title: Advanced virtual endoscopic pituitary surgery.
abstract: Endoscopy has recently been introduced to endonasal transsphenoidal pituitary surgery as a minimally invasive procedure for the removal of various kinds of pituitary tumors. To reduce morbidity and mortality with this new technique, the surgeon must be well-trained and well-prepared. Virtual endoscopy can be beneficial as a tool for training, preoperative planning, and intraoperative support. This paper introduces STEPS, a virtual endoscopy system designed to aid surgeons in getting acquainted with the endoscopic view of the anatomy, the handling of instruments, the transsphenoidal approach, and challenges associated with the procedure. STEPS also assists experienced surgeons in planning a real endoscopic intervention by getting familiar with the individual patient anatomy, identifying landmarks, planning the approach, and deciding upon the ideal target position of the actual surgical activity. The application provides interactive visualization, navigation, and perception aids and the possibility of simulating the procedure, including haptic feedback and simulation of surgical instruments.
authors.affiliation: VRVis Research Center, Donaucitystrasse 1, 1220 Wien, Austria. neubauer@vrvis.at
authors.forename: André
authors.initials: A
authors.lastname: Neubauer
authors.forename: Stefan
authors.initials: S
authors.lastname: Wolfsberger
authors.forename: Marie-Thérèse
authors.initials: MT
authors.lastname: Forster
authors.forename: Lukas
authors.initials: L
authors.lastname: Mroz
authors.forename: Rainer
authors.initials: R
authors.lastname: Wegenkittl
authors.forename: Katja
authors.initials: K
authors.lastname: Bühler
mesh_terms: D000465:Algorithms; D003196:Computer Graphics; D003198:Computer Simulation; D004724:Endoscopy / Q000193:education / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D016247:Information Storage and Retrieval / Q000379:methods; D008954:Models, Biological; D010911:Pituitary Neoplasms / Q000473:pathology* / Q000601:surgery*; D013382:Subtraction Technique; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014584:User-Computer Interface