包括医疗设备和虚拟人员。可以通过手动旋转来定位患者头部,并且可以绘制任意的开颅轮廓。通过使用显微镜视图暴露动脉瘤,可以评估所选入路。

结果:模拟评估分三个阶段进行:使用出声思考法测试模拟、进行调查以及检查轮廓绘制的精度。尽管虚拟交互与现实中的交互存在差异,但参与者喜欢这种沉浸感,并感觉置身于手术室中。计算出的表面骰子相似性系数、Hausdorff 距离和参与者的反馈表明,开颅的难度是适当的。

结论:所提出的头部定位和入路规划培训模拟得益于沉浸式环境。因此,它是一种适合新手神经外科医生和医学生的培训方法,旨在提高对解剖结构的理解,并认识到正确开颅孔的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec2f/8873137/16118c39a4ff/11548_2021_2538_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec2f/8873137/70741956a0ab/11548_2021_2538_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec2f/8873137/e7362be5913d/11548_2021_2538_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec2f/8873137/d01f48e63202/11548_2021_2538_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec2f/8873137/6ca34b7c9fbe/11548_2021_2538_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec2f/8873137/16118c39a4ff/11548_2021_2538_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec2f/8873137/70741956a0ab/11548_2021_2538_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec2f/8873137/e7362be5913d/11548_2021_2538_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec2f/8873137/d01f48e63202/11548_2021_2538_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec2f/8873137/6ca34b7c9fbe/11548_2021_2538_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec2f/8873137/16118c39a4ff/11548_2021_2538_Fig5_HTML.jpg

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本文引用的文献

[1]
Clinically Applicable Segmentation of Head and Neck Anatomy for Radiotherapy: Deep Learning Algorithm Development and Validation Study.

J Med Internet Res. 2021-7-12

[2]
Distance and force visualisations for improved simulation of intracranial aneurysm clipping.

Int J Comput Assist Radiol Surg. 2021-8

[3]
The evolution of intracranial aneurysm treatment techniques and future directions.

Neurosurg Rev. 2022-2

[4]
A High-Fidelity Hybrid Virtual Reality Simulator of Aneurysm Clipping Repair With Brain Sylvian Fissure Exploration for Vascular Neurosurgery Training.

Simul Healthc. 2021-8-1

[5]
Selection Strategy for Optimal Keyhole Approaches for Middle Cerebral Artery Aneurysms: Lateral Supraorbital Versus Minipterional Craniotomy.

World Neurosurg. 2019-2

[6]
Virtual Cerebral Aneurysm Clipping with Real-Time Haptic Force Feedback in Neurosurgical Education.

World Neurosurg. 2018-4

[7]
Highly immersive virtual reality laparoscopy simulation: development and future aspects.

Int J Comput Assist Radiol Surg. 2017-11-18

[8]
Effectiveness of Immersive Virtual Reality in Surgical Training-A Randomized Control Trial.

J Oral Maxillofac Surg. 2018-5

[9]
Microsurgery Simulator of Cerebral Aneurysm Clipping with Interactive Cerebral Deformation Featuring a Virtual Arachnoid.

Oper Neurosurg (Hagerstown). 2018-5-1

[10]
New dimensions in surgical training: immersive virtual reality laparoscopic simulation exhilarates surgical staff.

Surg Endosc. 2017-4-4

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