Muhammad Muddassir Malik

Challenges in Surgical Simulators

Muhammad Muddassir MalikMuhammad Adil Usman

SEECS, NUST, Islamabad

School of Electrical Engineering & Computer Science, National University of Sciences & Technology, Pakistan1

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Survey on Surgical Simulators

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Survey on Surgical Simulators

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System Components• Dataset• Mechanical Object• Tissue Modeling and Characterization• Illumination Mechanism• Collision Detection• Teaching Resources• Assessment through metrics and feedback• Performance Monitoring• Video

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Dataset• Geometric (derived from a scan?)– Triangular– Tetrahedral

• Volumetric (CT and MRI) (video)• Multimodal• Biomechanical

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Mechanical Object• Position Tracking (multi degree freedom)• Feedback– Visual – Hepatic• Force• Tactile

• Bi-directional Communications• To Ensure Correct Frame rate

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Tissue Modeling and Characterization

• Biomechanical properties• Physics• Stress-strain Relationship *• Topological Changes with wear and tear

(viscoelastic)• Inhomogeneous and Direction dependant

Tissue Behavior*• Fluid and movement (video)

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Illumination Mechanism• Global Light and Spot Light• Shadows• Depth Perception

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Collision Detection• Two stage collision detection (Boundary, Loci)• Collision Types:– Bounding Spheres– Axis-Aligned Bounding Boxes– Oriented (along Eigen Vector) Bounding Box

• Hardware Acceleration for Loci calculation

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Teaching Resources and Assessment

• Implementing Laparoscopic Training Manual and specific scenarios

• Cues, Feedback and comparisons• Assessment through metrics and qualitative

feedback– Errors– Movement– Time– Forces

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Performance• Depends on Implementation Platform• Study of Hardware and Software resources• Dry Run for Efficiency

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Discussion

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Four Modules• Simulation Engine– Based on Simulation Open Framework Architecture– Modeling and Simulation

• Basic Training Module– Fundamentals of Laparoscopic Surgery Curriculum for Surgeon

Training• Advanced Training Module– Simulation of complex laparoscopic procedures– Videos provided by Holy Family Hospital of different scenarios of

laparoscopic surgery• Evaluation Module– Evaluation of surgeons on the basis of simulator training

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The short comings in General• Dataset• Haptic Feedback• Stress-strain Relationship• Topological Changes with wear and tear

(viscoelastic)• Inhomogeneous Tissue behaviour• Shadows• Depth Perception• Simulation of Complex procedures

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Major Undecided Issues• Multimodal or Tetrahedral Dataset– Create or Acquire

• Laparoscopic Arms to use: No open source communication protocol available

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