A review of virtual reality simulators for neuroendoscopy

Baby, Britty; Singh, Ramandeep; Suri, Ashish; Dhanakshirur, Rohan Raju; Chakraborty, Argha; Kumar, Subodh; Kalra, Prem Kumar; Banerjee, Subhashis

doi:10.1007/s10143-019-01164-7

Cited by 23 publications

(13 citation statements)

References 78 publications

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“…For suturing, silastic sheets provide a reasonably good practice tool, and for endoscopy, our in-house neuroendoscope box trainer platform helps in developing good bimanual coordination and spatial awareness using basic tasks such as object manipulation and ring shifting maneuvers. 23,24 It offers not only recording of the endoscopic view but also recording through an external camera fixed to the box, which can record both the endoscope and instrument motion from a stationary reference. This requires the trainee to adapt and hone their skills to accomplish the task satisfactorily.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the current VR systems lack overall seriousness when it is known that poor performance will not lead to patient harm as in the OR, and the modules have relatively lower fidelity for experts who use different sensorimotor cues to guide during real neurosurgical procedures. 5,18,23 The utility and acceptability of the combination of taskand procedure-based modules were assessed based on feedback obtained from the residents. The task-based exercises, including both microsuturing and endoscopy exercises, were uniformly supported by the residents across all seniority groups as contributing positively to the enhancement of their surgical dexterity and identifying target areas of improvement.…”

Section: Discussionmentioning

confidence: 99%

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Interval assessment using task- and procedure-based simulations: an attempt to supplement neurosurgical residency curriculum

Sharma

Katiyar

Narwal

et al. 2022

Neurosurgical Focus

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OBJECTIVE The longer learning curve and smaller margin of error make nontraditional, or "out of operating room" simulation training, essential in neurosurgery. In this study, the authors propose an evaluation system for residents combining both task-based and procedure-based exercises and also present the perception of residents regarding its utility. METHODS Residents were evaluated using a combination of task-based and virtual reality (VR)–based exercises. The results were analyzed in terms of the seniority of the residents as well as their laboratory credits. Questionnaire-based feedback was sought from the residents regarding the utility of this evaluation system incorporating the VR-based exercises. RESULTS A total of 35 residents were included in this study and were divided into 3 groups according to seniority. There were 11 residents in groups 1 and 3 and 13 residents in group 2. On the overall assessment of microsuturing skills including both 4-0 and 10-0 microsuturing, the suturing skills of groups 2 and 3 were observed to be better than those of group 1 (p = 0.0014). Additionally, it was found that microsuturing scores improved significantly with the increasing laboratory credits (R2 = 0.72, p < 0.001), and this was found to be the most significant for group 1 residents (R2 = 0.85, p < 0.001). Group 3 residents performed significantly better than the other two groups in both straight (p = 0.02) and diagonal (p = 0.042) ring transfer tasks, but there was no significant difference between group 1 and group 2 residents (p = 0.35). Endoscopic evaluation points were also found to be positively correlated with previous laboratory training (p = 0.002); however, for the individual seniority groups, the correlation failed to reach statistical significance. The 3 seniority groups performed similarly in the cranial and spinal VR modules. Group 3 residents showed significant disagreement with the utility of the VR platform for improving surgical dexterity (p = 0.027) and improving the understanding of surgical procedures (p = 0.034). Similarly, there was greater disagreement for VR-based evaluation to identify target areas of improvement among the senior residents (groups 2 and 3), but it did not reach statistical significance (p = 0.194). CONCLUSIONS The combination of task- and procedure-based assessment of trainees using physical and VR simulation models can supplement the existing neurosurgery curriculum. The currently available VR-based simulations are useful in the early years of training, but they need significant improvement to offer beneficial learning opportunities to senior trainees.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Interval assessment using task- and procedure-based simulations: an attempt to supplement neurosurgical residency curriculum

Sharma

Katiyar

Narwal

et al. 2022

Neurosurgical Focus

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“…This study was reviewed by the ethics committee of our hospital. 3,4 (2) Surgical methods: All patients choose appropriate surgical approaches such as subfrontal lateral, frontal longitudinal fissure, wing point, corpus callosum-vault, etc. according to the nature, size, growth direction, and degree of invasion of the disease before surgery.…”

Section: Methodsmentioning

confidence: 99%

Application of MRI images based on Spatial Fuzzy Clustering Algorithm guided by Neuroendoscopy in the treatment of Tumors in the Saddle Region

Zhang¹,

Zhang²,

Zhao

2021

Pak J Med Sci

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Objective: The paper applies spatial fuzzy clustering algorithm to explore the role and value of neuroendoscopic assisted technology in the operation of tumors in the saddle region, and analyze the MRI image characteristics of tumors in the saddle region. Methods: The clinical data of 63 patients from our hospital who underwent neuroendoscopic assisted microscopy to remove tumors in the saddle area from 2017 to 2019 (neuroendoscopy-assisted group) were collected. Seventy six patients who occupied the saddle area by microscopic resection only in the same period (Simple microscope group) clinical data. By comparing the patient’s tumor resection rate, postoperative complication rate and postoperative recurrence rate, the surgical effect was evaluated. Results: The total resection rates of the tumors in the neuroendoscopy-assisted group and the microscope-only group were 95.24% (60/63) and 80.26% (61/76). The incidence of postoperative vasospasm was 3.17% (2/63) and 13.16% (10/76), the incidence of nerve injury was 0 (0/63) and 6.58% (5/76), the difference was statistically significant (P <0.05). There was no significant difference in the incidence of postoperative infection, cerebrospinal fluid leakage and postoperative recurrence rate between the two groups (P> 0.05). Conclusion: Neuroendoscopy-assisted microscopy-based removal of the saddle area occupying space based on spatial fuzzy clustering algorithm can increase the total tumor resection rate and reduce the incidence of complications. doi: https://doi.org/10.12669/pjms.37.6-WIT.4850 How to cite this:Zhang P, Zhang L, Zhao R. Application of MRI images based on Spatial Fuzzy Clustering Algorithm guided by Neuroendoscopy in the treatment of Tumors in the Saddle Region. Pak J Med Sci. 2021;37(6):1600-1604. doi: https://doi.org/10.12669/pjms.37.6-WIT.4850 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…8) The neuroendoscopic ultrasonic surgery tumor removal task is a valuable training exercise 0 (0%) 0 (0%) 0 (0%) 2 (20%) 8 (80%) 9) Use of this model helps to increase competency when applied to train endoscopic ventricular tumor removal 0 (0%) 0 (0%) 0 (0%) 3 (30%) 7 (70%) 10) I feel more confident using neuroendoscopic instruments for tumor removal after training w/ this model 0 (0%) 0 (0%) 2 (0%) 5 (50%) 3 (30%) ies in operating theaters. [5][6][7][8][9][10]12,18 In turn, surgical training requires a long learning curve, and thus a comparison of these realities reveals the conflict between the need for education on the one hand and efficiency combined with avoidance of complications on the other hand. Incorporation of neurosurgical training models that simulate live surgery in training programs and workshops has been growing over time, with cadaveric and animal model dissection courses representing established methods.…”

Section: )mentioning

confidence: 99%

“…Furthermore, it presupposes the need for dual-handed maneuverability, additional skills for eye-hand coordination, and the adaptation of 2D visualization. 5,16 Different models are used in surgical training, namely cadaveric and animal models, synthetic simulators, and virtual reality (VR) settings. Classically, cadaveric dissection has been the state of the art for anatomical learning.…”

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confidence: 99%

Development and validation of a synthetic 3D-printed simulator for training in neuroendoscopic ventricular lesion removal

Licci

Thieringer

Guzman

et al. 2020

Neurosurgical Focus

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OBJECTIVENeuroendoscopic surgery using an ultrasonic aspirator represents a valid tool with which to perform the safe resection of deep-seated ventricular lesions, but the handling of neuroendoscopic instruments is technically challenging, requiring extensive training to achieve a steep learning curve. Simulation-based methods are increasingly used to improve surgical skills, allowing neurosurgical trainees to practice in a risk-free, reproducible environment. The authors introduce a synthetic, patient-specific simulator that enables trainees to develop skills for endoscopic ventricular tumor removal, and they evaluate the model’s validity as a training instrument with regard to realism, mechanical proprieties, procedural content, and handling.METHODSThe authors developed a synthetic simulator based on a patient-specific CT data set. The anatomical features were segmented, and several realistic 1:1 skull models with all relevant ventricular structures were fabricated by a 3D printer. Vascular structures and the choroid plexus were included. A tumor model, composed of polyvinyl alcohol, mimicking a soft-consistency lesion, was secured in different spots of the frontal horn and within the third ventricle. Neurosurgical trainees participating in a neuroendoscopic workshop qualitatively assessed, by means of a feedback survey, the properties of the simulator as a training model that teaches neuroendoscopic ultrasonic ventricular tumor surgery; the trainees rated 10 items according to a 5-point Likert scale.RESULTSParticipants appreciated the model as a valid hands-on training tool for neuroendoscopic ultrasonic aspirator tumor removal, highly rating the procedural content. Furthermore, they mostly agreed on its comparably realistic anatomical and mechanical properties. By the model’s first application, the authors were able to recognize possible improvement measures, such as the development of different tumor model textures and the possibility, for the user, of creating a realistic surgical skull approach and neuroendoscopic trajectory.CONCLUSIONSA low-cost, patient-specific, reusable 3D-printed simulator for the training of neuroendoscopic ultrasonic aspirator tumor removal was successfully developed. The simulator is a useful tool for teaching neuroendoscopic techniques and provides support in the development of the required surgical skills.

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A review of virtual reality simulators for neuroendoscopy

Cited by 23 publications

References 78 publications

Interval assessment using task- and procedure-based simulations: an attempt to supplement neurosurgical residency curriculum

Interval assessment using task- and procedure-based simulations: an attempt to supplement neurosurgical residency curriculum

Application of MRI images based on Spatial Fuzzy Clustering Algorithm guided by Neuroendoscopy in the treatment of Tumors in the Saddle Region

Development and validation of a synthetic 3D-printed simulator for training in neuroendoscopic ventricular lesion removal

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