Force-feedback-assisted Bone Drilling Simulation Based on CT Data

Maier, Johannes; Huber, Michaela; Katzky, Uwe; Perret, Jérôme; Wittenberg, Thomas; Palm, Christoph

doi:10.1007/978-3-662-56537-7_78

Cited by 2 publications

(2 citation statements)

References 6 publications

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“…The ethical concerns relate to the use of patients as medical simulators, as, according to Gates [1997], the central ethical practice of medicine is to avoid harm to patients (5,8). Thus with HaptiVisT, a virtual reality (VR) based training system (Figure 1B) is being developed to teach especially young surgeons the interplay between accurate K-wire drilling and protection of risk structures (9,10). A haptic device (Virtuose 6D Desktop, Haption GmbH, Aachen, Germany, www.haption.com) for drilling with force feedback and an autostereoscopic three-dimensional (3D) monitor to visualize the drilling process (SeeFront GmbH, Hamburg, Germany, www.seefront.com) is used.…”

Section: Introductionmentioning

confidence: 99%

Optically tracked and 3D printed haptic phantom hand for surgical training system

Maier¹,

Weiherer²,

Huber³

et al. 2020

Quant Imaging Med Surg

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Background: For surgical fixation of bone fractures of the human hand, so-called Kirschner-wires (K-wires) are drilled through bone fragments. Due to the minimally invasive drilling procedures without a view of risk structures like vessels and nerves, a thorough training of young surgeons is necessary. For the development of a virtual reality (VR) based training system, a three-dimensional (3D) printed phantom hand is required. To ensure an intuitive operation, this phantom hand has to be realistic in both, its position relative to the driller as well as in its haptic features. The softest 3D printing material available on the market, however, is too hard to imitate human soft tissue. Therefore, a support-material (SUP) filled metamaterial is used to soften the raw material. Realistic haptic features are important to palpate protrusions of the bone to determine the drilling starting point and angle. An optical real-time tracking is used to transfer position and rotation to the training system.Methods: A metamaterial already developed in previous work is further improved by use of a new unit cell.Thus, the amount of SUP within the volume can be increased and the tissue is softened further. In addition, the human anatomy is transferred to the entire hand model. A subcutaneous fat layer and penetration of air through pores into the volume simulate shiftability of skin layers. For optical tracking, a rotationally symmetrical marker attached to the phantom hand with corresponding reference marker is developed. In order to ensure trouble-free position transmission, various types of marker point applications are tested.Results: Several cuboid and forearm sample prints lead to a final 30 centimeter long hand model. The whole haptic phantom could be printed faultless within about 17 hours. The metamaterial consisting of the new unit cell results in an increased SUP share of 4.32%. Validated by an expert surgeon study, this allows in combination with a displacement of the uppermost skin layer a good palpability of the bones. Tracking of the hand marker in dodecahedron design works trouble-free in conjunction with a reference marker attached to the worktop of the training system.Conclusions: In this work, an optically tracked and haptically correct phantom hand was developed using dual-material 3D printing, which can be easily integrated into a surgical training system.

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Section: Introductionmentioning

confidence: 99%

Optically tracked and 3D printed haptic phantom hand for surgical training system

Maier¹,

Weiherer²,

Huber³

et al. 2020

Quant Imaging Med Surg

Self Cite

View full text Add to dashboard Cite

show abstract

“…Several studies showed (11,12,15), that training on medical simulators increases surgical performance of surgeons in the operating room, decreasing the number of errors and reduces the duration of the surgery. Within the HaptiVisT project we developed a VR-based and visual assisted training system for minimally invasive hand surgery (16,17). For this, a driller is mounted at the tip of a haptic device (Virtuose 6D Desktop, Haption GmbH, Aachen, Germany, www.haption.…”

Section: Introductionmentioning

confidence: 99%

Imitating human soft tissue on basis of a dual-material 3D print using a support-filled metamaterial to provide bimanual haptic for a hand surgery training system

Maier¹,

Weiherer²,

Huber³

et al. 2019

Quant. Imaging Med. Surg

Self Cite

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Background: Currently, it is common practice to use three-dimensional (3D) printers not only for rapid prototyping in the industry, but also in the medical area to create medical applications for training inexperienced surgeons. In a clinical training simulator for minimally invasive bone drilling to fix hand fractures with Kirschner-wires (K-wires), a 3D-printed hand phantom must not only be geometrically but also haptically correct. Due to a limited view during an operation, surgeons need to perfectly localize underlying risk structures only by feeling of specific bony protrusions of the human hand. Methods: The goal of this experiment is to imitate human soft tissue with its haptic and elasticity for a realistic hand phantom fabrication, using only a dual-material 3D printer and support-material-filled metamaterial between skin and bone. We present our workflow to generate lattice structures between hard bone and soft skin with iterative cube edge (CE) or cube face (CF) unit cells. Cuboid and finger shaped sample prints with and without inner hard bone in different lattice thickness are constructed and 3D printed. Results: The most elastic available rubber-like material is too firm to imitate soft tissue. By reducing the amount of rubber in the inner volume through support material (SUP), objects become significantly softer. Without metamaterial, after disintegration, the SUP can be shifted through the volume and thus the body loses its original shape. Although the CE design increases the elasticity, it cannot restore the fabric form. In contrast to CE, the CF design increases not only the elasticity but also guarantees a local limitation of the SUP. Therefore, the body retains its shape and internal bones remain in its intended place. Various unit cell sizes, lattice thickening and skin thickness regulate the rubber material and SUP ratio. Test prints with higher SUP and lower rubber material percentage appear softer and vice versa. This was confirmed by an expert surgeon evaluation. Subjects adjudged pure rubber-like material as too firm and samples only filled with SUP or lattice structure in CE design as not suitable for imitating tissue. 3D-printed finger samples in CF design were rated as realistic compared to the haptic of human tissue with a good palpable bone structure. Conclusions: We developed a new dual-material 3D print technique to imitate soft tissue of the human hand with its haptic properties. Blowy SUP is trapped within a lattice structure to soften rubber-like 3D print material, which makes it possible to reproduce a realistic replica of human hand soft tissue.

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Force-feedback-assisted Bone Drilling Simulation Based on CT Data

Cited by 2 publications

References 6 publications

Optically tracked and 3D printed haptic phantom hand for surgical training system

Optically tracked and 3D printed haptic phantom hand for surgical training system

Imitating human soft tissue on basis of a dual-material 3D print using a support-filled metamaterial to provide bimanual haptic for a hand surgery training system

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