The development of a virtual simulator for training neurosurgeons to perform and perfect endoscopic endonasal transsphenoidal surgery.
BACKGROUND
A virtual reality (VR) neurosurgical simulator with haptic feedback may provide the best model for training and perfecting surgical techniques for transsphenoidal approaches to the sella turcica and cranial base. Currently there are 2 commercially available simulators: NeuroTouch (Cranio and Endo) developed by the National Research Council of Canada in collaboration with surgeons at teaching hospitals in Canada, and the Immersive Touch. Work in progress on other simulators at additional institutions is currently unpublished.


OBJECTIVE
This article describes a newly developed application of the NeuroTouch simulator that facilitates the performance and assessment of technical skills for endoscopic endonasal transsphenoidal surgical procedures as well as plans for collecting metrics during its early use.


METHODS
The main components of the NeuroTouch-Endo VR neurosurgical simulator are a stereovision system, bimanual haptic tool manipulators, and high-end computers. The software engine continues to evolve, allowing additional surgical tasks to be performed in the VR environment. Device utility for efficient practice and performance metrics continue to be developed by its originators in collaboration with neurosurgeons at several teaching hospitals in the United States. Training tasks are being developed for teaching 1- and 2-nostril endonasal transsphenoidal approaches. Practice sessions benefit from anatomic labeling of normal structures along the surgical approach and inclusion (for avoidance) of critical structures, such as the internal carotid arteries and optic nerves.


CONCLUSIONS
The simulation software for NeuroTouch-Endo VR simulation of transsphenoidal surgery provides an opportunity for beta testing, validation, and evaluation of performance metrics for use in neurosurgical residency training.


BACKGROUND
CTA, cognitive task analysisVR, virtual reality.
*Department of Neurosurgery, NorthShore University Health System, Evanston, Illinois; ‡Neurosurgical Simulation Research Centre, Montreal Neurological Institute and Hospital, Montreal, Quebec, Canada; §National Research Council Canada, Boucherville, Quebec, Canada; ¶National Research Council Canada, Winnipeg, Manitoba, Canada.
Gail
G
Rosseau
Julian
J
Bailes
Rolando
R
del Maestro
Anne
A
Cabral
Nusrat
N
Choudhury
Olivier
O
Comas
Patricia
P
Debergue
Gino
G
De Luca
Jordan
J
Hovdebo
Di
D
Jiang
Denis
D
Laroche
Andre
A
Neubauer
Valerie
V
Pazos
Francis
F
Thibault
Robert
R
Diraddo
D002339:Carotid Arteries / Q000033:anatomy & histology; D002983:Clinical Competence; D003198:Computer Simulation; D003479:Curriculum; D019723:Endoscopes; D004724:Endoscopy / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D009296:Nasal Cavity / Q000033:anatomy & histology* / Q000601:surgery*; D009493:Neurosurgery / Q000193:education*; D019635:Neurosurgical Procedures / Q000193:education*; D009900:Optic Nerve / Q000033:anatomy & histology; D012984:Software; D013100:Sphenoid Bone / Q000033:anatomy & histology* / Q000601:surgery*; D013525:Surgical Instruments; D014584:User-Computer Interface