Peng Matthew Jianqiao, Chen Hai-Yan, Chen Peikai, Tan Zhijia, Hu Yong, To Michael Kai-Tsun, He Erxing
Department of Spinal Surgery, Affiliated Jiangmen Traditional Chinese Medicine Hospital of Jinan University, Jiangmen, China.
Department of Orthopedics, Huidong People's Hospital, Huizhou, China.
Quant Imaging Med Surg. 2024 Feb 1;14(2):2060-2068. doi: 10.21037/qims-23-1151. Epub 2024 Jan 23.
The importance of virtual reality (VR) has been emphasized by many medical studies, yet it has been relatively under-applied to surgical operation. This study characterized how VR has been applied in clinical education and evaluated its tutorial utility by designing a surgical model of tumorous resection as a simulator for preoperative planning and medical tutorial. A 36-year-old male patient with a femoral tumor who was admitted to the Affiliated Jiangmen Traditional Chinese Medicine Hospital was randomly selected and scanned by computed tomography (CT). The data in digital imaging and communications in medicine (*.DICOM) format were imported into Mimics to reconstruct a femoral model, and were generated to the format of *.stl executing in the computer-aided design (CAD) software SenSable FreeForm Modeling (SFM). A bony tumor was simulated by adding clay to the femur, the procedure of tumorous resection was virtually performed with a toolkit called Phantom, and its bony defect was filled with virtual cement. A 3D workspace was created to enable the individual multimodality manipulation, and a virtual operation of tumorous excision was successfully carried out with indefinitely repeated running. The precise delineation of surgical margins was shown to be achieved with expert proficiency and inexperienced hands among 43 of 50 participants. This simulative educator presented an imitation of high definition, those trained by VR models achieved a higher success rate of 86% than the rate of 74% achieved by those trained by conventional methods. This tumorous resection was repeatably handled by SFM, including the establishment of surgical strategy, whereby participants felt that respondent force feedback was beneficial to surgical teaching programs, enabling engagement of learning experiences by immersive events which mimic real-world circumstances to reinforce didactic and clinical concepts.
许多医学研究都强调了虚拟现实（VR）的重要性，但它在外科手术中的应用相对较少。本研究通过设计一个肿瘤切除手术模型作为术前规划和医学教学的模拟器，描述了VR在临床教育中的应用方式，并评估了其教学效用。随机选取一名入住江门市五邑中医院的36岁股骨肿瘤男性患者，进行计算机断层扫描（CT）。将医学数字成像和通信（.DICOM）格式的数据导入Mimics中重建股骨模型，并在计算机辅助设计（CAD）软件Sensable FreeForm Modeling（SFM）中生成.stl格式。通过在股骨上添加黏土模拟骨肿瘤，使用名为Phantom的工具包虚拟执行肿瘤切除手术，并使用虚拟骨水泥填充骨缺损。创建了一个3D工作区以实现个体多模态操作，并成功进行了无限重复运行的肿瘤切除虚拟手术。50名参与者中有43人无论经验丰富与否都能精确勾勒出手术切缘。这种模拟教学工具呈现出高清模拟效果，通过VR模型训练的人员成功率为86%，高于传统方法训练人员的74%成功率。SFM可重复处理这种肿瘤切除手术，包括制定手术策略，参与者认为响应式力反馈有助于手术教学计划，通过模拟现实世界情况的沉浸式事件来促进学习体验，从而强化教学和临床概念。
