20 Years of VR Surgical Simulator and its Positioning Today

OBJECTIVEEndoscopic resection of third-ventricle colloid cysts is technically challenging due to the limited dexterity and visualization provided by neuroendoscopic instruments. Extensive training and experience are required to master the learning curve. To improve the education of neurosurgical trainees in this procedure, a synthetic surgical simulator was developed and its realism, procedural content, and utility as a training instrument were evaluated.METHODSThe simulator was developed based on the neuroimaging (axial noncontrast CT and T1-weighted gadolinium-enhanced MRI) of an 8-year-old patient with a colloid cyst and hydrocephalus. Image segmentation, computer-aided design, rapid prototyping (3D printing), and silicone molding techniques were used to produce models of the skull, brain, ventricles, and colloid cyst. The cyst was filled with a viscous fluid and secured to the roof of the third ventricle. The choroid plexus and intraventricular veins were also included. Twenty-four neurosurgical trainees performed a simulated colloid cyst resection using a 30° angled endoscope, neuroendoscopic instruments, and image guidance. Using a 19-item feedback survey (5-point Likert scales), participants evaluated the simulator across 5 domains: anatomy, instrument handling, procedural content, perceived realism, and confidence and comfort level.RESULTSParticipants found the simulator’s anatomy to be highly realistic (mean 4.34 ± 0.63 [SD]) and appreciated the use of actual instruments (mean 4.38 ± 0.58). The procedural content was also rated highly (mean 4.28 ± 0.77); however, the perceived realism was rated slightly lower (mean 4.08 ± 0.63). Participants reported greater confidence in their ability to perform an endoscopic colloid cyst resection after using the simulator (mean 4.45 ± 0.68). Twenty-three participants (95.8%) indicated that they would use the simulator for additional training. Recommendations were made to develop complex case scenarios for experienced trainees (normal-sized ventricles, choroid plexus adherent to cyst wall, bleeding scenarios) and incorporate advanced instrumentation such as side-cutting aspiration devices.CONCLUSIONSA patient-specific synthetic surgical simulator for training residents and fellows in endoscopic colloid cyst resection was successfully developed. The simulator’s anatomy, instrument handling, and procedural content were found to be realistic. The simulator may serve as a valuable educational tool to learn the critical steps of endoscopic colloid cyst resection, develop a detailed understanding of intraventricular anatomy, and gain proficiency with bimanual neuroendoscopic techniques.

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Predictors of Manual Dexterity in Simulation-Based Cataract Surgery

Journal of Academic Ophthalmology ◽

10.1055/s-0040-1718570 ◽

2020 ◽

Vol 12 (02) ◽

pp. e239-e243

Author(s):

Laura Palazzolo ◽

Anna Kozlova ◽

John J. Laudi ◽

Allison E. Rizzuti

Keyword(s):

Medical Students ◽

Video Games ◽

Cataract Surgery ◽

Prior Experience ◽

Musical Instruments ◽

Fine Motor ◽

Surgical Simulator ◽

Technical Ability ◽

Simulation Based ◽

And Training

Abstract Introduction The aim of this study is to determine if prior experience with fine motor hobbies influences a surgeon-in-training's performance on a cataract surgical simulator. Materials and Methods Medical students (n = 70) performed navigation, forceps, and capsulorhexis simulations using the Eyesi Ophthalmosurgical Simulator. Participants were surveyed regarding fine motor hobby experiences, including musical instruments, video games, sewing, knitting, origami, painting, crafting, jewelry making, drawing, and extracurricular dissection. Results Medical students with extracurricular dissection experience, including work in research laboratories involving microscopic animal dissection, did significantly better on the forceps simulator task (p = 0.009). Medical students with drawing experience performed better on capsulorhexis (p = 0.031). No other fine motor hobbies were significant for improving simulator scores. Conclusion Drawing and extracurricular dissection lend to improved technical ability on the cataract surgical simulator. This research continues the conversation regarding fine motor hobbies that correlate with microsurgical ability and adds to the growing area of research regarding the selection and training of ophthalmology residents.

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Web Based Nasal Surgical Simulator Using VRML and Java

2005 IEEE Engineering in Medicine and Biology 27th Annual Conference ◽

10.1109/iembs.2005.1617162 ◽

2005 ◽

Author(s):

Zhao Yuan-yuan ◽

Zhou Guo-hong ◽

Ye De-rong

Keyword(s):

Surgical Simulator ◽

Web Based

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Virtual learning solutions in COVID-19 era: University Italian Ophthalmology department perspective

European Journal of Ophthalmology ◽

10.1177/11206721211015576 ◽

2021 ◽

pp. 112067212110155

Author(s):

Carla Enrica Gallenga ◽

Luca Agnifili ◽

Rossella D’Aloisio ◽

Lorenza Brescia ◽

Lisa Toto ◽

...

Keyword(s):

Health Care ◽

Teaching And Learning ◽

Human Life ◽

Virtual Learning ◽

Virus Spread ◽

Surgical Simulator ◽

Team Members ◽

Academic Activities ◽

Virtual Platform ◽

Initial Results

Introduction: Few months after the COVID-19 pandemic burst, many aspects of the human life, including education, dramatically changed. Because of the lockdown measures taken to limit the virus spread in Italy, in-person teaching and learning have been interrupted in all health care disciplines and readapted in virtual formulae. Methods: As academic ophthalmology departments, we had to maintain the educational needs of medical and orthoptic students, internships, surgical training of residents, as well as to cover the scientific update of health care personnel (HCPs), and the continuation of research and academic activities. To assure these needs we ideated an educational strategy and a team, which was then translated on a multichannel virtual platform created with Microsoft Teams. Results: In this platform there were 21 channels organized in a public view mode, open to all Team members, or in private view mode to separate non-permanent HCPs, internships, residents, and students’ tasks, from permanent HCPs tasks. Virtual channels were dedicated to provide theoretical lessons, clinical cases, surgical video, internal meetings and webinar, to offer news from scientific societies, requests of appointments from biomedical companies, links with ophthalmological websites, to move forward research projects, to participate at institutional academic duties, and to obtain feedbacks from users. Residents continued their training on surgery using a surgical simulator, after consulting an agenda uploaded into the dedicated virtual channel. Conclusion: These positive initial results should represent a boost to rapidly proceed with the development of even more versatile virtual learning solutions, given that the forecasts for the duration of the COVID-19 pandemic are not encouraging.

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Efficacy of Eyesi surgical simulator training in improving high-tension capsules capsulorhexis performance

Revista Brasileira de Oftalmologia ◽

10.5935/0034-7280.20170022 ◽

2017 ◽

Vol 76 (2) ◽

Author(s):

Thiago Gonçalves dos Santos Martins ◽

Ana Luiza Fontes de Azevedo Costa ◽

Diogo Gonçalves dos Santos Martins

Keyword(s):

Simulator Training ◽

Surgical Simulator ◽

High Tension

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Development of a High-Fidelity, 3D Printed Otoplasty Surgical Simulator

Proceedings of IMPRS ◽

10.18060/23619 ◽

2019 ◽

Vol 2 (1) ◽

Author(s):

Chelsey Wallace, M.S. ◽

Zahra Nourmohammadi, Ph.D. ◽

David A. Zopf, M.D., M.S.

Keyword(s):

Surgical Simulation ◽

Low Cost ◽

Cost Effective ◽

Occurrence Rate ◽

Surgical Simulator ◽

Risk Environment ◽

Surgical Simulators ◽

Protruding Ears ◽

Surgical Trainees ◽

Ear Cartilage

Background and Hypothesis: Protruding ears, also known as prominauris, are prevalent worldwide at an occurrence rate of about 5%. Children with prominauris report lower self-esteem and experience increased teasing and social isolation at school. From a functional standpoint, protruding ears can make wearing prescription glasses difficult. This increased stress and anxiety and impaired functionality lead children and families to seek treatment. One of the most effective treatments for protruding ears is otoplasty. This procedure involves an incision in the back of the ear and the placement of non-resorbable sutures to reform the ear. Alternatively, the procedure can be performed using an incisionless technique. As this is an elective procedure done commonly in children, adequate education of medical trainees is critical to ensure the proper level of skill is attained and patient satisfaction is maximized. Currently, teaching otoplasty is done with cadavers and supervised procedures with an attending. Surgical simulators are employed in the instruction of a variety of surgical procedures and allow residents to practice in a zero-risk environment. In addition, 3D printing has facilitated the development of surgical simulators allowing for a more cost-effective, consistent, and anatomically correct simulator. We developed an ear model made from silicone for trainees to practice traditional and incisionless otoplasty. Project Methods: The otoplasty surgical simulator was developed by isolating an ear from a computed-tomography scan in the Materialise software to create a 3D model. This model was then altered to create a negative mold. The mold was printed using fusion deposition printing with 1.75 MM polylactic acid filament. After printing, the mold was filled with Dragon Skin Silicone Shore 20 to simulate ear cartilage. The model was then coated in a layer of Dragon Skin Silicone Shore 10 to simulate a layer of skin. Conclusion and Potential Impact: This otoplasty simulator will next be validated by expert surgeons and then used in a surgical simulation workshop for surgical trainees. Because of the low-cost of the surgical simulator and the ease of manufacturing, this simulator can also be used to train surgeons abroad where access to surgical training may not be readily available.

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Effect of time complexities and variation of mass spring model parameters on surgical simulation

Malaysian Journal of Fundamental and Applied Sciences ◽

10.11113/mjfas.v9n4.105 ◽

2014 ◽

Vol 9 (4) ◽

Cited By ~ 1

Author(s):

Salina Sulaiman ◽

Tan Sing Yee ◽

Abdullah Bade

Keyword(s):

Soft Tissue ◽

Human Liver ◽

Soft Tissues ◽

Surgical Simulation ◽

Model Parameters ◽

Spring Model ◽

Surgical Simulator ◽

Tissue Model ◽

Mass Spring Model ◽

Mass Spring

Physically based models assimilate organ-specific material properties, thus they are suitable in developing a surgical simulation. This study uses mass spring model (MSM) to represent the human liver because MSM is a discrete model that is potentially more realistic than the finite element model (FEM). For a high-end computer aided medical technology such as the surgical simulator, the most important issues are to fulfil the basic requirement of a surgical simulator. Novice and experienced surgeons use surgical simulator for surgery training and planning. Therefore, surgical simulation must provide a realistic and fast responding virtual environment. This study focuses on fulfilling the time complexity and realistic of the surgical simulator. In order to have a fast responding simulation, the choice of numerical integration method is crucial. This study shows that MATLAB ode45 is the fastest method compared to 2nd ordered Euler, MATLAB ode113, MATLAB ode23s and MATLAB ode23t. However, the major issue is human liver consists of soft tissues. In modelling a soft tissue model, we need to understand the mechanical response of soft tissues to surgical manipulation. Any interaction between haptic device and the liver model may causes large deformation and topology change in the soft tissue model. Thus, this study investigates and presents the effect of varying mass, damping, stiffness coefficient on the nonlinear liver mass spring model. MATLAB performs and shows simulation results for each of the experiment. Additionally, the observed optimal dataset of liver behaviour is applied in SOFA (Simulation Open Framework Architecture) to visualize the major effect.

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Development and Validation of a Low-Cost and Simple Simulator for Microlaryngeal Surgery

Clinical and Experimental Otorhinolaryngology ◽

10.21053/ceo.2019.00556 ◽

2020 ◽

Vol 13 (1) ◽

pp. 58-63

Author(s):

Pengcheng Yu ◽

Jia Luan ◽

Xidong Cui ◽

Xumao Li ◽

Xinqi Hu ◽

...

Keyword(s):

Surgical Training ◽

Co2 Laser ◽

Rating Scale ◽

Low Cost ◽

Global Rating Scale ◽

Global Rating ◽

Surgical Simulator ◽

Work Skills ◽

Carbon Dioxide Co2 ◽

Microlaryngeal Surgery

Objectives. The simulation of microlaryngeal skills is rarely seen in surgical training, but it is particularly important in phonomicrosurgery. This study described and validated the laryngeal surgical simulator through surgical training.Methods. A simple and low-cost simulator was developed for the fixation of the suspension laryngoscope and porcine larynges. Twenty participants with work skills and experience did preparation before training, and performed suture and carbon dioxide (CO2) laser cordectomy for simulator evaluation. The results were proposed by the aspects of time taken for each procedure, the global rating scale, a procedure-specific assessment, and a post-simulation questionnaire.Results. All participants completed the preparation within 9 minutes and reached the conclusion that the microlaryngeal surgical simulator was helpful in improving their surgical skills. The performance of experts was superior to that of novices in both suture and CO2 laser cordectomy.Conclusion. This simulator could be easily assembled and was successfully validated by microlaryngeal surgical training both subjectively and objectively. It may be helpful to clinicians in microlaryngeal skills.

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