title: High-level virtual reality simulator for endourologic procedures of lower urinary tract.
abstract: OBJECTIVE
  To analyze the limitations of existing simulators for urologic techniques, and then test and evaluate a novel virtual reality (VR) simulator for endourologic procedures of the lower urinary tract. Surgical simulation using VR has the potential to have a tremendous impact on surgical training, testing, and certification. Endourologic procedures seem to be an ideal target for VR systems.
  
  
  METHODS
  The URO-Trainer features genuine VR, obtained from digital video footage of more than 400 endourologic diagnostic and therapeutic procedures, as well as data from cross-sectional imaging. The software offers infinite random variations of the anatomy and pathologic features for diagnosis and surgical intervention. An advanced haptic force feedback is incorporated. Virtual cystoscopy and resection of bladder tumors were evaluated by 24 medical students and 12 residents at our department.
  
  
  RESULTS
  The system was assessed by more than 150 international urologists with varying experience at different conventions and workshops from March 2003 to September 2004. Because of these evaluations and constant evolutions, the final version provides a genuine representation of endourologic procedures. Objective data are generated by a tutoring system that has documented evident teaching benefits for medical students and residents in cystoscopy and treatment of bladder tumors.
  
  
  CONCLUSIONS
  The URO-Trainer represents the latest generation of endoscopy simulators. Authentic visual and haptic sensations, unlimited virtual cases, and an intelligent tutoring system make this modular system an important improvement in computer-based training and quality control in urology.
authors.affiliation: Department of Urology and Laser Research Center, University-Hospital Grosshadern, Ludwig-Maximilians-University Munich, Munich, Germany. oreich@med.uni-muenchen.de
authors.forename: Oliver
authors.initials: O
authors.lastname: Reich
authors.forename: Margarita
authors.initials: M
authors.lastname: Noll
authors.forename: Christian
authors.initials: C
authors.lastname: Gratzke
authors.forename: Alexander
authors.initials: A
authors.lastname: Bachmann
authors.forename: Raphaela
authors.initials: R
authors.lastname: Waidelich
authors.forename: Michael
authors.initials: M
authors.lastname: Seitz
authors.forename: Boris
authors.initials: B
authors.lastname: Schlenker
authors.forename: Reinhold
authors.initials: R
authors.lastname: Baumgartner
authors.forename: Alfons
authors.initials: A
authors.lastname: Hofstetter
authors.forename: Christian G
authors.initials: CG
authors.lastname: Stief
mesh_terms: D003198:Computer Simulation; D003558:Cystoscopy; D011795:Surveys and Questionnaires; D018666:Ureteroscopy; D013520:Urologic Surgical Procedures / Q000193:education*