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Surgical simulation has many applications in medical education, surgical training, surgical planning, and intra-operative assistance. However, extending current surface-based computer graphics methods to model phenomena such as the deformation, cutting, tearing, or repairing of soft tissues poses significant challenges for real-time interactions. This paper discusses the use of volumetric methods for modeling complex anatomy and tissue interactions. New techniques are introduced that use volumetric methods for modeling soft tissue deformation and tissue cutting at interactive rates. An initial prototype for simulating arthroscopic knee surgery is described which uses volumetric models of the knee derived from 3D Magnetic Resonance Imaging, visual feedback via real-time volume and polygon rendering, and haptic feedback provided by a force feedback device. To be published in Journal of Medical Image Analysis, December, 1997.This work may not be copied or reproduced in whole or in part for any commercial purpose. Permission to copy i n whole or in part without payment of fee is granted for nonprofit educational and research purposes provided that all such whole or partial copies include the following: a notice that such copying is by permission of Mitsubishi Electric Research Laboratories of Cambridge, Massachusetts; an acknowledgment of the authors and individual contributions to the work; and all applicable portions of the copyright notice. Copying, reproduction, or republishing for any other purpose shall require a license with payment of fee to Mitsubishi Electric Research Laboratories. All rights reserved. Copyright © Mitsubishi Electric Information AbstractSurgical simulation has many applications in medical education, surgical training, surgical planning, and intra-operative assistance. However, extending current surfacebased computer graphics methods to model phenomena such as the deformation, cutting, tearing, or repairing of soft tissues poses significant challenges for real-time interactions. This paper discusses the use of volumetric methods for modeling complex anatomy and tissue interactions. New techniques are introduced that use volumetric methods for modeling soft tissue deformation and tissue cutting at interactive rates. An initial prototype for simulating arthroscopic knee surgery is described which uses volumetric models of the knee derived from 3D Magnetic Resonance Imaging, visual feedback via real-time volume and polygon rendering, and haptic feedback provided by a force feedback device.

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Background A number of small bone-attached surgical robots have been introduced to overcome some disadvantages of large stand-alone surgical robots. In orthopaedics, increasing demand on minimally invasive joint replacement surgery has also been encouraging small surgical robot developments. Among various technical aspects of such an approach, optimal miniaturization that maintains structural strength for high speed bone removal was investigated. Methods By observing advantages and disadvantages from serial and parallel robot structures, a new hybrid kinematic configuration was designed for a bone-attached robot to perform precision bone removal for cutting the femoral implant cavity during patellofemoral joint arthroplasty surgery. A series of experimental tests were conducted in order to evaluate the performance of the new robot, especially with respect to accuracy of bone preparation. Results A miniaturized and rigidly-structured robot prototype was developed for minimally invasive bone-attached robotic surgery. A new minimally invasive modular clamping system was also introduced to enhance the robotic procedure. Foam and pig bone experimental results demonstrated a successful implementation of the new robot that eliminated a number of major design problems of a previous prototype. Conclusions For small bone-attached surgical robots that utilize high speed orthopaedic tools, structural rigidity and clamping mechanism are major design issues. The new kinematic configuration using hinged prismatic joints enabled an effective miniaturization with good structural rigidity. Although minor problems still exist at the prototype stage, the new development would be a significant step towards the practical use of such a robot.

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