Virtual reality in brain intervention: models and applications

Abstract

Human body models are key components of VR surgical simulators. We overview here our efforts and share experience in constructing cerebral models and using them in VR-based applications for brain intervention. We have constructed four groups of brain atlases: anatomical, functional, vascular, and physically-based. The atlas-assisted VR systems discussed here are applied to stereotactic and functional neurosurgery, interventional neuroradiology, and brain stereotaxy. We also briefly feature our concept of future surgery.

Cerebral Endovascular Neurosurgery

“…Even with the beautiful three-dimensional images that can now be generated, the working views on the road map remain two-dimensional with only preprocessed images helping to predict where a coil will lie in complex anatomy or suggesting the anatomic relationship of an implanted device such as a stent (76). Virtual reality software is being designed in which a patient's vascular imaging data set can be manipulated and the treatment strategies "war-gamed" for the best solution; these systems also provide fertile ground for training new endovascular surgeons (111,155). Real-time MRI, which has been used experimentally, offers the promise of being able to treat patients with the aid of real-time three-dimensional imaging (145).…”

Preparing for Conjoined Twins Separation Through Virtual Reality

“…Inexpensive commercially available hardware can be setup at home [1,2], while corporations are using VR to design mechanical systems and train pilots [3,4]. However, limited application is seen in the medical field.Most medical VR simulation focus on medical training, by incorporating anatomical models, physics models, haptics, and visualization to recreate surgical procedures [4][5][6]. These simulations teach foundational technical skills and show value for preoperative planning and image-guided surgery [4,7].…”

“…Simulations provide opportunities to develop surgical plans [7], and practice teamwork skills [8]. Studies have shown that expenses of implementing VR technology can be offset by reduced operating room time [5] and s can shape the operating room of the future [6].Procedural planning using VR shows positive results for patient outcomes. One study looking at VR use for procedural planning found an increase in operational success, a decrease in 30-day mortality and an estimated cost savings by incorporating 3D imaging [9].…”

“…A second study saw increase confidence in 14 of 16 study participants when virtual reality rehearsals were used prior to the procedure [5].Conjoined twins are very unique cases that require advanced planning to ensure the wellbeing of both patients. The separation of craniopagus conjoined twins in 1997 is the first record of using VR for preoperative separation planning [6]. The medical team used VIVIAN, a Dextroscope-based VR environment designed for neurosurgeries.…”

“…The technology assisted with three craniopagus conjoined twins separations from 1997 to 2004 [6,10,11]. VR technology presented the spatial relationships between anatomy and pathology to simulate the techniques needed during the surgery [6].In summary, we present the first case to our knowledge of VR used to assist in the separation planning of thoraco-omphalopagus conjoined twins; a connection at the chest, that includes sharing a heart and may also involve sharing their liver and digestive system.…”