Virtual reality training and assessment in laparoscopic rectum surgery

Background: Virtual-reality (VR) based simulation techniques offer an efficient and low cost alternative to conventional surgery training. This article describes a VR training and assessment system in laparoscopic rectum surgery. Methods: To give a realistic visual performance of interaction between membrane tissue and surgery tools, a generalized cylinder based collision detection and a multi-layer mass-spring model are presented. A dynamic assessment model is also designed for hierarchy training evaluation. Results: With this simulator, trainees can operate on the virtual rectum with both visual and haptic sensation feedback simultaneously. The system also offers surgeons instructions in real time when improper manipulation happens. The simulator has been tested and evaluated by ten subjects. Conclusions: This prototype system has been verified by colorectal surgeons through a pilot study. They believe the visual performance and the tactile feedback are realistic. It exhibits the potential to effectively improve the surgical skills of trainee surgeons and significantly shorten their learning curve. © 2014 John Wiley & Sons, Ltd

NOViSE: a virtual natural orifice transluminal endoscopic surgery simulator

Purpose: Natural Orifice Transluminal Endoscopic Surgery (NOTES) is a novel technique in minimally invasive surgery whereby a flexible endoscope is inserted via a natural orifice to gain access to the abdominal cavity, leaving no external scars. This innovative use of flexible endoscopy creates many new challenges and is associated with a steep learning curve for clinicians. Methods: We developed NOViSE - the first force-feedback enabled virtual reality simulator for NOTES training supporting a flexible endoscope. The haptic device is custom built and the behaviour of the virtual flexible endoscope is based on an established theoretical framework – the Cosserat Theory of Elastic Rods. Results: We present the application of NOViSE to the simulation of a hybrid trans-gastric cholecystectomy procedure. Preliminary results of face, content and construct validation have previously shown that NOViSE delivers the required level of realism for training of endoscopic manipulation skills specific to NOTES Conclusions: VR simulation of NOTES procedures can contribute to surgical training and improve the educational experience without putting patients at risk, raising ethical issues or requiring expensive animal or cadaver facilities. In the context of an experimental technique, NOViSE could potentially facilitate NOTES development and contribute to its wider use by keeping practitioners up to date with this novel surgical technique. NOViSE is a first prototype and the initial results indicate that it provides promising foundations for further development

Prevalence of haptic feedback in robot-mediated surgery : a systematic review of literature

© 2017 Springer-Verlag. This is a post-peer-review, pre-copyedit version of an article published in Journal of Robotic Surgery. The final authenticated version is available online at: https://doi.org/10.1007/s11701-017-0763-4With the successful uptake and inclusion of robotic systems in minimally invasive surgery and with the increasing application of robotic surgery (RS) in numerous surgical specialities worldwide, there is now a need to develop and enhance the technology further. One such improvement is the implementation and amalgamation of haptic feedback technology into RS which will permit the operating surgeon on the console to receive haptic information on the type of tissue being operated on. The main advantage of using this is to allow the operating surgeon to feel and control the amount of force applied to different tissues during surgery thus minimising the risk of tissue damage due to both the direct and indirect effects of excessive tissue force or tension being applied during RS. We performed a two-rater systematic review to identify the latest developments and potential avenues of improving technology in the application and implementation of haptic feedback technology to the operating surgeon on the console during RS. This review provides a summary of technological enhancements in RS, considering different stages of work, from proof of concept to cadaver tissue testing, surgery in animals, and finally real implementation in surgical practice. We identify that at the time of this review, while there is a unanimous agreement regarding need for haptic and tactile feedback, there are no solutions or products available that address this need. There is a scope and need for new developments in haptic augmentation for robot-mediated surgery with the aim of improving patient care and robotic surgical technology further.Peer reviewe

A novel haptic model and environment for maxillofacial surgical operation planning and manipulation

This paper presents a practical method and a new haptic model to support manipulations of bones and their segments during the planning of a surgical operation in a virtual environment using a haptic interface. To perform an effective dental surgery it is important to have all the operation related information of the patient available beforehand in order to plan the operation and avoid any complications. A haptic interface with a virtual and accurate patient model to support the planning of bone cuts is therefore critical, useful and necessary for the surgeons. The system proposed uses DICOM images taken from a digital tomography scanner and creates a mesh model of the filtered skull, from which the jaw bone can be isolated for further use. A novel solution for cutting the bones has been developed and it uses the haptic tool to determine and define the bone-cutting plane in the bone, and this new approach creates three new meshes of the original model. Using this approach the computational power is optimized and a real time feedback can be achieved during all bone manipulations. During the movement of the mesh cutting, a novel friction profile is predefined in the haptical system to simulate the force feedback feel of different densities in the bone

3D sound for simulation of arthroscopic surgery

Arthroscopic surgery offers many advantages compared to traditional surgery. Nevertheless, the required skills to practice this kind of surgery need specific training. Surgery simulators are used to train surgeon apprentices to practice specific gestures. In this paper, we present a study showing the contribution of 3D sound in assisting the triangulation gesture in arthroscopic surgery simulation. This ability refers to the capacity of the subject to manipulate the instruments while having a modified and limited view provided by the video camera of the simulator. Our approach, based on the use of 3D sound metaphors, provides interaction cues to the subjects about the real position of the instrument. The paper reports a performance evaluation study based on the perception of 3D sound integrated in the process of training of surgical task. Despite the fact that 3D sound cueing was not shown useful to all subjects in terms of execution time, the results of the study revealed that the majority of subjects who participated to the experiment confirmed the added value of 3D sound in terms of ease of use

Informational aspects of the haptic stimulation by the light for correction of the human functional state

Introduction. The study of the laws and principles of information processes in the biological systems of the human body in extreme forms of its activities and the development of the theory of medical information systems of such appointment, taking into account the status and trends of convergence of society, ecosystems and technology become very relevant. This state of affairs makes it possible to affirm that it is an actual scientific and applied problem of radical change of the existing paradigm of designing information systems. The purpose of the article is to specify the informational aspects of low intensity, haptic stimulation by the light, which is essential for correction of the functional state of an organism of the human being, who works in extreme conditions, to develop and study such methods and systems. Methods. Analyses of requirements, functions and systems for designing synthesis of information technologies and the control biotechnical system of correction of the functional state of an organism of the human, who works in extreme conditions. The theoretical and experimental dependences between the stimulation energy of light emission diode (LED) and the energy are transferred through the layered bio media design. Mathematical modelling and computational simulation. Comparison of these real and model data. Results. The base aspects requirements, functions and systems for designing synthesis of information technologies and the control biotechnical system of correction of the functional state of an organism of the human, who works in extreme conditions, low intensity, haptic stimulation by the light are defined. The methods for determining of intensity I0 of light emission diode, recursive expression , and formula for coefficient Cm , where M — quantity of bio media layers were developed. The bridges, which connects Maxwell’s phenomenological theory with the atomistic theory of matter and optics, were used. Computer simulation studies have confirmed the specification of requirements, functional and structural schemas of biotechnical system. Conclusions. Thanking to specification of requirements possibility-using recursive determining of the light flux intensity after every bio media layer was got. Under the effect of recurstion low computation complexity was caused. Information technology means (for automation optimal control) of the human state under external influences on the organism was developed. Further study to confirm statistical significance in representative samples of observations was opened