A virtual environment testbed for training laparoscopic surgical skills

With the introduction of minimally invasive techniques, surgeons must learn skills and procedures that are radically different from traditional open s urgery. Traditional methods of surgical training that were adequate when te chniques and instrumentation changed relatively slowly may not be as effici ent or effective in training substantially new procedures. Virtual environm ents are a promising new medium for training, This paper describes a testbed developed at the San Francisco, Berkeley, an d Santa Barbara campuses of the University of California for research in un derstanding, assessing, and training surgical skills. The testbed includes virtual environments for training perceptual motor skills, spatial skills, and critical steps of surgical procedures, Novel technical elements of the testbed include a four-DOF haptic interface, a fast collision detection alg orithm for detecting contact between rigid and deformable objects, and para llel processing of physical modeling and rendering. The major technical cha llenge in surgical simulation to be investigated using the testbed is the d evelopment of accurate, real-time methods for modeling deformable tissue be havior. Several simulations have been implemented in the testbed, including environments for assessing performance of basic perceptual motor skills. t raining the use of an angled laparoscope, and teaching critical steps of th e cholecystectomy, a common laparoscopic procedure, The major challenges of extending and integrating these tools for training are discussed.