Mixed-reality simulation for neurosurgical procedures.
BACKGROUND
Surgical education is moving rapidly to the use of simulation for technical training of residents and maintenance or upgrading of surgical skills in clinical practice. To optimize the learning exercise, it is essential that both visual and haptic cues are presented to best present a real-world experience. Many systems attempt to achieve this goal through a total virtual interface.


OBJECTIVE
To demonstrate that the most critical aspect in optimizing a simulation experience is to provide the visual and haptic cues, allowing the training to fully mimic the real-world environment.


METHODS
Our approach has been to create a mixed-reality system consisting of a physical and a virtual component. A physical model of the head or spine is created with a 3-dimensional printer using deidentified patient data. The model is linked to a virtual radiographic system or an image guidance platform. A variety of surgical challenges can be presented in which the trainee must use the same anatomic and radiographic references required during actual surgical procedures.


RESULTS
Using the aforementioned techniques, we have created simulators for ventriculostomy, percutaneous stereotactic lesion procedure for trigeminal neuralgia, and spinal instrumentation. The design and implementation of these platforms are presented.


CONCLUSIONS
The system has provided the residents an opportunity to understand and appreciate the complex 3-dimensional anatomy of the 3 neurosurgical procedures simulated. The systems have also provided an opportunity to break procedures down into critical segments, allowing the user to concentrate on specific areas of deficiency.
*Department of Neurosurgery and ‡Department of Anesthesiology, University of Florida, Gainesville, Florida.
Frank J
FJ
Bova
Didier A
DA
Rajon
William A
WA
Friedman
Gregory J
GJ
Murad
Daniel J
DJ
Hoh
R Patrick
RP
Jacob
Samsun
S
Lampotang
David E
DE
Lizdas
Gwen
G
Lombard
J Richard
JR
Lister
D000465:Algorithms; D017115:Catheter Ablation; D003198:Computer Simulation; D006257:Head / Q000033:anatomy & histology; D006801:Humans; D016268:Internal Fixators; D007396:Internship and Residency; D008953:Models, Anatomic; D009493:Neurosurgery / Q000193:education / Q000379:methods*; D019635:Neurosurgical Procedures / Q000193:education / Q000379:methods*; D011859:Radiography; D016634:Radiosurgery; D013131:Spine / Q000000981:diagnostic imaging / Q000601:surgery; D014277:Trigeminal Neuralgia / Q000628:therapy; D014584:User-Computer Interface; D014696:Ventriculostomy