Elements of virtual temporal bone surgery: Manipulandum format may be more important to surgeons than haptic device force capabilities

A toolkit for haptic force feedback in a telerobotic ultrasound system

OBJECTIVE

To develop a collision engine (haptic force feedback simulator) compatible with a 5-degrees-of-freedom (DOF) haptic wand. This has broad applications such as telerobotic ultrasound systems. Integrating force feedback into systems is critical to optimize remote scanning. A collision engine compatible with a 5-DOF haptic wand was developed based on the Gilbert-Johnson-Keerthi algorithm. The collision engine calculated force during collision between the wand and a virtual object based on code developed using MATLAB. A proportional force was subsequently returned to a user via the haptic wand, thereby simulating the collision force for the user. Three experiments were conducted to assess the accuracy of the collision engine on curved and flat surfaces.

RESULTS

The average errors in calculation of distances between the wand and virtual object were 2.1 cm, 3.4 cm, and 4.2 cm for the model of the human hand, cylinder, and cuboid, respectively. The collision engine accurately simulated forces on a flat surface, though was less accurate on curved surfaces. Future work will incorporate haptic force feedback into a telerobotic ultrasound system. The haptic force simulator presented here may also be used in the development of ultrasound simulators for training and education.

Training in temporal bone drilling

Acquiring surgical experience in the operating room is increasingly difficult. Simulation of temporal bone drilling is therefore essential, and more and more widely used. The aim of this review is to clarify the limitations of classical surgical training, and to describe the different types of simulation available for temporal bone drilling. Systematic Medline search used the terms: "temporal bone" and training and surgery; "temporal bone" and training and drilling. Seventy-one of the 467 articles identified were relevant for this review. Various temporal bone simulators have been created to get around the limitations (ethical, financial, cultural, working time) of temporal bone drilling. They can be classified as cadaver, animal, physical or virtual models. The main advantages of physical and virtual prototyping are their ease of access, the possibility of repeating gestures on a standardised model, and the absence of ethical issues. Validation is essential before these simulators can be included in the curriculum, to ensure efficacy and thus improve patient safety in the operating room.

Study on Collision Detection and Force Feedback Algorithm in Virtual Surgery

The development of virtual reality technology is expected to solve traditional surgical training. The lack of methods has brought revolutionary advances in technology. The virtual surgery system based on collision detection and force feedback can enable the operator to have stronger interaction, which is an exploration of the feature of touch in virtual reality technology. Reality is an important indicator of the virtual surgical system. This article improves the realism of the system from the visual and tactile senses and uses the surrounding ball collision detection and force feedback algorithms to build a realistic surgical platform. In the virtual surgery training system, the introduction of force feedback greatly improves the sense of presence during virtual surgery interaction. The operator can feel the softness and hardness of different tissues and organs through the force feedback device. Virtual reality is an interdisciplinary comprehensive technology that has been widely used in military, film, medical, and gaming fields. Virtual reality can simulate the objective world and display it visually, making people feel immersive. Virtual surgery provides surgeons with a recyclable surgical practice platform and can help doctors perform preoperative rehearsals and predict the results of surgery. The design of collision detection and force feedback algorithms is a prerequisite to ensure the immersion and transparency of the virtual surgical training system. This article mainly introduces the collision detection and force feedback algorithm research in virtual surgery, with the intention of providing some ideas and directions for the development of virtual surgery. This paper proposes two collision detection algorithms, space decomposition method and hierarchical bounding box method, and three force feedback algorithms including spring mass point algorithm, Runge–Kutta method, and Euler method to construct virtual surgery collision detection and force feedback. Experiment with the Overall System Architecture. This paper proves through experimental results that the average collision detection time after the application of the improved collision detection and force feedback algorithm in the virtual surgery system is more than 80.7% less than the traditional method, which greatly improves the detection speed.

A review of simulation applications in temporal bone surgery

Background

Temporal bone surgery is a technically challenging and high-risk procedure in an anatomically complex area. Safe temporal bone surgery emphasizes a consummate anatomic understanding and technique development that requires the guidance of an experienced otologic surgeon and years of practice. Temporal bone simulation can augment otologic surgical training and enable rehearsal of surgical procedures.

Objectives

The purpose of this article is to provide an updated review of temporal bone simulation platforms and their uses.

Data Sources

PubMed literature search. Search terms included temporal bone, temporal bone simulation, virtual reality (VR), and presurgical planning and rehearsal.

Discussion

Various simulation platforms such as cadaveric bone, three-dimensional (3D) printed models, and VR simulation have been used for temporal bone surgery training. However, each simulation method has its drawbacks. There is a need to improve upon current simulation platforms to enhance surgical training and skills assessment, as well as a need to explore other clinically significant applications of simulation, such as preoperative planning and rehearsal, in otologic surgery.

Conclusions

There is no replacement for actual surgical experience, but high-fidelity temporal bone models such as those produced with 3D printing and computer simulation have emerged as promising tools in otolaryngologic surgery. Improvements in the fidelity of both 3D printed and VR simulators as well as integration of a standardized assessment format would allow for an expansion in the use of these simulation platforms in training and assessment.

Level of Evidence

5.