The progressive miniaturization of surgical procedures and tools invests the concept of virtual reality with a new and revolutionary role. At the 67th Annual Scientific Meeting of the American Society of Plastic and Reconstructive Surgeons (ASPRS), held in Boston last month, the organizers presented a study, conducted by Dr. Paul J. Gorman, which highlights the benefits of advanced virtual reality training tools for the development of the plastic surgeon's skills. Medical experts already dream of replacing the basic training in microsurgery with virtual reality simulation.
The study includes a description of the design and validation of a virtual reality trainer to simulate microsurgical vascular anastomosis. This procedure involves the surgical joining of two blood vessels, thus enabling the flow from one vessel to the other. The training simulator can equally be used to refine the method for suturing tiny nerves, arteries and veins. The device is composed of three elements to perform the simulation. A graphics computer produces the 3D medical images to be viewed by the trainee. The microsurgical instruments are attached to haptic devices in order to provoke tactile feedback. A personal computer continuously monitors the control of the haptic tools.
During the training session, the haptic devices track the movements of the microsurgical instruments and send the data to the computer to calculate the force executed on the instrument by the trainee. The user experiences a push back, similar to the resistance exercised in a real surgical environment. In the 3D image, the trainee can watch the object move in the same way as it would when touched in reality. The surgeon wears 3D shutter glasses to view the results of every little move that is made. The 3D graphics are able to run at 30 cycles per second to enhance the realism of the scene.
The system performs a constant tracking of the hand movements and the positioning arms of the force feedback frames are updated no less than a 1000 times per second. This allows the trainee to follow the results of his actions in real time on the 3D computer graphic. Plastic and reconstructive surgeons have welcomed the innovative virtual reality simulator as a useful tool to train complex procedures in a safe, predictable and reproducible environment. In addition, it is possible to record the results of the training session, allowing the surgeon to review his performance and to improve his skills.
The virtual reality trainer offers the facility to measure outcome factors, such as possible tissue or surface damage, accuracy, as well as the relevance of new procedures and techniques. In the near future, other modules will be developed in order to integrate all disciplines of plastic, vascular and neuro-surgery. In the end, the virtual reality simulator may even serve as a means to measure criteria for the granting of credentials and hospital privileges to surgeons. For more information on the microsurgical virtual reality trainer, we refer to the Web site of the American Society of Plastic and Reconstructive Surgeons.