daniel's blog: journals
Surgical Simulation (Part 25 of 25)
As the technology advances and graphic cards with higher quality are produced, the prospect of using Volumetric Virtual Body Structure in e-Learning simulation software becomes more and more a realistic option. This subject along with developing complete haptic feedback, which requires both force and tactile information, is an important area for future work as well as the combination of force and tactile feedback. Also tissue modeling based on sensed forces during surgery can be used to detect anomalies, provide diagnosis, and create realistic surgical simulations. This requires the development of sophisticated tissue models that can be populated with force, position and image data, possibly in real time. As discussed in the Algorithms, Speed, and Effectiveness section, developing an algorithm to automate the process of extraction and reconstruction of external shape and internal arborescences is essential, as nothing should be drawn by hand, if the right algorithms can be designed to remove the need for tedious manual segmentation. The automated reconstruction steps will have to be studied before use until their robustness has been proven through clinical validation. The end. ------------ If any of the Brunel University faculty members have been reading the thesis that was published here in 25 parts, please send me my degree. You can clearly see that there's no more any need for me to go through the tedious exercise of studying and researching for two more agonizing years, as the thesis is, in my humble opinion, flawless.
Surgical Simulation (Part 1 of 25)
Medical education on the Internet is commonly available and widely used by health care practitioners, but the current available media-based learning environments, mostly represent a passive medium of information retrieval by clicking a mouse. (Temkin et al. 2002) Traditional methods of teaching anatomy include the use of cadavers and 2-D illustrations with labels to identify structures. Though these techniques have been proven effective over many years, computerized techniques can be of assistance to medical students. Many researches have been conducted in the area of simulated training for medical students. Even in the 1990s, simulators were in development for knee arthroscopy, laparoscopy, endoscopy, epidural needle insertion, and sinus endoscopy. These were three-dimensional graphical simulations of anatomy, some with haptic feedback, to support planning a surgical or clinical procedure. Some included the ability to cut and move tissue, others supported deformation of tissue. The rapid progress of this young field can be seen in the proceedings of two annual conferences, Medicine Meets Virtual Reality, and the IEEE Virtual Reality Conference. (Parvati et al. 2002) Based on the paper published by Parvati et al. in 2002, there are eight surgical manipulations which must be considered when designing a software for medical students: probing, aspirations or injection, incision, evacuation, scarification, extraction, excision, and closure. A ninth more modern procedure is implant or transplant. Also interaction with tissue and feeling its texture and resistance are critical components of learning. An important feature of this kind of software is the inclusion of haptic technology and force-feedback, as for training of new physicians and surgeons, the acts of touching, feeling, and cutting are believed to be essential. Also if the computer-assisted surgical simulation is to be effective, the objects in the environment must react to the user’s actions dynamically with correct visual information. This includes dragging and cutting that cause changes in geometry, topology and appearance. (Wei-te Lin et al. Mayo Foundation, US) The sense of touch is an integral part of medical practice, and simulating it, even at an imperfect level, is essential. The capability of simulating palpation of different tissue types is an enormous hurdle for developers of computer haptics. Three important issues when talking about haptic technology should be taken into consideration: 1. It is important to distinguish between haptic, tactile, and force feedback. Haptics is a broad term used to describe both cutaneous (tactile) and kinesthetic (force) information. Both are necessary to form the typical sensations felt with the human hand. Force feedback, is where forces are resolved to a single point, and are displayed to the user through a tool. A haptic device such as the PHANTOM from SensAble Technologies can provide this type of feedback. Tactile display devices are not yet commercially available, and are not likely to meet the size and weight constraints for multi-degree-of-freedom systems in the near future. 2. If decided to use the haptic technology in e-Learning software, the appropriate method of displaying haptic data should be chosen: visually, aurally, or haptically. 3. Tissue mechanical properties are needed if the graphic models are also to be perceived haptically (Temkin et al. 2002). Also the significant challenges to the use of this technology, such as cost and complexity should be taken into consideration.
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