title: Virtual reality cerebral aneurysm clipping simulation with real-time haptic feedback.
abstract: BACKGROUND
  With the decrease in the number of cerebral aneurysms treated surgically and the increase of complexity of those treated surgically, there is a need for simulation-based tools to teach future neurosurgeons the operative techniques of aneurysm clipping.
  
  
  OBJECTIVE
  To develop and evaluate the usefulness of a new haptic-based virtual reality simulator in the training of neurosurgical residents.
  
  
  METHODS
  A real-time sensory haptic feedback virtual reality aneurysm clipping simulator was developed using the ImmersiveTouch platform. A prototype middle cerebral artery aneurysm simulation was created from a computed tomographic angiogram. Aneurysm and vessel volume deformation and haptic feedback are provided in a 3-dimensional immersive virtual reality environment. Intraoperative aneurysm rupture was also simulated. Seventeen neurosurgery residents from 3 residency programs tested the simulator and provided feedback on its usefulness and resemblance to real aneurysm clipping surgery.
  
  
  RESULTS
  Residents thought that the simulation would be useful in preparing for real-life surgery. About two-thirds of the residents thought that the 3-dimensional immersive anatomic details provided a close resemblance to real operative anatomy and accurate guidance for deciding surgical approaches. They thought the simulation was useful for preoperative surgical rehearsal and neurosurgical training. A third of the residents thought that the technology in its current form provided realistic haptic feedback for aneurysm surgery.
  
  
  CONCLUSIONS
  Neurosurgical residents thought that the novel immersive VR simulator is helpful in their training, especially because they do not get a chance to perform aneurysm clippings until late in their residency programs.
authors.affiliation: *Department of Neurosurgery, University of Illinois College of Medicine at Chicago, Chicago, Illinois; ‡Department of Mechanical and Industrial Engineering, University of Illinois at Chicago, Chicago, Illinois; §ImmersiveTouch, Inc., Westmont, Illinois; ¶College of Engineering, University of Illinois at Chicago, Chicago, Illinois; ‖Division of Neurosurgery, Department of Surgery, University of Chicago, Chicago, Illinois; and #Department of Neurosurgery, Weill Cornell Medical College, New York.
authors.forename: Ali
authors.initials: A
authors.lastname: Alaraj
authors.forename: Cristian J
authors.initials: CJ
authors.lastname: Luciano
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Bailey
authors.forename: Abdussalam
authors.initials: A
authors.lastname: Elsenousi
authors.forename: Ben Z
authors.initials: BZ
authors.lastname: Roitberg
authors.forename: Antonio
authors.initials: A
authors.lastname: Bernardo
authors.forename: P Pat
authors.initials: PP
authors.lastname: Banerjee
authors.forename: Fady T
authors.initials: FT
authors.lastname: Charbel
mesh_terms: D003198:Computer Simulation; D005246:Feedback; D006801:Humans; D007396:Internship and Residency; D002532:Intracranial Aneurysm / Q000601:surgery*; D008953:Models, Anatomic; D009493:Neurosurgery / Q000193:education*; D019635:Neurosurgical Procedures / Q000193:education*; D014584:User-Computer Interface