Marescaux J, Clément J M, Nord M, Russier Y, Tassetti V, Mutter D, Cotin S, Ayache N
Service de Chirurgie Digestive et Endocrinienne/IRCAD-EITS, Hôpitaux Universitaires de Strasbourg.
Bull Acad Natl Med. 1997 Nov;181(8):1609-21; discussion 1622-3.
Surgical simulation increasingly appears to be an essential aspect of tomorrow's surgery. The development of a hepatic surgery simulator is an advanced concept calling for a new writing system which will transform the medical world: virtual reality. Virtual reality extends the perception of our five senses by representing more than the real state of things by the means of computer sciences and robotics. It consists of three concepts: immersion, navigation and interaction. Three reasons have led us to develop this simulator: the first is to provide the surgeon with a comprehensive visualisation of the organ. The second reason is to allow for planning and surgical simulation that could be compared with the detailed flight-plan for a commercial jet pilot. The third lies in the fact that virtual reality is an integrated part of the concept of computer assisted surgical procedure. The project consists of a sophisticated simulator which has to include five requirements: visual fidelity, interactivity, physical properties, physiological properties, sensory input and output. In this report we will describe how to get a realistic 3D model of the liver from bi-dimensional 2D medical images for anatomical and surgical training. The introduction of a tumor and the consequent planning and virtual resection is also described, as are force feedback and real-time interaction.
手术模拟日益成为未来手术的一个重要方面。肝脏手术模拟器的开发是一个先进的概念，需要一种新的书写系统来改变医学世界：虚拟现实。虚拟现实通过计算机科学和机器人技术呈现超越事物真实状态的内容，从而扩展了我们五种感官的感知。它由三个概念组成：沉浸感、导航和交互。促使我们开发这个模拟器有三个原因：第一个是为外科医生提供器官的全面可视化。第二个原因是允许进行可与商业喷气式客机飞行员的详细飞行计划相媲美的手术规划和模拟。第三个原因在于虚拟现实是计算机辅助手术程序概念的一个组成部分。该项目包括一个复杂的模拟器，它必须满足五个要求：视觉逼真度、交互性、物理特性、生理特性、感官输入和输出。在本报告中，我们将描述如何从二维医学图像中获取肝脏的逼真三维模型，用于解剖学和手术训练。还描述了肿瘤的引入以及随之而来的规划和虚拟切除，以及力反馈和实时交互。
