Surgeons hone skills in virtual operations


No one likes to make mistakes, particularly surgeons whose trained minds and hands can save lives but who, through the slightest of errors, can permanently impair or, even worse, end lives altogether.

Researchers at the Computing and Communication Center of the Technical University of Aachen in Germany hope to reduce the level of error in surgical operations. In collaboration with Department of Plastic Surgery, Hand and Burn Surgery at the University of Aachen Hospital, they have developed a prototype virtual operating room that someday could help young surgeons learn operating techniques and experienced surgeons prepare for difficult procedures — with no risk to human patients.

Virtual operations that enable frequent, thorough training at all levels could lead to faster, safer and more cost efficient surgery — that’s the aim of computer scientists and surgeons cooperating in the Virtual Reality Surgical Training project.

The “trick” of performing a virtual surgery is to simulate a realistic operating environment, according to computer scientist Torsten Kuhlen. That means creating not only a near real-life virtual operating theatre but also virtual patients and all their various organs, bones, muscles and tissues.

For virtual operating to be a useful learning tool, surgeons must be able to view the entire body, down to the various layers of skin. To create a realistic feeling of using a scalpel during surgery, they also need to sense the skin’s resistance to cutting. And not only that, they need all the action taking place during a virtual surgery to happen very fast — ideally in real time — to make the situation as realistic as possible.

In the prototype virtual operating room developed by researchers of the Computer and Communication Center, surgeons wear special glasses, allowing them to see not only a virtual operating table but also a holographic image of a patient lying on top. The image is created by a video beamer installed in the table. To relay the skin’s resistance to basic manipulations such as pinching, cutting and dissecting, the Aachen team has developed a robotic device that holds the scalpel. When the surgeon grabs hold of the scalpel and begins to cut through the virtual skin, the device generates tension to simulate the action of cutting through different layers of the human skin. The level of tension varies according to the type of skin and depth of the incision.

The computer scientists have developed complex algorithms to emulate a wide range of tissues, such as fatty and glandular tissue, pectoral muscles and the abdominal wall. And they have developed a complex, ultra-fast mathematical rendering of realistic skin layers to correspond with incisions in real time.

Realistic simulations of cutting through tissue along various lines and at various depths, as surgeons would perform in typical operations, have not been possible in the past, according to the university researchers. Experts agree that the opportunity to perform virtual operations without risk to humans could significantly improve the training of young surgeons who need repeated practice, which isn’t possible on human patients. And, even for the highly skilled surgeon, the chance to practice difficult surgical procedures could reduce the level of risk — and stress — in complicated operations as well.

Although the computer scientists at the University of Aachen have created a prototype virtual operating room, they are still busy optimizing the technology. Their hope is that by the end of the decade, surgeons will be able to perform their first virtual operations.


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Jim Love, Chief Content Officer, IT World Canada

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