Endoscopic surgery training using virtual reality and deformable tissue simulation

Surgical training systems based on virtual reality (VR) and simulation tech niques for tissue deformation may represent a more cost-effective and effic ient alternative to traditional training methods. Additionally, VR is a tec hnology that can teach surgeons new procedures and can determine their leve l of competence: before they operate on patients. At Forschungszentrum Karl sruhe (FZK), a virtual reality training system for minimally invasive surge ry (MIS), based on the simulation software KISMET, has been developed. An o verview of the current si:ate of development for the "Karlsruhe Endoscopic Surgery Trainer" is presented. For quick and easy creation of surgical scen es containing deformable anatomical organ models, the spline-based modeller KisMo has been developed, which generates beside the geometry also a spati al mass-spring network of the objects for the elastodynamic simulation in K ISMET. The MIS trainer provides several surgical interaction modules for de formable objects like grasping, application of clips, cutting, coagulation, injection and suturing. Additionally, it is possible to perform irrigation and suction in the operation area. Active deformable objects are used For the morphodynamic simulation of the stomach and the intestines. Furthermore , a hierarchical pulse simulation in virtual arterial vessel trees has been realized, which enables the palpation of the pulse with a Force-feedback d evice. The pulse simulation is coupled with an arterial bleeding simulation , which gets activated by injuries of arteries and stopped by application o f clips. The simulation system has been applied to minimally invasive surge ry training in gynaecology and laparoscopy. Special attention is addressed to elastodynamically deformable tissue models and geometric modelling techn iques for graphical real-time performance. (C) 2000 Elsevier Science Ltd. A ll rights reserved.