Medical images drive virtual reality surgical trainer

A new technology that combines high-resolution 3D medical images with an artificial sense of touch to create a realistic simulation of surgical procedures allows trainee surgeons to learn and practice surgery on "virtual patients."

With the new system, students not only see realistic "organs," they can also "feel" and manipulate them.

Using the revolutionary Haptic (touch feedback) Workbench system developed by the Australian Commonwealth Scientific and Industrial Research Organization (CSIRO), trainees feel the pressure of the surgical instrument as it cuts through tissue. They can even tell when they hit a bone or make a wrong move.

The surgical trainer, also developed by CSIRO scientists, is currently in assessment trials. The first phase is under way in the surgery division at Nepean Hospital in Sydney.

This phase is attempting to measure the differences in surgical skill by comparing the results of identical surgical procedures performed by experienced surgeons and novices, according to Dr. Matthew Hutchins, CSIRO computer scientist and virtual reality expert.

In the trial, surgical trainees use the system to perform keyhole surgery to remove a gall bladder from their virtual patient by inserting instruments through a keyhole incision in a dummy abdomen while viewing a 3D simulation of the procedure of what is happening inside the "patient."

"Results of all the trials will show us what aspects of the system are useful and effective for training and how to improve it," Hutchins said. "They will tell us how realistic the images and touch feedback need to be to make the simulation useful for learning and practice."

The secret of the technology lies under the surgical drapes where a robotic arm resists the movement of the instruments in the same way that real organs would resist being moved or cut. This gives the surgery a feel of authenticity even though the organs do not actually exist.

Beyond training surgical students, experienced surgeons may find the VR solution uses less of their time and resources as they prep for a procedure. By using imaging studies of actual patient data to generate the virtual 3D images, for instance, a surgeon can rehearse a complex surgical procedure on a precise simulation of an individual patient.

The system will also allow surgeons to keep their skills current by permitting them to practice new surgical procedures and techniques on virtual patients.