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

SOFA: A Multi-Model Framework for Interactive Physical Simulation

International audienceSOFA (Simulation Open Framework Architecture) is an open-source C++ library primarily targeted at interactive computational medical simulation. SOFA facilitates collaborations between specialists from various domains, by decomposing complex simulators into components designed independently and organized in a scenegraph data structure. Each component encapsulates one of the aspects of a simulation, such as the degrees of freedom, the forces and constraints, the differential equations, the main loop algorithms, the linear solvers, the collision detection algorithms or the interaction devices. The simulated objects can be represented using several models, each of them optimized for a different task such as the computation of internal forces, collision detection, haptics or visual display. These models are synchronized during the simulation using a mapping mechanism. CPU and GPU implementations can be transparently combined to exploit the computational power of modern hardware architectures. Thanks to this flexible yet efficient architecture, \sofa{} can be used as a test-bed to compare models and algorithms, or as a basis for the development of complex, high-performance simulators

From measured physical parameters to the haptic feeling of fabric

Abstract real-time cloth simulation involves the solution of many computational challenges, particularly in the context of haptic applications, where high frame rates are necessary for obtaining a satisfactory tactile experience. In this paper, we present a real-time cloth simulation system that offers a compromise between a realistic physically-based simulation of fabrics and a haptic application with high requirements in terms of computation speed. We place emphasis on architecture and algorithmic choices for obtaining the best compromise in the context of haptic applications. A first implementation using a haptic device demonstrates the features of the proposed system and leads to the development of new approaches for haptic rendering using the proposed approac

Haptics Rendering and Applications

There has been significant progress in haptic technologies but the incorporation of haptics into virtual environments is still in its infancy. A wide range of the new society's human activities including communication, education, art, entertainment, commerce and science would forever change if we learned how to capture, manipulate and reproduce haptic sensory stimuli that are nearly indistinguishable from reality. For the field to move forward, many commercial and technological barriers need to be overcome. By rendering how objects feel through haptic technology, we communicate information that might reflect a desire to speak a physically- based language that has never been explored before. Due to constant improvement in haptics technology and increasing levels of research into and development of haptics-related algorithms, protocols and devices, there is a belief that haptics technology has a promising future

Research on real-time physics-based deformation for haptic-enabled medical simulation

This study developed a multiple effective visuo-haptic surgical engine to handle a variety of surgical manipulations in real-time. Soft tissue models are based on biomechanical experiment and continuum mechanics for greater accuracy. Such models will increase the realism of future training systems and the VR/AR/MR implementations for the operating room

VISIO-HAPTIC DEFORMABLE MODEL FOR HAPTIC DOMINANT PALPATION SIMULATOR

Vision and haptic are two most important modalities in a medical simulation. While visual cues assist one to see his actions when performing a medical procedure, haptic cues enable feeling the object being manipulated during the interaction. Despite their importance in a computer simulation, the combination of both modalities has not been adequately assessed, especially that in a haptic dominant environment. Thus, resulting in poor emphasis in resource allocation management in terms of effort spent in rendering the two modalities for simulators with realistic real-time interactions. Addressing this problem requires an investigation on whether a single modality (haptic) or a combination of both visual and haptic could be better for learning skills in a haptic dominant environment such as in a palpation simulator. However, before such an investigation could take place one main technical implementation issue in visio-haptic rendering needs to be addresse

Frictional Contact in Interactive Deformable Environments

L\u2019uso di simulazioni garantisce notevoli vantaggi in termini di economia, realismo e di flessibilit\ue0 in molte aree di ricerca e in ambito dello sviluppo tecnologico. Per questo motivo le simulazioni vengono usate spesso in ambiti quali la prototipazione di parti meccaniche, nella pianificazione e nell\u2019addestramento di procedure di assemblaggio e disassemblaggio inoltre, di recente, le simulazioni si sono dimostrate validi strumenti anche nell\u2019assistenza e nell\u2019addestramento ai chirurghi, in particolare nel caso della chirurgia laparoscopica. La chirurgia laparoscopica, infatti, \ue8 considerata lo standard per molte procedure chirurgiche. La principale differenza rispetto alla chirurgia tradizionale risiede nella notevole limitazione che ha il chirurgo nell\u2019interagire e nel percepire l\u2019ambiente in lavora, sia nella vista che nel tatto. Questo rappresenta una forte limitazione per il chirurgo a cui \ue8 richiesta una lunga fase di addestramento prima di poter ottenere la necessaria destrezza per intervenire in laparoscopia con profitto. Queste limitazioni, d\u2019altra parte, rendono la laparoscopia il candidato ideale per l\u2019introduzione della simulazione nell\u2019addestramento. Attualmente sono disponibili in commercio dei software per l\u2019addestramento alla laparoscopia, tuttavia essi sono in genere basati su modelli rigidi, o modelli che comunque mancano del necessario realismo fisico. L\u2019introduzione di modelli deformabili migliorerebbe notevolmente l\u2019accuratezza e il realismo delle simulazioni. Nel caso dell\u2019addestramento il maggior realismo permetterebbe all\u2019utente di acquisire non solo le conoscenze motorie basilari ma anche capacit\ue0 e conoscenze di pi\uf9 alto livello. I corpi rigidi, infatti, rappresentano una buona approssimazione della realt\ue0 solo in situazioni particolari ed entro intervalli di sollecitazioni molto ristretti. Quando si considerano materiali non ingegneristici, come accade nelle simulazioni chirurgiche, le deformazioni non possono essere trascurate senza compromettere irrimediabilmente il realismo dei risultati. L\u2019uso di modelli deformabili tuttavia introduce notevole complessit\ue0 computazionale per il calcolo della fisica che regola le deformazioni e limita fortemente l\u2019uso di dati precalcolati, spesso utilizzati per velocizzare la fase di identificazione delle collisioni tra i corpi. I ritardi dovuti all\u2019uso di modelli deformabili rappresentano un grosso limite soprattutto nelle applicazioni interattive che, per consentire all\u2019utente di interagire con l\u2019ambiente, richiedono il calcolo della simulazione entro intervalli di tempo molto ridotti. In questa tesi viene affrontato il tema della simulazione di ambienti interattivi composti da corpi deformabili che interagiscono con attrito. Vengono analizzati e sviluppati differenti tecniche e metodi per le diverse componenti della simulazione: dalla simulazione di modelli deformabili, agli algoritmi di identificazione e soluzione delle collisioni e alla modellazione e integrazione dell\u2019attrito nella simulazione. In particolare vengono valutati i principali metodi che rappresentano lo stato dell\u2019arte nella modellazione di materiali deformabili. L\u2019analisi considera i fondamenti fisici su cui i modelli si basano e quindi sul grado di realismo che possono garantire in termini di deformazioni modellabili e la semplicit\ue0 d\u2019uso degli stessi (ovvero la facilit\ue0 di comprensione del metodo, la calibrazione del modello e la possibilit\ue0 di adattare il modello a situazioni differenti) ma viene considerata anche la complessit\ue0 computazionale di ciascun metodo in quanto essa rappresenta un fattore estremamente importante nella scelta e nell\u2019uso dei modelli deformabili nelle simulazioni. Il confronto dei differenti modelli e le caratteristiche identificate hanno motivato lo sviluppo di un metodo innovativo per fornire un\u2019interfaccia comune ai vari metodi di simulazione dei tessuti deformabili. Tale interfaccia ha il vantaggio di fornire dei metodi omogenei per la manipolazione dei diversi modelli deformabili. Ci\uf2 garantisce la possibilit\ue0 di scambiare il modello usato per la simulazione delle deformazioni mantenendo inalterati le altre strutture dati e i metodi della simulazione. L\u2019introduzione di tale interfaccia unificata si dimostra particolarmente vantaggiosa in quanto permette l\u2019uso di un solo metodo per l\u2019identificazione delle collisioni per tutti i differenti modelli deformabili. Ci\uf2 semplifica molto l\u2019analisi e la definizione dei requisiti di tale modulo software. L\u2019identificazione delle collisioni tra modelli rigidi generalmente precalcola delle partizioni dello spazio in cui i corpi sono definiti oppure sfrutta la suddivisione del corpo analizzato in parti convesse per velocizzare la simulazione. Nel caso di modelli deformabili non \ue8 possibile applicare tali tecniche a causa dei continui cambiamenti nella configurazione dei corpi. Dopo che le collisioni tra i corpi sono state riconosciute e che i punti di contatto sono stati identificati e necessario risolvere le collisioni tenendo conto della fisica sottostante i contatti. Per garantire il realismo \ue8 necessario assicurare che i corpi non si compenetrino mai e che nella simulazione delle collisioni tutti i fenomeni fisici di interesse coinvolti nel contatto tra i corpi vengano considerati: questi includono le forze elastiche che si esercitano tra i corpi e le forze di attrito che si generano lungo le superfici di contatto. L\u2019innovativo metodo proposto per la soluzione delle collisioni garantisce il realismo della simulazione e l\u2019integrazione con l\u2019interfaccia proposta per la gestione unificata dei modelli. Una caratteristica importante dei tessuti biologici \ue8 il comportamento anisotropico, dovuto, in genere, alla loro struttura fibrosa. In questa tesi viene proposto un nuovo metodo per aggiungere l\u2019anisotropia al comportamento dei modelli massa molla. Il metodo ha il vantaggio di mantenere la velocit\ue0 computazionale e la semplicit\ue0 di implementazione dei modelli massa molla classici e riesce a differenziare efficacemente la risposta del modello alle sollecitazioni lungo le differenti direzioni. Le tecniche descritte sono state integrate in due applicazioni che forniscono la simulazione della fisica di ambienti con corpi deformabili. La prima delle due implementa tutti i metodi descritti per la simulazione dei modelli deformabili, identifica le collisioni con precisione e le risolve fornendo la possibilit\ue0 di scegliere il modello di attrito pi\uf9 adatto, dimostrando cos\uec la fattibilit\ue0 dell\u2019approccio proposto. La limitazione principale di tale simulatore risiede nell\u2019alto tempo di calcolo richiesto per la simulazione dei singoli passi di simulazione. Tale limitazione \ue8 stata superata in una seconda implementazione che sfrutta il parallelismo intrinseco delle simulazioni fisiche per ottimizzare gli algoritmi e che, quindi, riesce a sfruttare al meglio la potenza computazionale delle architetture hardware parallele. Al fine di ottenere le prestazioni richieste per la simulazione di ambienti interattivi con ritorno di forza, la simulazione \ue8 basata su un algoritmo di identificazione delle collisioni semplificato, ma implementa gli altri metodi descritti in questa tesi. L\u2019implementazione parallela sfrutta le capacit\ue0 di calcolo delle moderne schede video munite di processori altamente paralleli e ci\uf2 permette di aggiornare la scena ogni millisecondo. Questo elimina ogni discontinuit\ue0 nel ritorno di forza reso all\u2019utente e nell\u2019aggiornamento della grafica della scena, inoltre garantisce il realismo necessario alla simulazione fisica sottostante. Le applicazioni implementate provano la fattibilit\ue0 della simulazione della fisica di interazioni complesse tra corpi deformabili. Inoltre, l\u2019implementazione parallela della simulazione rappresenta un promettente punto di partenza per la realizzazione di simulazioni interattive che potr\ue0 essere utilizzato in ambiti di ricerca differenti, quali l\u2019addestramento di chirurghi o la prototipazione rapida.The use of simulations provides great advantages in term of economy, realism, and adaptability to user requirements in many research and technological fields. For this reason simulations are currently exploited, for example, in prototyping of machinery parts, in assembly-disassembly test or training and, recently, simulations have also allowed the development of many useful and promising tools for the assistance and learning of surgical procedures. This is particularly true for laparoscopic intervention. Laparoscopy, in fact, represents the gold standard for many surgical procedures. The principal difference from standard surgery is the reduction of the surgeon ability to perceive the surgical scenario, both from visual and tactile point of view. This represents a great limitation for surgeons who undergo long training before being able to perform laparoscopic intervention with proficiency. This, on the other hand, makes laparoscopy an excellent candidate for the use of simulations for training. Some commercial training softwares are already available on the market, but they are usually based on rigid body models that completely lack the physical realism. The introduction of deformable models may leads to a great increment in terms of realism and accuracy. And, in the case of laparoscopy trainer it may allow the user to learn not only basic motor skills, but also higher level capabilities and knowledge. Rigid bodies, in fact, represents a good approximation of reality only in some situations and in very restricted ranges of solicitations. In particular, when non engineering materials are involved, as happens in surgical simulations, deformations cannot be neglected without completely loosing the realism of the environment. The use of deformable models, however, is limited for the high computational costs involved in the computation of the physics undergoing the deformations and because of the reduction in pre computable data in particular for collision detection between bodies. This represents a very limiting factor in interactive environments where, to allow the user to interactively control the virtual bodies, the simulation should be performed in real time. In this thesis we address the simulation of interactive environment populated with deformable models that interact with frictional contacts. This includes the analysis and the development of different techniques which implement the various parts of the simulation: mainly the methods for the simulation of deformable models, the collision detection and collision solution techniques but also the modelling and the integration of suitable friction models in the simulation. In particular we evaluated the principal methods that represent the state of the art in soft tissue modeling. Our analysis is based on the physical background of each method and thus on its realism in terms of deformations that the method can mimic and on the ease of use (i.e. method understanding, calibration and ability to adapt to different scenarios) but we also compared the computational complexity of different models, as it represents an extremely important factor in the choice and in the use of models in simulations. The comparison of different features in analyzed methods motivated us to the development of an innovative method to wrap in a common representation framework different methodologies of soft tissue simulation. This framework has the advantage of providing a unified interface for all the deformable models and thus it provides the ability to switch between deformable model keeping unchanged all other data structures and methods of the simulation. The use of this unique interface allows us to use one single method to perform the collision detection phase for all the analyzed deformable models, this greatly helped during the identification of requirements and features of such software module. Collision detection phase, when applied to rigid bodies, usually takes advantage of pre computation to subdivide body shapes in convex elements or to construct partitions of the space in which the body is defined to speed up the computation. When handling deformable models this is not possible because of the continuous changes in bodies shape. The collision detection method used in this work takes into account this problem and regularly adapt the data structures to the body configuration. After collisions have been detected and contact points have been identified on colliding bodies, it is necessary to solve the collision in a physics based way. To this extent we have to ensure that objects never compenetrate during the simulation and that, when solving collisions, all the physical phenomena involved in the contact of real bodies are taken into account: this include the elastic response of bodies during the contact and the frictional force exerted between each pair of colliding bodies. The innovative method for solving collision that we describe in this thesis ensures the realism of the simulation and the seamless interaction with the common framework used to integrate deformable models. One important feature of biologic tissues is their anisotropic behavior that usually comes from the fibrous structure of these tissues. In this thesis we propose a new method to introduce anisotropy in mass spring model. The method has the advantages of preserving the speed and ease of implementation of the model and it effectively introduces differentiation of the model behavior along the chosen directions. The described techniques have been integrated in two applications that allows the physical simulation of environments populated with deformable models. The first application implements all the described methods to simulate deformable models, it performs precise collision detection and solution with the possibility to chose the most suitable friction model for the simulation. It demonstrates the effectiveness of the proposed framework. The main limitation of this simulator, i.e. its high computation time, is tackled and solved in a second application that exploits the intrinsic parallelism of physical simulations to optimize the implementation and to exploit parallel architecture computational power. To obtain the performances required for an interactive environment the simulation is based on a simplified collision detection algorithm, but it features all the other techniques described in this thesis. The parallel implementation exploits graphic cards processor, a highly parallel architecture that update the scene every milliseconds. This allows the rendering of smooth haptic feedback to the user and ensures the realism of the physics simulation. The implemented applications prove the feasibility of the simulation of complex interactions between deformable models with physics realism. In addition, the parallel implementation of the simulator represents a promising starting point for the development of interactive simulations that can be used in different fields of research, such as surgeon training or fast prototyping