For a generation of surgeons who have grown up playing video games, they are now learning temporal bone surgery of the skull in a similar way. Physicians and researchers at Nationwide Children's Hospital are using state-of-the-art computer animation to help train the next generation of surgeons. The Virtual Temporal Bone Project, a multi-disciplinary approach developed in conjunction with the Ohio Supercomputer Center and The Ohio State University, uses technology and simulated surgery to operate on the temporal bone of the skull and skull-based tumours.
The Virtual Temporal Bone simulator creates a true-to-life experience encountered in ear surgery. The temporal bone contains the structures for hearing and balance, and the simulator allows future surgeons to practise delicate surgical drilling techniques on a computer-based teaching system instead of cadavers or as apprenticeships in operating rooms. A multi-institutional validation study is now underway to determine if surgical residents taught by this simulator achieve better surgical results compared to traditional methods.
The system's realism is enhanced with a SensAble PHANTOM haptic device, which allows surgeons to "feel" the surgery they are performing, as well as see and hear it. SensAble's device and accompanying software employ force-feedback technology to literally push back on the trainees' hand as they look through a binocular viewer that replicates the view that a surgeon would see through a microscope during surgery. Drilling sounds are then modulated based upon the pressures and area of bone being removed.
"This is not just cool technology", Gregory Wiet, MD, a surgeon in Otolaryngology at Nationwide Children's Hospital, explained. "It is designed to be so much more. We want to actually see that it does transfer into learning and transfer into better outcomes for our patients."
This training simulator can do everything from mimic the movement of a drill, to read the density of the temporal bone. A phantom joystick is used to guide the student through surgery actually feeling the resistance of the bone. Unlike typical training methods on cadavers, virtual patients can bleed allowing students to train and think on their feet in life-like demonstrations.
In choosing the Netter Award, the selection committee commended the system's "high production values, the incorporating of multiple sensory modalities - sight sound and touch - and the ease of distribution that make the Virtual Temporal Bone a unique learning object with tremendous potential impact in the field of medical education."
"With SensAble's technology in our system, surgeons are not only learning with their eyes, but also with their sense of touch", stated Don Stredney, director of the OSC Interface Lab and the project's other lead investigator. Don Stredney also serves as an adjunct instructor in biomedical informatics and otolaryngology at The Ohio State University.
"SensAble's Open Haptics software developers' kit enabled us to easily integrate haptics into our application, and to provide a training environment that presents a safe, cost-effective way to learn fundamental techniques. This could be an important tool in the learning process for surgeons to develop all their senses in order to guide their surgery", Don Stredney stated.
"This team has built a very impressive virtual environment for surgical training, and we are pleased they have incorporated our PHANTOM haptic device into the solution", stated David Chen, PhD, and SensAble's chief technology officer. "We are equally proud to see their work recognized by this award."
The Virtual Temporal Bone Project is funded by the National Institute on Deafness and Other Communication Disorders, The National Institutes of Health. It is with the help of this funding that Dr. Gregory Wiet has begun a multi-site study regarding the use of the simulator in a project geared at the development and evaluation of a virtual environment for resident training in surgical techniques of temporal bone surgery. The multi-institutional validation study involves a number of national and international otolaryngological programmes.
Celebrating more than 20 years of service, the Ohio Supercomputer Center is a catalytic partner of Ohio universities and industries that provides a reliable high performance computing and high performance networking infrastructure for a diverse statewide/regional community including education, academic research, industry, and state government. Funded by the Ohio Board of Regents, OSC promotes and stimulates computational research and education in order to act as a key enabler for the state's aspirations in advanced technology, information systems, and advanced industries.
Founded in 1993, SensAble Technologies is a developer of 3D touch-enabled (force feedback) solutions and technology that allow users to not only see and hear an on-screen computer application, but to actually "feel" it. With 32 patents granted and over 6000 systems installed worldwide, SensAble Technologies' haptic technology is being used in applications ranging from designing toys and footwear, to surgical simulation and stroke rehabilitation, to dental restorations, to as well as a range of research and robotic applications.
The company markets its own 3D modelling solutions as well as its haptic devices and developer toolkits to medical, dental, design, and manufacturing companies; educational and research institutions; and OEMs. SensAble products are available through direct and reseller channels worldwide. More company news is available in the VMW June 2008 article SensAble chooses 3D Systems' ProJet 3D Printer and adds Williams Dental Laboratory to its Authorized Production Center Programme.