Real-Time Needle Force Modeling for VR-Based Renal Biopsy Training with Respiratory Motion Using Direct Clinical Data

Abstract

Realistic tool-tissue interactive modeling has been recognized as an essential requirement in the training of virtual surgery. A virtual basic surgical training framework integrated with real-time force rendering has been recognized as one of the most immersive implementations in medical education. Yet, compared to the original intraoperative data, there has always been an argument that these data are represented by lower fidelity in virtual surgical training. In this paper, a dynamic biomechanics experimental framework is designed to achieve a highly immersive haptic sensation during the biopsy therapy with human respiratory motion; it is the first time to introduce the idea of periodic extension idea into the dynamic percutaneous force modeling. Clinical evaluation is conducted and performed in the Yunnan First People’s Hospital, which not only demonstrated a higher fitting degree (AVG: 99.36%) with the intraoperation data than previous algorithms (AVG: 87.83%, 72.07%, and 66.70%) but also shows a universal fitting range with multilayer tissue. 27 urologists comprising 18 novices and 9 professors were invited to the VR-based training evaluation based on the proposed haptic rendering solution. Subjective and objective results demonstrated higher performance than the existing benchmark training simulator. Combining these in a systematic approach, tuned with specific fidelity requirements, haptically enabled medical simulation systems would be able to provide a more immersive and effective training environment.

Virtual Reality Head-Mounted Displays in Medical Education

“…For practicing sleeve gastrectomy, the participants' self-assessed mental and physical loads decreased 42 . Residents reported a better understanding of neurosurgery and anatomy, 28 and expert surgeons would recommend the use of a VR-HMD model as an educational framework 8 …”

“…3 Virtual reality (VR) simulation training has been suggested as a supplementary tool to address this problem. [4][5][6][7][8][9][10][11][12][13][14][15][16] It allows trainees to repetitively practice various skills without unwanted consequences. In addition, VR training allows trainees to progress through different levels of difficulty in reproducible learning environments.…”

Review on Needle Insertion Haptic Simulation

“…Li et al enhanced this setup by simulating the fake probe with a second Touch interface to render probe-patient interaction forces (see Fig. 3) [14]. The originality of this study mainly concerns the methods Fig.…”

“…Figure 6 describes these phases and the total axial force pattern due to the penetration of the needle. These models have still been used in recent works such as [7,11,13,13,14,[24][25][26][27][28][29][30][31][32][33][34]. Recently, works focused on the ability to render multiple layers of tissues, using piece-wise exponential models [13] or nested boxes [25] rendering each one its stiffness and cutting forces according to [35].…”

“…Measuring devices usually rely on 6 DoF force sensors and means to track positions during insertions. The measurement apparatus can either be handheld by an expert surgeon [13,14,49] or be robotically inserted through tissues [14,51]. To improve the reliability of insertion tests into ex vivo tissues, Li et al developed a test platform that would record forces during needle insertion while simulating movements due to respiration [14].…”