Virtual reality (VR)-based surgical simulator systems offer a very elegant approach to enriching and enhancing traditional training in endoscopic surgery. However, while a number of VR simulator systems have been proposed and realized in the past few years, most of these systems are far from being able to provide a reasonably realistic surgical environment. We explore the current limits for realism and the approaches to reaching and surpassing those limits by describing and analyzing the most important components of VR-based endoscopic simulators. The feasibility of the proposed techniques is demonstrated on a modular prototype system that implements the basic algorithms for VR training in gynaecologic laparoscopy.

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