Modelling anisotropic viscoelasticity for real-time soft tissue simulation

Previously almost all biomechanically-based time-critical surgical simulation has ignored the well established features of tissue mechanical response of anisotropy and time-dependence. We address this issue by presenting an efficient solution procedure for anisotropic visco-hyperelastic constitutive models which allows use of these in nonlinear explicit dynamic finite element algorithms. We show that the procedure allows incorporation of both anisotropy and viscoelasticity for as little as 5.1% additional cost compared with the usual isotropic elastic models. When combined with high performance GPU execution the complete framework is suitable for time-critical simulation applications such as interactive surgical simulation and intraoperative image registration

Découpage virtuel interactif de corps élastiques pour simulation chirurgicale

''RÉSUMÉ : La simulation chirurgicale dans un environnement de réalité virtuelle fournit un moyen de pratiquer certaines opérations sans les risques associés à une intervention sur un patient ou le coût d’un mannequin. Afin de générer un sentiment de présence, on cherche à produire un environnement le plus complet possible, incluant une vision 3D, un retour haptique, des interactions crédibles et un comportement physique réaliste des objets présents. La recherche présentée ici porte sur la simulation physique du comportement d’organes mous, comme le foie ou le cerveau, ainsi que sur le découpage de ces organes à l’aide d’un scalpel, une interaction particulièrement difficile à reproduire virtuellement de façon réaliste. L’objectif principal est de développer une méthode de déformation à la fois réaliste et efficace, et de permettre à un utilisateur de découper interactivement un objet simulé par cette méthode, à l’aide d’un outil tranchant virtuel. De plus, nous voulons que la déformation et les interactions soient décrites avec une grande précision, tout en permettant d’effectuer les calculs très rapidement, pour une interaction fluide qui maintient le sentiment de présence.''----------''ABSTRACT : Surgery simulation in a virtual reality environment provides a way to practice certain operations without the risks associated with performing surgery on a patient or the cost of using arealistic dummy. To facilitate immersion, we seek to produce an environment as complete as possible, including 3D vision, haptic feedback, credible interactions and a realistic physical behavior of simulated objects. The research presented in this document focuses on the physical behavior of soft organs, like the brain or liver, and on cutting these organs using a scalpel. It is especially difficult to reproduce virtually that interaction in a realistic way. The main objective is to develop a deformation method that is both realistic and efficient, and to allow a user to interactively cut an object simulated through this method, using a virtual sharp tool. Furthermore, we want the deformation and interactions to be described with high precision while allowing for fast computations, for a smooth interaction that maintains immersion.'

Technologies for Biomechanically-Informed Image Guidance of Laparoscopic Liver Surgery

Laparoscopic surgery for liver resection has a number medical advantages over open surgery, but also comes with inherent technical challenges. The surgeon only has a very limited field of view through the imaging modalities routinely employed intra-operatively, laparoscopic video and ultrasound, and the pneumoperitoneum required to create the operating space and gaining access to the organ can significantly deform and displace the liver from its pre-operative configuration. This can make relating what is visible intra-operatively to the pre-operative plan and inferring the location of sub-surface anatomy a very challenging task. Image guidance systems can help overcome these challenges by updating the pre-operative plan to the situation in theatre and visualising it in relation to the position of surgical instruments. In this thesis, I present a series of contributions to a biomechanically-informed image-guidance system made during my PhD. The most recent one is work on a pipeline for the estimation of the post-insufflation configuration of the liver by means of an algorithm that uses a database of segmented training images of patient abdomens where the post-insufflation configuration of the liver is known. The pipeline comprises an algorithm for inter and intra-subject registration of liver meshes by means of non-rigid spectral point-correspondence finding. My other contributions are more fundamental and less application specific, and are all contained and made available to the public in the NiftySim open-source finite element modelling package. Two of my contributions to NiftySim are of particular interest with regards to image guidance of laparoscopic liver surgery: 1) a novel general purpose contact modelling algorithm that can be used to simulate contact interactions between, e.g., the liver and surrounding anatomy; 2) membrane and shell elements that can be used to, e.g., simulate the Glisson capsule that has been shown to significantly influence the organ’s measured stiffness