Virtual reality training simulator for endonasal surgery

Background: Traditional training methods for surgeons include anatomical studies on human cadavers. Limited availability and ethical problems led to the consideration of alternatives. The surgeon's level of training could be significantly increased by a interactive training system trough computer graphics and virtual reality (VR). Methods: Two main issues addressed are the 3-D reconstruction process and 3-D interaction to guide the surgical instruments. To provide the virtual environment, a realistic representation of the region of interest with all relevant anatomical parts is required. This model has to be suitable for computer simulation, while preserving as accurately as possible important anatomic features. Therefore the concept of creating a 3-D representation semiautomatically was developed. Textures derived from endoscopic images are superimposed on the virtual anatomic structures and provide better realism, Results: Intuitive handling of the surgical instruments is ensured by using the tracking technique. The system allows navigation via a virtual camera and interaction with the virtual anatomical structures. Currently the use of a force feedback system and the simulation of deformations of tissues is critical, Conclusions: The VR based simulation system offers an alternative to conventional training methods, The future role of surgical simulation depends on overcoming the current drawbacks to provide greater interactive realism: the integration of a force feedback system to simulate the resistance of anatomical structures and the simulation of tissue deformations - both currently under development.