Real-time hybrid cutting with dynamic fluid visualization for virtual surgery

It is widely accepted that a reform in medical teaching must be made to meet today's high volume training requirements. Virtual simulation offers a potential method of providing such trainings and some current medical training simulations integrate haptic and visual feedback to enhance procedure learning. The purpose of this project is to explore the capability of Virtual Reality (VR) technology to develop a training simulator for surgical cutting and bleeding in a general surgery

Realistic tool-tissue interaction models for surgical simulation and planning

Surgical simulators present a safe and potentially effective method for surgical training, and can also be used in pre- and intra-operative surgical planning. Realistic modeling of medical interventions involving tool-tissue interactions has been considered to be a key requirement in the development of high-fidelity simulators and planners. The soft-tissue constitutive laws, organ geometry and boundary conditions imposed by the connective tissues surrounding the organ, and the shape of the surgical tool interacting with the organ are some of the factors that govern the accuracy of medical intervention planning.\ud \ud This thesis is divided into three parts. First, we compare the accuracy of linear and nonlinear constitutive laws for tissue. An important consequence of nonlinear models is the Poynting effect, in which shearing of tissue results in normal force; this effect is not seen in a linear elastic model. The magnitude of the normal force for myocardial tissue is shown to be larger than the human contact force discrimination threshold. Further, in order to investigate and quantify the role of the Poynting effect on material discrimination, we perform a multidimensional scaling study. Second, we consider the effects of organ geometry and boundary constraints in needle path planning. Using medical images and tissue mechanical properties, we develop a model of the prostate and surrounding organs. We show that, for needle procedures such as biopsy or brachytherapy, organ geometry and boundary constraints have more impact on target motion than tissue material parameters. Finally, we investigate the effects surgical tool shape on the accuracy of medical intervention planning. We consider the specific case of robotic needle steering, in which asymmetry of a bevel-tip needle results in the needle naturally bending when it is inserted into soft tissue. We present an analytical and finite element (FE) model for the loads developed at the bevel tip during needle-tissue interaction. The analytical model explains trends observed in the experiments. We incorporated physical parameters (rupture toughness and nonlinear material elasticity) into the FE model that included both contact and cohesive zone models to simulate tissue cleavage. The model shows that the tip forces are sensitive to the rupture toughness. In order to model the mechanics of deflection of the needle, we use an energy-based formulation that incorporates tissue-specific parameters such as rupture toughness, nonlinear material elasticity, and interaction stiffness, and needle geometric and material properties. Simulation results follow similar trends (deflection and radius of curvature) to those observed in macroscopic experimental studies of a robot-driven needle interacting with gels

Haptic feedback from human tissues of various stiffness and homogeneity

This work presents methods for haptic modelling of soft and hard tissue with varying stiffness. The model provides visualization of deformation and calculates force feedback during simulated epidural needle insertion. A spring-mass-damper (SMD) network is configured from magnetic resonance image (MRI) slices of patient’s lumbar region to represent varying stiffness throughout tissue structure. Reaction force is calculated from the SMD network and a haptic device is configured to produce a needle insertion simulation. The user can feel the changing forces as the needle is inserted through tissue layers and ligaments. Methods for calculating the force feedback at various depths of needle insertion are presented. Voxelization is used to fill ligament surface meshes with spring mass damper assemblies for simulated needle insertion into soft and hard tissues. Modelled vertebrae cannot be pierced by the needle. Graphs were produced during simulated needle insertions to compare the applied force to haptic reaction force. Preliminary saline pressure measurements during Tuohy epidural needle insertion are also used as a basis for forces generated in the simulation

Meshless Mechanics and Point-Based Visualization Methods for Surgical Simulations

Computer-based modeling and simulation practices have become an integral part of the medical education field. For surgical simulation applications, realistic constitutive modeling of soft tissue is considered to be one of the most challenging aspects of the problem, because biomechanical soft-tissue models need to reflect the correct elastic response, have to be efficient in order to run at interactive simulation rates, and be able to support operations such as cuts and sutures. Mesh-based solutions, where the connections between the individual degrees of freedom (DoF) are defined explicitly, have been the traditional choice to approach these problems. However, when the problem under investigation contains a discontinuity that disrupts the connectivity between the DoFs, the underlying mesh structure has to be reconfigured in order to handle the newly introduced discontinuity correctly. This reconfiguration for mesh-based techniques is typically called dynamic remeshing, and most of the time it causes the performance bottleneck in the simulation. In this dissertation, the efficiency of point-based meshless methods is investigated for both constitutive modeling of elastic soft tissues and visualization of simulation objects, where arbitrary discontinuities/cuts are applied to the objects in the context of surgical simulation. The point-based deformable object modeling problem is examined in three functional aspects: modeling continuous elastic deformations with, handling discontinuities in, and visualizing a point-based object. Algorithmic and implementation details of the presented techniques are discussed in the dissertation. The presented point-based techniques are implemented as separate components and integrated into the open-source software framework SOFA. The presented meshless continuum mechanics model of elastic tissue were verified by comparing it to the Hertzian non-adhesive frictionless contact theory. Virtual experiments were setup with a point-based deformable block and a rigid indenter, and force-displacement curves obtained from the virtual experiments were compared to the theoretical solutions. The meshless mechanics model of soft tissue and the integrated novel discontinuity treatment technique discussed in this dissertation allows handling cuts of arbitrary shape. The implemented enrichment technique not only modifies the internal mechanics of the soft tissue model, but also updates the point-based visual representation in an efficient way preventing the use of costly dynamic remeshing operations

Investigation of the use of meshfree methods for haptic thermal management of design and simulation of MEMS

This thesis presents a novel approach of using haptic sensing technology combined with virtual environment (VE) for the thermal management of Micro-Electro-Mechanical-Systems (MEMS) design. The goal is to reduce the development cycle by avoiding the costly iterative prototyping procedure. In this regard, we use haptic feedback with virtua lprototyping along with an immersing environment. We also aim to improve the productivity and capability of the designer to better grasp the phenomena operating at the micro-scale level, as well as to augment computational steering through haptic channels. To validate the concept of haptic thermal management, we have implemented a demonstrator with a user friendly interface which allows to intuitively "feel" the temperature field through our concept of haptic texturing. The temperature field in a simple MEMS component is modeled using finite element methods (FEM) or finite difference method (FDM) and the user is able to feel thermal expansion using a combination of different haptic feedback. In haptic application, the force rendering loop needs to be updated at a frequency of 1Khz in order to maintain continuity in the user perception. When using FEM or FDM for our three-dimensional model, the computational cost increases rapidly as the mesh size is reduced to ensure accuracy. Hence, it constrains the complexity of the physical model to approximate temperature or stress field solution. It would also be difficult to generate or refine the mesh in real time for CAD process. In order to circumvent the limitations due to the use of conventional mesh-based techniques and to avoid the bothersome task of generating and refining the mesh, we investigate the potential of meshfree methods in the context of our haptic application. We review and compare the different meshfree formulations against FEM mesh based technique. We have implemented the different methods for benchmarking thermal conduction and elastic problems. The main work of this thesis is to determine the relevance of the meshfree option in terms of flexibility of design and computational charge for haptic physical model

Design and development of a VR system for exploration of medical data using haptic rendering and high quality visualization

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Collision Detection and Merging of Deformable B-Spline Surfaces in Virtual Reality Environment

This thesis presents a computational framework for representing, manipulating and merging rigid and deformable freeform objects in virtual reality (VR) environment. The core algorithms for collision detection, merging, and physics-based modeling used within this framework assume that all 3D deformable objects are B-spline surfaces. The interactive design tool can be represented as a B-spline surface, an implicit surface or a point, to allow the user a variety of rigid or deformable tools. The collision detection system utilizes the fact that the blending matrices used to discretize the B-spline surface are independent of the position of the control points and, therefore, can be pre-calculated. Complex B-spline surfaces can be generated by merging various B-spline surface patches using the B-spline surface patches merging algorithm presented in this thesis. Finally, the physics-based modeling system uses the mass-spring representation to determine the deformation and the reaction force values provided to the user. This helps to simulate realistic material behaviour of the model and assist the user in validating the design before performing extensive product detailing or finite element analysis using commercially available CAD software. The novelty of the proposed method stems from the pre-calculated blending matrices used to generate the points for graphical rendering, collision detection, merging of B-spline patches, and nodes for the mass spring system. This approach reduces computational time by avoiding the need to solve complex equations for blending functions of B-splines and perform the inversion of large matrices. This alternative approach to the mechanical concept design will also help to do away with the need to build prototypes for conceptualization and preliminary validation of the idea thereby reducing the time and cost of concept design phase and the wastage of resources

Haptics-based Modeling and Simulation of Micro-Implants Surgery

Ph.DDOCTOR OF PHILOSOPH