Journal articles: 'Surgical simulation systems'

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Mendel, Shaun, Donald Curtis, and Jeffrey C. Page. "Interprofessional Podiatric Surgical Simulation." Journal of the American Podiatric Medical Association 105, no. 4 (July 1, 2015): 331–37. http://dx.doi.org/10.7547/13-164.1.

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Background Interprofessional collaboration is key to quality outcomes in the health-care systems of today. Simulation is a common tool in podiatric medical education, and interprofessional education has become more common in podiatric medicine programs. Interprofessional simulation is the blending of these educational strategies. Methods A quantitative design was used to determine the impact of an isolated interprofessional podiatric surgical simulation between nurse anesthesia and podiatric medical students. Results Statistically significant differences were observed among participants between preintervention and postintervention surveys using the revised Interdisciplinary Education Perception Scale. Conclusions Interprofessional simulation can be an effective educational opportunity for podiatric medical and nurse anesthesia students.

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Garstka, Meghan E., Douglas P. Slakey, Christopher A. Martin, Eric R. Simms, and James R. Korndorffer. "Effectiveness of systems changes suggested by simulation of adverse surgical outcomes." BMJ Simulation and Technology Enhanced Learning 1, no. 3 (December 2015): 83–86. http://dx.doi.org/10.1136/bmjstel-2015-000055.

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BackgroundSimulation of adverse outcomes (SAO) has been described as a technique to improve effectiveness of root cause analysis (RCA) in healthcare. We hypothesise that SAO can effectively identify unsuspected root causes amenable to systems changes.MethodsSystems changes were developed and tested for effectiveness in a modified simulation, which was performed eight times, recorded and analysed.ResultsIn seven of eight simulations, systems changes were effectively utilised by participants, who contacted anaesthesia using the number list and telephone provided to express concern. In six of seven simulations where anaesthesia was contacted, they provided care that avoided the adverse event. In two simulations, the adverse event transpired despite implemented systems changes, but for different reasons than originally identified. In one case, appropriate personnel were contacted but did not provide the direction necessary to avoid the adverse event, and in one case, the telephone malfunctioned.ConclusionsSystems changes suggested by SAO can effectively correct deficiencies and help improve outcomes, although adverse events can occur despite implementation. Further study of systems concepts may provide suggestions for changes that function more reliably in complex healthcare systems. The information gathered from these simulations can be used to identify potential deficiencies, prevent future errors and improve patient safety.

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Székely, G., Ch Brechbühler, J. Dual, R. Enzler, J. Hug, R. Hutter, N. Ironmonger, et al. "Virtual Reality-Based Simulation of Endoscopic Surgery." Presence: Teleoperators and Virtual Environments 9, no. 3 (June 2000): 310–33. http://dx.doi.org/10.1162/105474600566817.

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Virtual reality (VR)-based surgical simulator systems offer a very elegant approach to enriching and enhancing traditional training in endoscopic surgery. However, while a number of VR simulator systems have been proposed and realized in the past few years, most of these systems are far from being able to provide a reasonably realistic surgical environment. We explore the current limits for realism and the approaches to reaching and surpassing those limits by describing and analyzing the most important components of VR-based endoscopic simulators. The feasibility of the proposed techniques is demonstrated on a modular prototype system that implements the basic algorithms for VR training in gynaecologic laparoscopy.

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Liu, Alan, Frank Tendick, Kevin Cleary, and Christoph Kaufmann. "A Survey of Surgical Simulation: Applications, Technology, and Education." Presence: Teleoperators and Virtual Environments 12, no. 6 (December 2003): 599–614. http://dx.doi.org/10.1162/105474603322955905.

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Surgical simulation for medical education is increasingly perceived as a valuable addition to traditional teaching methods. Simulators provide a structured learning experience, permitting practice without danger to patients, and simulators facilitate the teaching of rare or unusual cases. Simulators can also be used to provide an objective assessment of skills. This paper is a survey of current surgical simulator systems. The components of a simulator are described, current research directions are discussed, and key research questions are identified.

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Loukas, Constantinos. "Surgical Simulation Training Systems: Box Trainers, Virtual Reality and Augmented Reality Simulators." International Journal of Advanced Robotics and Automation 1, no. 2 (July 11, 2016): 1–9. http://dx.doi.org/10.15226/2473-3032/1/2/00109.

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Lim, Yi-Je, Wei Jin, and Suvranu De. "On Some Recent Advances in Multimodal Surgery Simulation: A Hybrid Approach to Surgical Cutting and the Use of Video Images for Enhanced Realism." Presence: Teleoperators and Virtual Environments 16, no. 6 (December 1, 2007): 563–83. http://dx.doi.org/10.1162/pres.16.6.563.

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In this paper, we present some recent advances in realistic surgery simulation including novel algorithms for simulating surgical cutting and techniques of improving visual realism of the simulated scenarios using images. Simulation of surgical cutting is one of the most challenging tasks in the development of a surgery simulator. Changes in topology during simulation render precomputed data unusable. Moreover, the process is nonlinear and the underlying physics is complex. Therefore, fully realistic simulation of surgical cutting at real-time rates on single processor machines is possibly out of reach at the present time. In this paper, we present a hybrid approach to the simulation of surgical cutting procedures by combining a node-snapping technique with a physically based meshfree computational scheme, the point-associated finite field (PAFF) approach, and empirical data obtained from controlled cutting experiments. To enhance the realism of the rendered scenarios, we propose an innovative way of using images obtained from videos acquired during actual surgical processes. Using a combination of techniques such as image mosaicing and view-dependent texture-mapping, we have been able to achieve excellent realistic effects with desired tissue glistening as the camera position is changed. Realistic examples are presented to showcase the results.

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Wright, M. B. "The application of a surgical bed simulation model." European Journal of Operational Research 32, no. 1 (October 1987): 26–32. http://dx.doi.org/10.1016/0377-2217(87)90268-2.

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Shi, Wen, Peter Xiaoping Liu, and Minhua Zheng. "Cutting procedures with improved visual effects and haptic interaction for surgical simulation systems." Computer Methods and Programs in Biomedicine 184 (February 2020): 105270. http://dx.doi.org/10.1016/j.cmpb.2019.105270.

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Shi, Wen, Xin Gao, Lei Lv, Zhuo Pan, and Jing Shao. "A new geometric combination of cutting and bleeding modules for surgical simulation systems." Computer Methods and Programs in Biomedicine 206 (July 2021): 106109. http://dx.doi.org/10.1016/j.cmpb.2021.106109.

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Nekrasov, R. Yu, I. V. Soloviev, and A. I. Starikov. "Simulation of Technological Systems for Diagnosis and Management Machining with CNC." Applied Mechanics and Materials 770 (June 2015): 617–21. http://dx.doi.org/10.4028/www.scientific.net/amm.770.617.

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The article deals with the problem of increasing the precision of products engineering on CNC machines. The authors proposed a solution to this problem by providing input operational adjustments to control the trajectory of the Executive bodies of the machine. The necessity of the creation of mathematical models of technological processes of diagnostics system "machine-fixture-tool-workpiece" was justified. Based on the study, the authors proposed a general scheme of diagnostics and surgical input, corrections and approximate mathematical models of individual processes of diagnostics.

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Smith, C. Daniel. "Simulation Technology: A Strategy for Implementation in Surgical Education and Certification." Presence: Teleoperators and Virtual Environments 9, no. 6 (December 2000): 632–37. http://dx.doi.org/10.1162/105474600300040420.

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Virtual reality and simulation technology promise to be key technologies in medical education. The flight simulator tech nology that has so effectively replaced live, inflight training of pilots is being reengineered for use in medical and surgi cal education. Despite the considerable enthusiasm for this concept, very little practical work has been performed to integrate simulation technology into surgical education and certification. To achieve the potential offered by medical simulation, developers of these new technologies must join with medical/surgical educators to develop meaningful simu lators and virtual learning tools. This paper reviews the cur rent paradigm in surgical education and suggests a strategy for effecting a paradigm shift that facilitates the adoption of simulation technology in surgical education.

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Misra, Sarthak, K. T. Ramesh, and Allison M. Okamura. "Modeling of Tool-Tissue Interactions for Computer-Based Surgical Simulation: A Literature Review." Presence: Teleoperators and Virtual Environments 17, no. 5 (October 1, 2008): 463–91. http://dx.doi.org/10.1162/pres.17.5.463.

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Surgical simulators present a safe and potentially effective method for surgical training, and can also be used in robot-assisted surgery for pre- and intra-operative planning. Accurate modeling of the interaction between surgical instruments and organs has been recognized as a key requirement in the development of high-fidelity surgical simulators. Researchers have attempted to model tool-tissue interactions in a wide variety of ways, which can be broadly classified as (1) linear elasticity-based, (2) nonlinear (hyperelastic) elasticity-based finite element (FE) methods, and (3) other techniques not based on FE methods or continuum mechanics. Realistic modeling of organ deformation requires populating the model with real tissue data (which are difficult to acquire in vivo) and simulating organ response in real time (which is computationally expensive). Further, it is challenging to account for connective tissue supporting the organ, friction, and topological changes resulting from tool-tissue interactions during invasive surgical procedures. Overcoming such obstacles will not only help us to model tool-tissue interactions in real time, but also enable realistic force feedback to the user during surgical simulation. This review paper classifies the existing research on tool-tissue interactions for surgical simulators specifically based on the modeling techniques employed and the kind of surgical operation being simulated, in order to inform and motivate future research on improved tool-tissue interaction models.

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YUAN, ZHIYONG, SHIKUN FENG, QIAN YIN, XIALI WANG, DENGYI ZHANG, JIANHUI ZHAO, and MIANYUN CHEN. "ENDOSCOPIC IMAGE CUTTING SIMULATION BASED ON MASS-SPRING MODEL AND COMPUTATIONAL GEOMETRY." Journal of Circuits, Systems and Computers 18, no. 08 (December 2009): 1453–65. http://dx.doi.org/10.1142/s0218126609005782.

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As minimally invasive surgical techniques become widely known to patients, medical training systems based on virtual simulation are highly desired. These systems help surgeon trainees to acquire, practice and evaluate their surgical skills. A key component in a virtual training system is to simulate the dynamics that occur in surgical procedures. Tissue cutting, as a common phenomenon during surgery, has attracted many research efforts in computer simulation. In this paper, we propose an approach to endoscopic image cutting simulation which is based on both mass-spring model and Computational Geometry. In the cutting simulation model, the springs to be cut off are imagined into line segments. In the calculation of the elastic force on mass points, we have found that whether some adjacent springs of a mass point to be eliminated or not during a cutting is critical. If a spring intersects the cutting plane, we set the elastic force of this spring to zero. We adopted properties of cross product and related algorithms (the rapid exclusion test, the crossover test) in Computational Geometry to determine the springs that are intersected with the cutting plane. And then, we utilized the bilinear interpolation and OpenGL techniques to render the cutting procedure of the soft tissue. The experimental results show that our cutting simulation is effective and practical.

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Oishi, Makoto, Masafumi Fukuda, Tetsuya Hiraishi, Naoki Yajima, Yosuke Sato, and Yukihiko Fujii. "Interactive virtual simulation using a 3D computer graphics model for microvascular decompression surgery." Journal of Neurosurgery 117, no. 3 (September 2012): 555–65. http://dx.doi.org/10.3171/2012.5.jns112334.

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Object The purpose of this paper is to report on the authors' advanced presurgical interactive virtual simulation technique using a 3D computer graphics model for microvascular decompression (MVD) surgery. Methods The authors performed interactive virtual simulation prior to surgery in 26 patients with trigeminal neuralgia or hemifacial spasm. The 3D computer graphics models for interactive virtual simulation were composed of the brainstem, cerebellum, cranial nerves, vessels, and skull individually created by the image analysis, including segmentation, surface rendering, and data fusion for data collected by 3-T MRI and 64-row multidetector CT systems. Interactive virtual simulation was performed by employing novel computer-aided design software with manipulation of a haptic device to imitate the surgical procedures of bone drilling and retraction of the cerebellum. The findings were compared with intraoperative findings. Results In all patients, interactive virtual simulation provided detailed and realistic surgical perspectives, of sufficient quality, representing the lateral suboccipital route. The causes of trigeminal neuralgia or hemifacial spasm determined by observing 3D computer graphics models were concordant with those identified intraoperatively in 25 (96%) of 26 patients, which was a significantly higher rate than the 73% concordance rate (concordance in 19 of 26 patients) obtained by review of 2D images only (p < 0.05). Surgeons evaluated interactive virtual simulation as having “prominent” utility for carrying out the entire surgical procedure in 50% of cases. It was evaluated as moderately useful or “supportive” in the other 50% of cases. There were no cases in which it was evaluated as having no utility. The utilities of interactive virtual simulation were associated with atypical or complex forms of neurovascular compression and structural restrictions in the surgical window. Finally, MVD procedures were performed as simulated in 23 (88%) of the 26 patients . Conclusions Our interactive virtual simulation using a 3D computer graphics model provided a realistic environment for performing virtual simulations prior to MVD surgery and enabled us to ascertain complex microsurgical anatomy.

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Zhang, Jinao, Yongmin Zhong, Julian Smith, and Chengfan Gu. "Cellular neural network modelling of soft tissue dynamics for surgical simulation." Technology and Health Care 25 (July 20, 2017): 337–44. http://dx.doi.org/10.3233/thc-171337.

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Harders, M., D. Bachofen, M. Grassi, M. Bajka, U. Spaelter, M. Teschner, B. Heidelberger, et al. "Virtual Reality Based Simulation of Hysteroscopic Interventions." Presence: Teleoperators and Virtual Environments 17, no. 5 (October 1, 2008): 441–62. http://dx.doi.org/10.1162/pres.17.5.441.

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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 intra-uterine tumors, or the use of the surgical instrument.

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Delp, Scott L., Peter Loan, Cagatay Basdogan, and Joseph M. Rosen. "Surgical Simulation: An Emerging Technology for Training in Emergency Medicine." Presence: Teleoperators and Virtual Environments 6, no. 2 (April 1997): 147–59. http://dx.doi.org/10.1162/pres.1997.6.2.147.

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The current methods of training medical personnel to provide emergency medical care have several important shortcomings. For example, in the training of wound debridement techniques, animal models are used to gain experience treating traumatic injuries. We propose an alternative approach by creating a three-dimensional, interactive computer model of the human body that can be used within a virtual environment to learn and practice wound debridement techniques and Advanced Trauma Life Support (ATLS) procedures. As a first step, we have developed a computer model that represents the anatomy and physiology of a normal and injured lower limb. When visualized and manipulated in a virtual environment, this computer model will reduce the need for animals in the training of trauma management and potentially provide a superior training experience. This article describes the development choices that were made in implementing the preliminary system and the challenges that must be met to create an effective medical training environment.

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Wachter, Andreas, Jan Kost, and Werner Nahm. "MATLAB Simulation Environment for Estimating the Minimal Number and Positions of Cameras for 3D Surface Reconstruction in a Fully-Digital Surgical Microscope." Current Directions in Biomedical Engineering 4, no. 1 (September 1, 2018): 517–20. http://dx.doi.org/10.1515/cdbme-2018-0124.

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AbstractContemporary surgical microscope systems have excellent optical properties but some desirable features remain unavailable. The number of co-observers is currently restricted, by spatial and optical limitations, to only two. Moreover, ergonomics poses are a problem: Current microscope systems impede free movement and sometimes demand that surgeons take uncomfortable postures over long periods of time. To rectify these issues, some companies developed surgical microscope systems based on a streaming approach. These systems remove some of the limitations. Multi-observer positions, for example, are not independent from each other, for example. In order to overcome the aforementioned limitations, we are currently developing an approach for the next generation of surgical microscope: Namely the fully digital surgical microscope, where the current observation system is replaced with a camera array, allowing real-time 3D reconstruction of surgical scenes and, consequently, the rendering of almost unlimited views for multiple observers. These digital microscopes could make the perspective through the microscope unnecessary allowing the surgeon to move freely and work in more comfortable postures. The requirements on the camera array in such a system have to be determined. For this purpose, we propose of estimation the minimal number of cameras and their positions needed for the 3D reconstruction of microsurgical scenes. The method of estimation is based on the requirements for the 3D reconstruction. Within the MATLAB simulation environment, we have developed a 3D model of a microsurgical scene, used for the determination of the number of required cameras. In a next step a small, compact and costefficient system with few opto-mechanical components could be manufactured.

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Higgins, Gerald A., Gregory L. Merrill, Lawrence J. Hettinger, Christoph R. Kaufmann, Howard R. Champion, and Richard M. Satava. "New Simulation Technologies for Surgical Training and Certification: Current Status and Future Projections." Presence: Teleoperators and Virtual Environments 6, no. 2 (April 1997): 160–72. http://dx.doi.org/10.1162/pres.1997.6.2.160.

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Computer-based virtual reality technology has evolved to the point at which medical simulation can be incorporated into medical education and into the eventual objective evaluation of surgical competence. Flight simulation provides a model for examining the role of computer-based simulation in medical training and certification. The plan by which medical simulators are being designed and validated for surgical training is presented, as is a description of the current state of medical simulation and the limitations of the technology. A realistic argument for adoption is suggested that takes into account lower price constraints, technological limitations, and professional barriers to the implementation of simulator-based training and accreditation.1

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Whitehurst, Sabrina V., Ernest G. Lockrow, Thomas S. Lendvay, Anthony M. Propst, Susan G. Dunlow, Christopher J. Rosemeyer, Joseph M. Gobern, Lee W. White, Anna Skinner, and Jerome L. Buller. "Comparison of Two Simulation Systems to Support Robotic-Assisted Surgical Training: A Pilot Study (Swine Model)." Journal of Minimally Invasive Gynecology 22, no. 3 (March 2015): 483–88. http://dx.doi.org/10.1016/j.jmig.2014.12.160.

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Bing, Eric G., Megan L. Brown, Anthony Cuevas, Richard Sullivan, and Groesbeck P. Parham. "User Experience With Low-Cost Virtual Reality Cancer Surgery Simulation in an African Setting." JCO Global Oncology, no. 7 (March 2021): 435–42. http://dx.doi.org/10.1200/go.20.00510.

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PURPOSE Limited access to adequate cancer surgery training is one of the driving forces behind global inequities in surgical cancer care. Affordable virtual reality (VR) surgical training could enhance surgical skills in low- and middle-income settings, but most VR and augmented reality systems are too expensive and do not teach open surgical techniques commonly practiced in these contexts. New low-cost VR can offer skill development simulations relevant to these settings, but little is known about how knowledge is gained and applied by surgeons training and working in specific resource-constrained settings. This study addresses this gap, exploring gynecologic oncology trainee learning and user experience using a low-cost VR simulator to learn to perform an open radical abdominal hysterectomy in Lusaka, Zambia. METHODS Eleven surgical trainees rotating through the gynecologic oncology service were sequentially recruited from the University Teaching Hospital in Lusaka to participate in a study evaluating a VR radical abdominal hysterectomy training designed to replicate the experience in a Zambian hospital. Six participated in semi-structured interviews following the training. Interviews were analyzed using open and axial coding, informed by grounded theory. RESULTS Simulator participation increased participants' perception of their surgical knowledge, confidence, and skills. Participants believed their skills transferred to other related surgical procedures. Having clear goals and motivation to improve were described as factors that influenced success. CONCLUSION For cancer surgery trainees in lower-resourced settings learning medical and surgical skills, even for those with limited VR experience, low-cost VR simulators may enhance anatomical knowledge and confidence. The VR simulator reinforced anatomical and clinical knowledge acquired through other modalities. VR-enhanced learning may be particularly valuable when mentored learning opportunities are limited.

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Dahroug, Bassem, Brahim Tamadazte, and Nicolas Andreff. "Unilaterally Constrained Motion of a Curved Surgical Tool." Robotica 38, no. 11 (January 10, 2020): 1940–62. http://dx.doi.org/10.1017/s0263574719001735.

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SUMMARYConstrained motion is essential for varying robotics tasks, especially in surgical robotics, for instance, the case of minimally invasive interventions. This article proposes generic formulations of the classical bilateral constrained motion (i.e., when the incision hole has almost the same diameter as that of the tool) as well as unilaterally constrained motion (i.e., when the hole incision has a larger diameter compared to the tool diameter). One of the latter constraints is combined with another surgical task such as incision/ablation or suturing a wound (modeled here by 3D geometric paths). The developed control methods based on the hierarchical task approach are able to manage simultaneously the constrained motion (depending on the configuration case, i.e., bilateral or unilateral constraint) and a 3D path following. In addition, the proposed methods can operate with both straight or curved surgical tools. The proposed methods were successfully validated in various scenarios. Foremost, a simulation framework was proposed to access the performances of each proposed controller. Thereafter, several experimental validations were carried out. Both the simulation and experimental results have demonstrated the relevance of the proposed approach, as well as promising performances in terms of behavior as well as accuracy.

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Wachter, Andreas, Jan Kost, and Werner Nahm. "Simulation-Based Estimation of the Number of Cameras Required for 3D Reconstruction in a Narrow-Baseline Multi-Camera Setup." Journal of Imaging 7, no. 5 (May 13, 2021): 87. http://dx.doi.org/10.3390/jimaging7050087.

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Graphical visualization systems are a common clinical tool for displaying digital images and three-dimensional volumetric data. These systems provide a broad spectrum of information to support physicians in their clinical routine. For example, the field of radiology enjoys unrestricted options for interaction with the data, since information is pre-recorded and available entirely in digital form. However, some fields, such as microsurgery, do not benefit from this yet. Microscopes, endoscopes, and laparoscopes show the surgical site as it is. To allow free data manipulation and information fusion, 3D digitization of surgical sites is required. We aimed to find the number of cameras needed to add this functionality to surgical microscopes. For this, we performed in silico simulations of the 3D reconstruction of representative models of microsurgical sites with different numbers of cameras in narrow-baseline setups. Our results show that eight independent camera views are preferable, while at least four are necessary for a digital surgical site. In most cases, eight cameras allow the reconstruction of over 99% of the visible part. With four cameras, still over 95% can be achieved. This answers one of the key questions for the development of a prototype microscope. In future, such a system can provide functionality which is unattainable today.

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Stone, Robert J. "The (human) science of medical virtual learning environments." Philosophical Transactions of the Royal Society B: Biological Sciences 366, no. 1562 (January 27, 2011): 276–85. http://dx.doi.org/10.1098/rstb.2010.0209.

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The uptake of virtual simulation technologies in both military and civilian surgical contexts has been both slow and patchy. The failure of the virtual reality community in the 1990s and early 2000s to deliver affordable and accessible training systems stems not only from an obsessive quest to develop the ‘ultimate’ in so-called ‘immersive’ hardware solutions, from head-mounted displays to large-scale projection theatres, but also from a comprehensive lack of attention to the needs of the end users. While many still perceive the science of simulation to be defined by technological advances, such as computing power, specialized graphics hardware, advanced interactive controllers, displays and so on, the true science underpinning simulation—the science that helps to guarantee the transfer of skills from the simulated to the real—is that of human factors, a well-established discipline that focuses on the abilities and limitations of the end user when designing interactive systems, as opposed to the more commercially explicit components of technology. Based on three surgical simulation case studies, the importance of a human factors approach to the design of appropriate simulation content and interactive hardware for medical simulation is illustrated. The studies demonstrate that it is unnecessary to pursue real-world fidelity in all instances in order to achieve psychological fidelity—the degree to which the simulated tasks reproduce and foster knowledge, skills and behaviours that can be reliably transferred to real-world training applications.

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Gosal, Jaskaran Singh, Sarbesh Tiwari, Tarunesh Sharma, Mohit Agrawal, Mayank Garg, Sayani Mahal, Suryanarayanan Bhaskar, Raghavendra Kumar Sharma, Vikas Janu, and Deepak Kumar Jha. "Simulation of surgery for supratentorial gliomas in virtual reality using a 3D volume rendering technique: a poor man's neuronavigation." Neurosurgical Focus 51, no. 2 (August 2021): E23. http://dx.doi.org/10.3171/2021.5.focus21236.

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OBJECTIVE Different techniques of performing image-guided neurosurgery exist, namely, neuronavigation systems, intraoperative ultrasound, and intraoperative MRI, each with its limitations. Except for ultrasound, other methods are expensive. Three-dimensional virtual reconstruction and surgical simulation using 3D volume rendering (VR) is an economical and excellent technique for preoperative surgical planning and image-guided neurosurgery. In this article, the authors discuss several nuances of the 3D VR technique that have not yet been described. METHODS The authors included 6 patients with supratentorial gliomas who underwent surgery between January 2019 and March 2021. Preoperative clinical data, including patient demographics, preoperative planning details (done using the VR technique), and intraoperative details, including relevant photos and videos, were collected. RadiAnt software was used for generating virtual 3D images using the VR technique on a computer running Microsoft Windows. RESULTS The 3D VR technique assists in glioma surgery with a preoperative simulation of the skin incision and craniotomy, virtual cortical surface marking and navigation for deep-seated gliomas, preoperative visualization of morbid cortical surface and venous anatomy in surfacing gliomas, identifying the intervenous surgical corridor in both surfacing and deep-seated gliomas, and pre- and postoperative virtual 3D images highlighting the exact spatial geometric residual tumor location and extent of resection for low-grade gliomas (LGGs). CONCLUSIONS Image-guided neurosurgery with the 3D VR technique using RadiAnt software is an economical, easy-to-learn, and user-friendly method of simulating glioma surgery, especially in resource-constrained countries where expensive neuronavigation systems are not readily available. Apart from cortical sulci/gyri anatomy, FLAIR sequences are ideal for the 3D visualization of nonenhancing diffuse LGGs using the VR technique. In addition to cortical vessels (especially veins), contrast MRI sequences are perfect for the 3D visualization of contrast-enhancing high-grade gliomas.

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Kim, Hyun, Nhayoung Hong, Myungjoon Kim, Sang Yoon, Hyeong Yu, Hyoun-Joong Kong, Su-Jin Kim, et al. "Application of a Perception Neuron® System in Simulation-Based Surgical Training." Journal of Clinical Medicine 8, no. 1 (January 21, 2019): 124. http://dx.doi.org/10.3390/jcm8010124.

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While multiple studies show that simulation methods help in educating surgical trainees, few studies have focused on developing systems that help trainees to adopt the most effective body motions. This is the first study to use a Perception Neuron® system to evaluate the relationship between body motions and simulation scores. Ten medical students participated in this study. All completed two standard tasks with da Vinci Skills Simulator (dVSS) and five standard tasks with thyroidectomy training model. This was repeated. Thyroidectomy training was conducted while participants wore a perception neuron. Motion capture (MC) score that indicated how long the tasks took to complete and each participant’s economy-of-motion that was used was calculated. Correlations between the three scores were assessed by Pearson’s correlation analyses. The 20 trials were categorized as low, moderate, and high overall-proficiency by summing the training model, dVSS, and MC scores. The difference between the low and high overall-proficiency trials in terms of economy-of-motion of the left or right hand was assessed by two-tailed t-test. Relative to cycle 1, the training model, dVSS, and MC scores all increased significantly in cycle 2. Three scores correlated significantly with each other. Six, eight, and six trials were classified as low, moderate, and high overall-proficiency, respectively. Low- and high-scoring trials differed significantly in terms of right (dominant) hand economy-of-motion (675.2 mm and 369.4 mm, respectively) (p = 0.043). Perception Neuron® system can be applied to simulation-based training of surgical trainees. The motion analysis score is related to the traditional scoring system.

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Omisore, Olatunji Mumini, Shipeng Han, Yousef Al-Handarish, Wenjing Du, Wenke Duan, Toluwanimi Oluwadara Akinyemi, and Lei Wang. "Motion and Trajectory Constraints Control Modeling for Flexible Surgical Robotic Systems." Micromachines 11, no. 4 (April 7, 2020): 386. http://dx.doi.org/10.3390/mi11040386.

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Success of the da Vinci surgical robot in the last decade has motivated the development of flexible access robots to assist clinical experts during single-port interventions of core intrabody organs. Prototypes of flexible robots have been proposed to enhance surgical tasks, such as suturing, tumor resection, and radiosurgery in human abdominal areas; nonetheless, precise constraint control models are still needed for flexible pathway navigation. In this paper, the design of a flexible snake-like robot is presented, along with the constraints model that was proposed for kinematics and dynamics control, motion trajectory planning, and obstacle avoidance during motion. Simulation of the robot and implementation of the proposed control models were done in Matlab. Several points on different circular paths were used for evaluation, and the results obtained show the model had a mean kinematic error of 0.37 ± 0.36 mm with very fast kinematics and dynamics resolution times. Furthermore, the robot’s movement was geometrically and parametrically continuous for three different trajectory cases on a circular pathway. In addition, procedures for dynamic constraint and obstacle collision detection were also proposed and validated. In the latter, a collision-avoidance scheme was kept optimal by keeping a safe distance between the robot’s links and obstacles in the workspace. Analyses of the results showed the control system was optimal in determining the necessary joint angles to reach a given target point, and motion profiles with a smooth trajectory was guaranteed, while collision with obstacles were detected a priori and avoided in close to real-time. Furthermore, the complexity and computational effort of the algorithmic models were negligibly small. Thus, the model can be used to enhance the real-time control of flexible robotic systems.

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Mitra, Probal, and Günter Niemeyer. "Haptic Simulation of Manipulator Collisions Using Dynamic Proxies." Presence: Teleoperators and Virtual Environments 16, no. 4 (August 1, 2007): 367–84. http://dx.doi.org/10.1162/pres.16.4.367.

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Haptic simulations aim to create an immersive, interactive computer generated environment, using haptic devices to render forces to the user based on interactions in the virtual world. In many applications, these simulations must be capable of handling interactions between multiple users, multiple hands, and complex virtual tools. In particular, consider the example of simulating two-handed robotic surgery, where each hand independently directs its own surgical robot to manipulate a tool. Traditionally only quasi-static, point-like proxies are used to represent the human in virtual environments. In previous works, we proposed dynamic proxies to improve upon this notion. Giving the proxy first order, velocity based dynamics makes it massless but capable of producing crisp dynamic interaction forces. With this paper, we generalize the proxy concept to the case of independent, multiple degree-of-freedom virtual manipulators, by giving the proxy not only first-order dynamics, but its own kinematic properties as well. Like real robots, the virtual manipulators' tips track the user and master motion while generating force feedback. Interactions between the virtual arms and with other objects are implemented as geometric constraints on the tip velocities, and solved in a linearly constrained least-squares minimization. A stability proof is given in terms of passivity. The approach is demonstrated on an actual two-handed haptic console, running a real-time simulation of a pair of six degree-of-freedom virtual manipulators with cylindrical links.

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Jue, Jessica, Neal A. Shah, and Tim Ken Mackey. "An Interdisciplinary Review of Surgical Data Recording Technology Features and Legal Considerations." Surgical Innovation 27, no. 2 (December 6, 2019): 220–28. http://dx.doi.org/10.1177/1553350619891379.

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Surgical data recording technology has great promise to generate patient safety and quality data that can be utilized to potentially reduce medical errors. Variations of these systems aim to improve surgical technique, develop better training simulation, and promote adverse event investigation similar to the aims of black box technology utilized in other industries. However, many unknowns remain for surgical data recording utilization in operating rooms and clinical settings in the United States. This includes the need to appropriately design systems so they collect meaningful and useful data that can be discussed by surgical team members in an open and safe environment to optimize clinical care processes. In order to better understand the clinical and regulatory environment for surgical data recording systems, we conducted an interdisciplinary review to identify key technology approaches, and assess legal and regulatory implications associated with this potentially disruptive technology. We found technology ranging from audio and visual data, to systems utilizing mobile applications, and kinematic data capture. The data collected present legal questions over ownership of information and privacy, along with regulatory issues at the federal and state levels. The benefits of these data should be balanced with the need to develop appropriate policies and regulations that protect the interests of both clinicians and patients in order to encourage further innovation and better realize the potential of surgical data recording technology to improve clinical decision making and patient safety outcomes.

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King, A. P., P. J. Edwards, C. R. Maurer, D. A. de Cunha, R. P. Gaston, M. Clarkson, D. L. G. Hill, et al. "Stereo Augmented Reality in the Surgical Microscope." Presence: Teleoperators and Virtual Environments 9, no. 4 (August 2000): 360–68. http://dx.doi.org/10.1162/105474600566862.

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This paper describes the MAGI (microscope-assisted guided interventions) augmented-reality system, which allows surgeons to view virtual features segmented from preoperative radiological images accurately overlaid in stereo in the optical path of a surgical microscope. The aim of the system is to enable the surgeon to see in the correct 3-D position the structures that are beneath the physical surface. The technical challenges involved are calibration, segmentation, registration, tracking, and visualization. This paper details our solutions to these problems. As it is difficult to make reliable quantitative assessments of the accuracy of augmented-reality systems, results are presented from a numerical simulation, and these show that the system has a theoretical overlay accuracy of better than 1 mm at the focal plane of the microscope. Implementations of the system have been tested on volunteers, phantoms, and seven patients in the operating room. Observations are consistent with this accuracy prediction.

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Tendick, Frank, Michael Downes, Tolga Goktekin, Murat Cenk Cavusoglu, David Feygin, Xunlei Wu, Roy Eyal, Mary Hegarty, and Lawrence W. Way. "A Virtual Environment Testbed for Training Laparoscopic Surgical Skills." Presence: Teleoperators and Virtual Environments 9, no. 3 (June 2000): 236–55. http://dx.doi.org/10.1162/105474600566772.

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With the introduction of minimally invasive techniques, surgeons must learn skills and procedures that are radically different from traditional open surgery. Traditional methods of surgical training that were adequate when techniques and instrumentation changed relatively slowly may not be as efficient or effective in training substantially new procedures. Virtual environments are a promising new medium for training. This paper describes a testbed developed at the San Francisco, Berkeley, and Santa Barbara campuses of the University of California for research in understanding, assessing, and training surgical skills. The testbed includes virtual environments for training perceptual motor skills, spatial skills, and critical steps of surgical procedures. Novel technical elements of the testbed include a four-DOF haptic interface, a fast collision detection algorithm for detecting contact between rigid and deformable objects, and parallel processing of physical modeling and rendering. The major technical challenge in surgical simulation to be investigated using the testbed is the development of accurate, real-time methods for modeling deformable tissue behavior. Several simulations have been implemented in the testbed, including environments for assessing performance of basic perceptual motor skills, training the use of an angled laparoscope, and teaching critical steps of the cholecystectomy, a common laparoscopic procedure. The major challenges of extending and integrating these tools for training are discussed.

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Aebersold, Michelle, Mary Jo Kocan, Dana Tschannen, and Janet Michaels. "Use of Simulation in Stroke Unit Education." Journal of Neuroscience Nursing 43, no. 6 (December 2011): 349–53. http://dx.doi.org/10.1097/jnn.0b013e318234e9ca.

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XU, DA, XUKUN SHEN, ZHONGJUN MO, and YUBO FAN. "EMPIRICAL FORMULA AND EXPERIMENT BASED FORCE MODELING FOR HAPTIC SPINE SURGERY SIMULATION." International Journal of Modeling, Simulation, and Scientific Computing 02, no. 01 (March 2011): 29–44. http://dx.doi.org/10.1142/s1793962311000359.

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Realistic force modeling of bone drilling is critical to haptic simulation systems for precise surgical training such as pedicle screw fixation in spine surgery. Existing method of force modeling applied metal machining theory to bone drilling directly. However, the mechanical property of bony material is different from continuous metal. In this paper, we present a novel force modeling method of bone drilling based on empirical formula and drilling experiment to provide a force model with high fidelity. A simplified empirical model of drilling in bony material is derived from the empirical formula of metal drilling. To determine the parameters in our empirical model, we construct an experimental system and perform a group of drilling experiments on real bones. We implement our force model in a group of drilling simulations and compare the computational force with the original experimental data to testify its validity.

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Schipper, Joerg, Wolfgang Maier, Iakovos Arapakis, Uwe Spetzger, and R. Laszig. "Navigation as a tool to visualize bone-covered hidden structures in transfrontal approaches." Journal of Laryngology & Otology 118, no. 11 (November 2004): 849–56. http://dx.doi.org/10.1258/0022215042703651.

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A retrospective analysis of 10 patients was performed to evaluate navigation systems in extranasal frontal skull base surgery. When performing a craniotomy following a bicoronal skin incision, the surgeon has to calculate the extent of the frontal sinus to avoid unnecessary damage to the dura or mucoceles later. Due to surgical morbidity including compression of the frontal lobe, many skull base surgeons have refused to use such an approach. Malformation or bone-destruction complicates the identification of the borders and increases the risk ofside-effects. Navigation systems can be an alternative for calculating the frontal sinus outlines during surgery. In the authors’ surgical procedure two different navigation systems were used. Conventional surgery using the transfrontal, transbasal or subcranial approach consisting of trepanation and craniotomy were performed, while the navigated surgical procedure was evaluated.The analysis showed that computer-assisted surgery (CAS) is applicable to extranasal frontalskull base surgery. In comparison to X-ray beam-controlled craniotomy, CAS is beneficial as it constitutes a noninvasive instrument of quality management. Furthermore, the analysis indicatedthat under the guidance of a navigation system a precise pre-surgical simulation is available in order to perform an optimal craniotomy and reconstruction of the frontal skull base.

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De, Suvranu, Dhannanjay Deo, Ganesh Sankaranarayanan, and Venkata S. Arikatla. "A Physics-Driven Neural Networks-Based Simulation System (PhyNNeSS) for Multimodal Interactive Virtual Environments Involving Nonlinear Deformable Objects." Presence: Teleoperators and Virtual Environments 20, no. 4 (August 1, 2011): 289–308. http://dx.doi.org/10.1162/pres_a_00054.

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While an update rate of 30 Hz is considered adequate for real-time graphics, a much higher update rate of about 1 kHz is necessary for haptics. Physics-based modeling of deformable objects, especially when large nonlinear deformations and complex nonlinear material properties are involved, at these very high rates is one of the most challenging tasks in the development of real-time simulation systems. While some specialized solutions exist, there is no general solution for arbitrary nonlinearities. In this work we present PhyNNeSS—a Physics-driven Neural Networks-based Simulation System—to address this long-standing technical challenge. The first step is an offline precomputation step in which a database is generated by applying carefully prescribed displacements to each node of the finite element models of the deformable objects. In the next step, the data is condensed into a set of coefficients describing neurons of a Radial Basis Function Network (RBFN). During real-time computation, these neural networks are used to reconstruct the deformation fields as well as the interaction forces. We present realistic simulation examples from interactive surgical simulation with real-time force feedback. As an example, we have developed a deformable human stomach model and a Penrose drain model used in the Fundamentals of Laparoscopic Surgery (FLS) training tool box. A unique computational modeling system has been developed that is capable of simulating the response of nonlinear deformable objects in real time. The method distinguishes itself from previous efforts in that a systematic physics-based precomputational step allows training of neural networks which may be used in real-time simulations. We show, through careful error analysis, that the scheme is scalable, with the accuracy being controlled by the number of neurons used in the simulation. PhyNNeSS has been integrated into SoFMIS (Software Framework for Multimodal Interactive Simulation) for general use.

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Yu, Lingtao, Zhengyu Wang, Peng Yu, Tao Wang, Huajian Song, and Zhijiang Du. "A new kinematics method based on a dynamic visual window for a surgical robot." Robotica 32, no. 4 (September 4, 2013): 571–89. http://dx.doi.org/10.1017/s026357471300088x.

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SUMMARYThis paper proposes a new effective kinematics method based on the dynamic visual window (DVW) for a surgical robot that is equipped with two instrument arms and one laparoscope arm, to enable doctors to achieve operations with their visual habits under the laparoscopic visual environment. The problem of the consistency principle between the doctor's operations under the visual window's feedback and the master–slave operations of the surgical robot is solved. The kinematics models of the surgical robotic arms are established, and the new kinematics methods based on the DVW of the laparoscope and instrument arms are proposed according to their inverse kinematics with respect to the visual coordinate system. Finally, the proposed kinematics method is verified by simulation experiments based on the theoretical algorithm and the mechanism model; the multiple sets of the simulation data are presented to illustrate the correctness and feasibility of the new method in this research.

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Ding, Jienan, and Nabil Simaan. "Choice of handedness and automated suturing for anthropomorphic dual-arm surgical robots." Robotica 33, no. 08 (June 4, 2014): 1775–93. http://dx.doi.org/10.1017/s026357471400109x.

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SUMMARYLaparoscopic and Single Port Access Surgery (SPAS) present unique dexterity challenges related to dual-arm operations in confined spaces and tele-manipulation of highly dexterous surgical slaves. In an effort to reduce tele-manipulation burden, new paradigms for semi-automating surgical tasks are needed. This paper presents a new minimal constraint suturing and automated choice of handedness for anthropomorphic dual-arm robots. The automated choice of handedness supports surgeons during tele-manipulation of complex robotic slaves where dexterity and workspace constraints are difficult to learn. This criterion is also used to support automated dual-arm rendezvous for quicker suture exchange during dual-arm suturing. The minimal constraint algorithm presented in this paper allows surgeons to operate within a shared-control tele-manipulation framework whereby the surgeon controls the needle insertion speed and the robot controls the needle orientation while respecting a minimalistic set of tissue constraints. This framework is evaluated on a novel insertable robotic end-effectors platform for SPAS. A simulation study demonstrates the effectiveness of the automated choice of handedness criterion through a study of dexterity limitations of each arm. Additional simulations show the proposed algorithm for automated rendezvous and suture exchange.

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DeStephano, Christopher C., Delaney W. La Rosa, Amy M. Lannen, Jesse C. Dove, Dorin T. Colibaseanu, and Tri A. Dinh. "Development of a low-cost, reusable laparoscopic entry and emergency model." Journal of Defense Modeling and Simulation: Applications, Methodology, Technology 14, no. 4 (April 29, 2016): 399–405. http://dx.doi.org/10.1177/1548512916647812.

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Although studies on simulation of rare complications have become more common in the trauma and obstetric literature, there is a paucity of studies on simulation of rare laparoscopic emergencies. High-fidelity models, virtual reality systems, and porcine labs are available; however, their cost limits wider use and repetition of skills. A low-cost, laparoscopic entry and emergency model was created using on-hand base parts. A convenience sample of obstetrics/gynecology and general surgery residents and attending surgeons completed a laparoscopic entry and emergency scenario using an innovative model in the multidisciplinary simulation center. A total of 29 gynecology, urology, and general surgery residents, fellows, and attending surgeons participated in the laparoscopic emergency simulation drill. Of the 29 participants of the laparoscopic emergency simulation drill using the model, 27 (93.1%) agreed or strongly agreed that the simulated drill approximates the stress of a vascular injury during laparoscopy and 27 (93.1%) agreed or strongly agreed that the model set up appears appropriate for approximating a retroperitoneal hematoma. The reusable, laparoscopic simulation model and emergency drill were rated favorably by participants. The model and drill have the potential to be used for multidisciplinary drills that include anesthesiologists, surgical nurses, surgical technologists, and surgeons.

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De, Suvranu, Yi-Je Lim, Muniyandi Manivannan, and Mandayam A. Srinivasan. "Physically Realistic Virtual Surgery Using the Point-Associated Finite Field (PAFF) Approach." Presence: Teleoperators and Virtual Environments 15, no. 3 (June 1, 2006): 294–308. http://dx.doi.org/10.1162/pres.15.3.294.

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The generation of multimodal virtual environments for surgical training is complicated by the necessity to develop heterogeneous simulation scenarios such as surgical incision, cauterization, bleeding, and smoke generation involving the interaction of surgical tools with soft biological tissues in real time. While several techniques ranging from rapid but nonphysical geometry-based procedures to complex but computationally inefficient finite element analysis schemes have been proposed, none is uniquely suited to solve the digital surgery problem. In this paper we discuss the challenges facing the field of realistic surgery simulation and present a novel point-associated finite field (PAFF) approach, developed specifically to cope with these challenges. Based upon the equations of motion dictated by physics, this technique is independent of the state of matter, geometry and material properties and permits different levels of detail. We propose several specializations of this scheme for various operational complexities. The accuracy and efficiency of this technique is compared with solutions using traditional finite element methods and simulation results are reported on segmented models obtained from the Visible Human Project.

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Leniowska, Lucyna, and Ryszard Leniowski. "The Joint Vibration Analysis of a Multi-Link Surgical Manipulator." Archives of Acoustics 37, no. 4 (December 1, 2012): 475–82. http://dx.doi.org/10.2478/v10168-012-0059-7.

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Abstract This paper presents a vibration analysis of a multi-link surgical micromanipulator joint, based on its detailed mathematical model. The manipulator’s prototype contains 6 links with the diameter of 8-10 [mm] and with the length of the modules of about 130 [mm]. It is driven by brushless servomotors with worm and planetary gears, for which the total transmission ratio is above 1/10000. Regarding the low efficiency of micro-robot drive systems and its vibrations, a reliable joint model and its performance is crucial for the development of a high-precision control system. To achieve the required accuracy, modelling framework has been enriched with an advanced model of friction. Simulation results are presented and discussed.

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Gieseler, Oliver, Hubert Roth, and Jürgen Wahrburg. "A novel 4 camera multi-stereo tracking system for application in surgical navigation systems." tm - Technisches Messen 87, no. 7-8 (July 26, 2020): 451–58. http://dx.doi.org/10.1515/teme-2019-0144.

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AbstractIn this paper, we present a novel 4 camera stereo system for application as optical tracking component in navigation systems in computer-assisted surgery. This shall replace a common stereo camera system in several applications. The objective is to provide a tracking component consisting of four single industrial cameras. The system can be built up flexibly in the operating room e. g. at the operating room lamp. The concept is characterized by independent, arbitrary camera mounting poses and demands easy on-site calibration procedures of the camera setup. Following a short introduction describing the environment, motivation and advantages of the new camera system, a simulation of the camera setup and arrangement is depicted in Section 2. From this, we gather important information and parameters for the hardware setup, which is described in Section 3. Section 4 includes the calibration of the cameras. Here, we illustrate the background of camera model and applied calibration procedures, a comparison of calibration results obtained with different calibration programs and a new concept for fast and easy extrinsic calibration.

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Torabi, Ali, Mohsen Khadem, Koroush Zareinia, Garnette Roy Sutherland, and Mahdi Tavakoli. "Using a Redundant User Interface in Teleoperated Surgical Systems for Task Performance Enhancement." Robotica 38, no. 10 (May 20, 2020): 1880–94. http://dx.doi.org/10.1017/s0263574720000326.

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SUMMARYThe enhanced dexterity and manipulability offered by master–slave teleoperated surgical systems have significantly improved the performance and safety of minimally invasive surgeries. However, effective manipulation of surgical robots is sometimes limited due to the mismatch between the slave and master robots’ kinematics and workspace. The purpose of this paper is first to formulate a quantifiable measure of the combined master–slave system manipulability. Next, we develop a null-space controller for the redundant master robot that employs the proposed manipulability index to enhance the performance of teleoperation tasks by matching the kinematics of the redundant master robot with the kinematics of the slave robot. The null-space controller modulates the redundant degrees of freedom of the master robot to reshape its manipulability ellipsoid (ME) towards the ME of the slave robot. The ME is the geometric interpretation of the kinematics of a robot. By reshaping the master robot’s manipulability, we match the master and slave robots’ kinematics. We demonstrate that by using a redundant master robot, we are able to enhance the master–slave system manipulability and more intuitively transfer the slave robot’s dexterity to the user. Simulation and experimental studies are performed to validate the performance of the proposed control strategy. Results demonstrate that by employing the proposed manipulability index, we can enhance the user’s control over the force/velocity of a surgical robot and minimize the user’s control effort for a teleoperated task.

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Hau, Hans-Michael, Jürgen Weitz, and Ulrich Bork. "Impact of the COVID-19 Pandemic on Student and Resident Teaching and Training in Surgical Oncology." Journal of Clinical Medicine 9, no. 11 (October 26, 2020): 3431. http://dx.doi.org/10.3390/jcm9113431.

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The COVID-19 pandemic has tremendously changed private and professional interactions and behaviors worldwide. The effects of this pandemic and the actions taken have changed our healthcare systems, which consequently has affected medical education and surgical training. In the face of constant disruptions of surgical education and training during this pandemic outbreak, structured and innovative concepts and adapted educational curricula are important to ensure a high quality of medical treatment. While efforts were undertaken to prevent viral spreading, it is important to analyze and assess the effects of this crisis on medical education, surgical training and teaching at large and certainly in the field of surgical oncology. Against this background, in this paper we introduce practical and creative recommendations for the continuity of students’ and residents’ medical and surgical training and teaching. This includes virtual educational curricula, skills development classes, video-based feedback and simulation in the specialty field of surgical oncology. In conclusion, the effects of COVID 19 on Surgical Training and Teaching, certainly in the field of Surgical Oncology, are challenging.

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Sobolev, Boris G., Victor Sanchez, and Christos Vasilakis. "Systematic Review of the Use of Computer Simulation Modeling of Patient Flow in Surgical Care." Journal of Medical Systems 35, no. 1 (July 7, 2009): 1–16. http://dx.doi.org/10.1007/s10916-009-9336-z.

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Lee, Sangbok, and Yuehwern Yih. "Reducing patient-flow delays in surgical suites through determining start-times of surgical cases." European Journal of Operational Research 238, no. 2 (October 2014): 620–29. http://dx.doi.org/10.1016/j.ejor.2014.03.043.

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Agus, Marco, Andrea Giachetti, Enrico Gobbetti, Gianluigi Zanetti, and Antonio Zorcolo. "Real-Time Haptic and Visual Simulation of Bone Dissection." Presence: Teleoperators and Virtual Environments 12, no. 1 (February 2003): 110–22. http://dx.doi.org/10.1162/105474603763835378.

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Bone dissection is an important component of many surgical procedures. In this paper, we discuss a haptic and visual simulation of a bone-cutting burr that is being developed as a component of a training system for temporal bone surgery. We use a physically motivated model to describe the burr-bone interaction, which includes haptic forces evaluation, the bone erosion process, and the resulting debris. The current implementation, directly operating on a voxel discretization of patient-specific 3D CT and MR imaging data, is efficient enough to provide real-time feedback on a low-end multiprocessing PC platform.

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Palter, Vanessa N. "Comprehensive Training Curricula for Minimally Invasive Surgery." Journal of Graduate Medical Education 3, no. 3 (September 1, 2011): 293–98. http://dx.doi.org/10.4300/jgme-d-11-00091.1.

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Abstract Background The unique skill set required for minimally invasive surgery has in part contributed to a certain portion of surgical residency training transitioning from the operating room to the surgical skills laboratory. Simulation lends itself well as a method to shorten the learning curve for minimally invasive surgery by allowing trainees to practice the unique motor skills required for this type of surgery in a safe, structured environment. Although a significant amount of important work has been done to validate simulators as viable systems for teaching technical skills outside the operating room, the next step is to integrate simulation training into a comprehensive curriculum. Objectives This narrative review aims to synthesize the evidence and educational theories underlining curricula development for technical skills both in a broad context and specifically as it pertains to minimally invasive surgery. Findings The review highlights the critical aspects of simulation training, such as the effective provision of feedback, deliberate practice, training to proficiency, the opportunity to practice at varying levels of difficulty, and the inclusion of both cognitive teaching and hands-on training. In addition, frameworks for integrating simulation training into a comprehensive curriculum are described. Finally, existing curricula on both laparoscopic box trainers and virtual reality simulators are critically evaluated.

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Struys, Michel M. R. F., Tom De Smet, Scott Greenwald, Anthony R. Absalom, Servaas Bingé, and Eric P. Mortier. "Performance Evaluation of Two Published Closed-loop Control Systems Using Bispectral Index Monitoring." Anesthesiology 100, no. 3 (March 1, 2004): 640–47. http://dx.doi.org/10.1097/00000542-200403000-00026.

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Background Although automated closed-loop control systems may improve quality of care, their safety must be proved under extreme control conditions. This study describes a simulation methodology to test automated controllers and its application in a comparison of two published controllers for Bispectral Index (BIS)-guided propofol administration. Methods A patient simulator was developed to compare controllers. Using input scripts to dictate patient characteristics, target BIS values, and the time course of surgical events, the simulator continuously monitors the infusion pump under control and generates BIS values as a composite of modeled response to drug, perceived stimulation, and random noise. The simulator formats the output stream of BIS data as input to the controller under test to emulate the serial output of the actual BIS monitor. A published model-based controller and a classic proportional integral derivative controller were compared when using the BIS value as a controlled variable. Each controller was tested using a set of 10 virtual patients undergoing a fixed surgical profile that was repeated with BIS targets set at 30, 50, and 70. Controller performance was assessed using median (absolute) prediction error, divergence, wobble, and percentage time within BIS target range metrics. Results The median prediction error was significantly smaller for the proportional integral derivative controller than for the model-based controller. The median absolute prediction error was smaller for the model-based controller than for the proportional integral derivative controller for each BIS target, reaching statistical significance for targets 30 and 50. Conclusions When simulating closed-loop control of BIS using propofol, the use of a patient-individualized, model-based adaptive closed-loop system with effect site control resulted in better control of BIS compared with a standard proportional integral derivative controller with plasma site control. Even under extreme conditions, the modeled-based controller exhibited no behavioral problems.

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Goddard, Leslie, and Lila Jordan. "Changing Attitudes About Persons with Disabilities: Effects of a Simulation." Journal of Neuroscience Nursing 30, no. 5 (October 1998): 307–13. http://dx.doi.org/10.1097/01376517-199810000-00006.

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Vasilakis, C., B. G. Sobolev, L. Kuramoto, and A. R. Levy. "A simulation study of scheduling clinic appointments in surgical care: individual surgeon versus pooled lists." Journal of the Operational Research Society 58, no. 2 (February 2007): 202–11. http://dx.doi.org/10.1057/palgrave.jors.2602235.

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Journal articles on the topic 'Surgical simulation systems'

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