Surgeons and astronauts are entering new territory thanks to the training capabilities of virtual reality (VR). The technology might not be a giant leap for mankind, but it could be an important step toward a new medical frontier. VR simulation is enabling surgeons — and astronauts — to practice surgical procedures in immersive and semi-immersive environments. Although some challenges remain, including developing standards in the technology, virtual reality is pioneering a new approach to surgical planning and medical education.

Immersing yourself
An immersive environment is primarily a way to get information to the clinician or user. With stereo glasses, the user can fly through medical images, manipulating the information and viewing the material in 3D.

“Broadly speaking, what one does is take a lot of information about a patient — much of that is in the form of medical imaging — and you combine that with information that you know about people in general to make a computer model that basically fuses or synthesizes everything you know about that individual,” says Russell Taylor, Ph.D., professor of computer science at The Johns Hopkins University (Baltimore, Md.) and director of the National Science Foundation’s Engineering Research Center (Baltimore). “Then the computer can use that information in various ways to help the clinician. The immersive environment aspect largely concerns ways for the physician to interact with that model.”

That process can include real-time visualization, which often is three-dimensional in nature. You can combine the sense of touch with the surgeons’ ability to perceive forces in interactive ways. One of those ways is the use of surgical simulators for training surgeons.

“This is obviously very important, and I think the main progress that’s being made is in developing better ways of realistically modeling how tissue behaves in the physical world, things like deformation, heart beat or what happens if you poke something,” Taylor says. “There has been some extraordinarily good work in the last year on ways to simulate what happens to an organ when you poke it with a needle and what the forces on the needle would be.”

Building surgical skills
At Stanford University School of Medicine (Palo Alto, Calif.), surgeons train through a project called the Surgery Work Bench that teaches medical students and residents the basic manipulations of surgery. “What we say is that there are basically eight or nine movements, manipulations, such as any kind of probing, pushing, lifting,” says Parvati Dev, Ph.D., associate dean for learning technologies and director of the Stanford University Medical Media and Information Technologies (SUMMIT) Lab. “Each manipulation is reflected in the technology in that the tools have certain properties. You can pick up a tool and then you can add on the anatomy to push things aside, to cut things or to suture.”

Please refer to the August 2002 issue for the complete story. For information on article reprints, contact Martin St. Denis