title: High-fidelity haptic and visual rendering for patient-specific simulation of temporal bone surgery.
abstract: Medical imaging techniques provide a wealth of information for surgical preparation, but it is still often the case that surgeons are examining three-dimensional pre-operative image data as a series of two-dimensional images. With recent advances in visual computing and interactive technologies, there is much opportunity to provide surgeons an ability to actively manipulate and interpret digital image data in a surgically meaningful way. This article describes the design and initial evaluation of a virtual surgical environment that supports patient-specific simulation of temporal bone surgery using pre-operative medical image data. Computational methods are presented that enable six degree-of-freedom haptic feedback during manipulation, and that simulate virtual dissection according to the mechanical principles of orthogonal cutting and abrasive wear. A highly efficient direct volume renderer simultaneously provides high-fidelity visual feedback during surgical manipulation of the virtual anatomy. The resulting virtual surgical environment was assessed by evaluating its ability to replicate findings in the operating room, using pre-operative imaging of the same patient. Correspondences between surgical exposure, anatomical features, and the locations of pathology were readily observed when comparing intra-operative video with the simulation, indicating the predictive ability of the virtual surgical environment.
authors.affiliation: a Department of Computer Science , University of Calgary , Calgary , AB , Canada.
authors.forename: Sonny
authors.initials: S
authors.lastname: Chan
authors.affiliation: b Department of Otolaryngology - Head and Neck Surgery , Stanford University , Stanford , CA , USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Li
authors.affiliation: b Department of Otolaryngology - Head and Neck Surgery , Stanford University , Stanford , CA , USA.
authors.forename: Garrett
authors.initials: G
authors.lastname: Locketz
authors.affiliation: c Departments of Computer Science and Surgery , Stanford University , Stanford , CA , USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Salisbury
authors.affiliation: b Department of Otolaryngology - Head and Neck Surgery , Stanford University , Stanford , CA , USA.
authors.forename: Nikolas H
authors.initials: NH
authors.lastname: Blevins
mesh_terms: D004210:Dissection; D005246:Feedback; D006801:Humans; D021621:Imaging, Three-Dimensional; D013506:Otologic Surgical Procedures; D016544:Patient Simulation; D066230:Patient-Specific Modeling; D013701:Temporal Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014584:User-Computer Interface
keywords: Force feedback; haptics; simulation; skull base surgery; surgical planning; virtual reality