The force pyramid: a spatial analysis of force application during virtual reality brain tumor resection

被引：29

作者：

Azarnoush, Hamed ^{[1
,2
]}

Siar, Samaneh ^{[2
]}

Sawaya, Robin ^{[1
]}

Al Zhrani, Gmaan ^{[1
,3
]}

Winkler-Schwartz, Alexander ^{[1
]}

Alotaibi, Fahad Eid ^{[1
,3
]}

Bugdadi, Abdulgadir ^{[1
,4
]}

Bajunaid, Khalid ^{[1
,5
]}

Marwa, Ibrahim ^{[1
]}

Sabbagh, Abdulrahman Jafar ^{[1
,6
,7
]}

Del Maestro, Rolando F. ^{[1
]}

机构：

[1] McGill Univ, Montreal Neurol Inst & Hosp, Dept Neurosurg, Neurosurg Simulat Res & Training Ctr, 3801 Univ,Rm W201, Montreal, PQ H3A 2B4, Canada

[2] Amirkabir Univ Technol, Tehran Polytech, Dept Biomed Engn, Tehran, Iran

[3] King Fahad Med City, Dept Neurosurg, Natl Neurosci Inst, Riyadh, Saudi Arabia

[4] Umm Al Qura Univ, Fac Med, Dept Surg, Makkah Almukarramah

[5] Univ Jeddah, Fac Med, Div Neurosurg, Jeddah, Saudi Arabia

[6] King Abdulaziz Univ, Fac Med, Dept Surg, Div Neurosurg, Jeddah, Saudi Arabia

[7] King Abdulaziz Univ, Clin Skill & Simulat Ctr, Jeddah, Saudi Arabia

来源：

JOURNAL OF NEUROSURGERY | 2017年 / 127卷 / 01期

关键词：

force pyramid; Tier 3 performance metrics; virtual reality neurosurgical simulation; ergonomics; brain tumor resection; NeuroTouch; NeuroVR; surgical technique; ENDOSCOPIC SINUS SURGERY; MCGILL SIMULATOR; PERFORMANCE; NEUROTOUCH;

D O I：

10.3171/2016.7.JNS16322

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

OBJECTIVE Virtual reality simulators allow development of novel methods to analyze neurosurgical performance. The concept of a force pyramid is introduced as a Tier 3 metric with the ability to provide visual and spatial analysis of 3D force application by any instrument used during simulated tumor resection. This study was designed to answer 3 questions: 1) Do study groups have distinct force pyramids? 2) Do handedness and ergonomics influence force pyramid structure? 3) Are force pyramids dependent on the visual and haptic characteristics of simulated tumors? METHODS Using a virtual reality simulator, NeuroVR (formerly NeuroTouch), ultrasonic aspirator force application was continually assessed during resection of simulated brain tumors by neurosurgeons, residents, and medical students. The participants performed simulated resections of 18 simulated brain tumors with different visual and haptic characteristics. The raw data, namely, coordinates of the instrument tip as well as contact force values, were collected by the simulator. To provide a visual and qualitative spatial analysis of forces, the authors created a graph, called a force pyramid, representing force sum along the z-coordinate for different xy coordinates of the tool tip. RESULTS Sixteen neurosurgeons, 15 residents, and 84 medical students participated in the study. Neurosurgeon, resident and medical student groups displayed easily distinguishable 3D "force pyramid fingerprints." Neurosurgeons had the lowest force pyramids, indicating application of the lowest forces, followed by resident and medical student groups. Handedness, ergonomics, and visual and haptic tumor characteristics resulted in distinct well-defined 3D force pyramid patterns. CONCLUSIONS Force pyramid fingerprints provide 3D spatial assessment displays of instrument force application during simulated tumor resection. Neurosurgeon force utilization and ergonomic data form a basis for understanding and modulating resident force application and improving patient safety during tumor resection.

引用

页码：171 / 181

页数：11

共 26 条

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