Virtual Reality Based Simulation of Hysteroscopic Interventions

Virtual reality based simulation is an appealing option to supplement traditional clinical education. However, the formal integration of training simulators into the medical curriculum is still lacking. Especially, the lack of a reasonable level of realism supposedly hinders the widespread use of this technology. Therefore, we try to tackle this situation with a reference surgical simulator of the highest possible fidelity for procedural training. This overview describes all elements that have been combined into our training system as well as first results of simulator validation. Our framework allows the rehearsal of several aspects of hysteroscopy—for instance, correct fluid management, handling of excessive bleeding, appropriate removal of intrauterine tumors, or the use of the surgical instrument

Evaluation of a new virtual-reality training simulator for hysteroscopy

BACKGROUND: To determine realism and training capacity of HystSim, a new virtual-reality simulator for the training of hysteroscopic interventions. METHODS: Sixty-two gynaecological surgeons with various levels of expertise were interviewed at the 13(th) Practical Course in Gynaecologic Endoscopy in Davos, Switzerland. All participants received a 20-min hands-on training on the simulator and filled out a four-page questionnaire. Twenty-three questions with respect to the realism of the simulation and the training capacity were answered on a seven-point Likert scale along with 11 agree-disagree statements concerning the HystSim training in general. RESULTS: Twenty-six participants had performed more than 50 hysteroscopies ("experts") and 36 equal to or fewer than 50 ("novices"). Four of 60 (6.6%) responding participants judged the overall impression as "7 - absolutely realistic", 40 (66.6%) as "6 - realistic", and 16 (26.6%) as "5 - somewhat realistic". Novices (6.48; 95% confidence interval [CI] 6.28-6.7) rated the overall training capacity significantly higher than experts (6.08; 95% CI 5.85-6.3), however, high-grade acceptance was found in both groups. In response to the statements, 95.2% believe that HystSim allows procedural training of diagnostic and therapeutic hysteroscopy, and 85.5% suggest that HystSim training should be offered to all novices before performing surgery on real patients. CONCLUSION: Face validity has been established for a new hysteroscopic surgery simulator. Potential trainees and trainers assess it to be a realistic and useful tool for the training of hysteroscopy. Further systematic validation studies are needed to clarify how this system can be optimally integrated into the gynaecological curriculum

A Computer-Based RealTime Simulation of Interventional Radiology

Abstract — Interventional radiology is a minimally invasive procedure where thin instruments, guidewires and catheters or stents are steered through the patient’s vascular system under X-ray imaging for treatment of vascular diseases. The complexity of these procedures makes training in order to master hand-eye coordination, instrument manipulation and procedure protocols for each radiologist mandatory. In this paper, we present a computer-based real-time simulation of interventional radiology procedures, which deploys a very efficient physics-based thread model to simulate the elastic behavior of guidewires and catheters. A fast collision detection scheme provides continuous collision response, which reveals more details of arterial walls than a centerline approach. Furthermore rendering techniques for realistic X-ray effect have been implemented. Our simulation structure is updated at a haptic rate of 500 Hz, thus contributing to physical realism. I