Haptic-enabled virtual training in orthognathic surgery

Medellín-Castillo, Hugo I.; Zaragoza-Siqueiros, Jorge; Govea-Valladares, Eder H.; Garza-Camargo, Hector de la; Lim, Theodore; Ritchie, James Millar

doi:10.1007/s10055-020-00438-6

Cited by 12 publications

(5 citation statements)

References 25 publications

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“…Hence, operators can still acquire realistic experience of making incisions on facial skin through this system. Tactile feedback was proved to be meaningful for operators to practice skills and improve their performance [ 13 , 30 ]. In most of proposed virtual surgical systems, haptic feedback was not realized or haptic rendering was not authentic for the reasons that interaction between surgical instruments and bio-tissue has not been studied too much and real deformation and experimental force data are insufficient.…”

Section: Discussionmentioning

confidence: 99%

Development of a maxillofacial virtual surgical system based on biomechanical parameters of facial soft tissue

et al. 2022

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Purpose Lack of biomechanical force model of soft tissue hinders the development of virtual surgical simulation in maxillofacial surgery. In this study, a physical model of facial soft tissue based on real biomechanical parameters was constructed, and a haptics-enabled virtual surgical system was developed to simulate incision-making process on facial soft tissue and to help maxillofacial surgery training. Methods CT data of a 25-year-old female patient were imported into Mimics software to reconstruct 3D models of maxillofacial soft and skeletal tissues. 3dMD stereo-photo of the patient was fused on facial surface to include texture information. Insertion and cutting parameters of facial soft tissue measured on fresh cadavers were integrated, and a maxillofacial biomechanical force model was established. Rapid deformation and force feedback were realized through localized deformation algorithm and axis aligned bounding box (AABB)-based collision detection. The virtual model was validated quantitatively and qualitatively. Results A patient-specific physical model composed of skeletal and facial soft tissue was constructed and embedded in the virtual surgical system. Insertion and cutting in different regions of facial soft tissue were simulated using omega 6, and real-time feedback force was recorded. The feedback force was consistent with acquired force data of experiments conducted on tissue specimen. Real-time graphic and haptic feedback were realized. The mean score of the system performance was 3.71 given by surgeons in evaluation questionnaires. Conclusion The maxillofacial physical model enabled operators to simulate insertion and cutting on facial soft tissue with realization of realistic deformation and haptic feedback. The combination of localized deformation algorithm and AABB-based collision detection improved computational efficiency. The proposed virtual surgical system demonstrated excellent performance in simulation and training of incision-making process.

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Section: Discussionmentioning

confidence: 99%

Development of a maxillofacial virtual surgical system based on biomechanical parameters of facial soft tissue

et al. 2022

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“…On the other side, according to the surgical specialty considered, these systems can make trainees deal with various complex hazards, rarely occurring in practice in OR, but potentially very dangerous if not carefully faced. This is especially the case of specialties involving drilling or burring, like mastoidectomy (27), orthognathic (28) and dental implantation (29), and orthopedic surgery (30).…”

Section: Discussionmentioning

confidence: 99%

Augmented Reality in Medical Practice: From Spine Surgery to Remote Assistance

et al. 2021

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Background: While performing surgeries in the OR, surgeons and assistants often need to access several information regarding surgical planning and/or procedures related to the surgery itself, or the accessory equipment to perform certain operations. The accessibility of this information often relies on the physical presence of technical and medical specialists in the OR, which is increasingly difficult due to the number of limitations imposed by the COVID emergency to avoid overcrowded environments or external personnel. Here, we analyze several scenarios where we equipped OR personnel with augmented reality (AR) glasses, allowing a remote specialist to guide OR operations through voice and ad-hoc visuals, superimposed to the field of view of the operator wearing them.Methods: This study is a preliminary case series of prospective collected data about the use of AR-assistance in spine surgery from January to July 2020. The technology has been used on a cohort of 12 patients affected by degenerative lumbar spine disease with lumbar sciatica co-morbidities. Surgeons and OR specialists were equipped with AR devices, customized with P2P videoconference commercial apps, or customized holographic apps. The devices were tested during surgeries for lumbar arthrodesis in a multicenter experience involving author's Institutions.Findings: A total number of 12 lumbar arthrodesis have been performed while using the described AR technology, with application spanning from telementoring (3), teaching (2), surgical planning superimposition and interaction with the hologram using a custom application for Microsoft hololens (1). Surgeons wearing the AR goggles reported a positive feedback as for the ergonomy, wearability and comfort during the procedure; being able to visualize a 3D reconstruction during surgery was perceived as a straightforward benefit, allowing to speed-up procedures, thus limiting post-operational complications. The possibility of remotely interacting with a specialist on the glasses was a potent added value during COVID emergency, due to limited access of non-resident personnel in the OR.Interpretation: By allowing surgeons to overlay digital medical content on actual surroundings, augmented reality surgery can be exploited easily in multiple scenarios by adapting commercially available or custom-made apps to several use cases. The possibility to observe directly the operatory theater through the eyes of the surgeon might be a game-changer, giving the chance to unexperienced surgeons to be virtually at the site of the operation, or allowing a remote experienced operator to guide wisely the unexperienced surgeon during a procedure.

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“…Students’ feedback was quite positive. Medellin-Castillo et al [ 11 ] conducted three case studies to study haptics and virtual reality for the training of the orthognathic surgery (OGS), which is a very complex procedure that allows to correct a wide range of skeletal and dental irregularities, requiring surgical skills traditionally acquired through extended hands-on training using cadavers or models. Lin et al [ 12 ] evaluated the use of virtual reality technologies to assist in the training of the lateral ventricle puncture necessary for external ventricular drain.…”

Section: Background and Significancementioning

confidence: 99%

Application of Mixed Reality to Ultrasound-guided Femoral Arterial Cannulation During Real-time Practice in Cardiac Interventions

Alonso-Felipe,

Aguiar-Pérez,

Pérez-Juárez

et al. 2023

J Healthc Inform Res

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Mixed reality opens interesting possibilities as it allows physicians to interact with both, the real physical and the virtual computer-generated environment and objects, in a powerful way. A mixed reality system, based in the HoloLens 2 glasses, has been developed to assist cardiologists in a quite complex interventional procedure: the ultrasound-guided femoral arterial cannulations, during real-time practice in interventional cardiology. The system is divided into two modules, the transmitter module, responsible for sending medical images to HoloLens 2 glasses, and the receiver module, hosted in the HoloLens 2, which renders those medical images, allowing the practitioner to watch and manage them in a 3D environment. The system has been successfully used, between November 2021 and August 2022, in up to 9 interventions by 2 different practitioners, in a large public hospital in central Spain. The practitioners using the system confirmed it as easy to use, reliable, real-time, reachable, and cost-effective, allowing a reduction of operating times, a better control of typical errors associated to the interventional procedure, and opening the possibility to use the medical imagery produced in ubiquitous e-learning. These strengths and opportunities were only nuanced by the risk of potential medical complications emerging from system malfunction or operator errors when using the system (e.g., unexpected momentary lag). In summary, the proposed system can be taken as a realistic proof of concept of how mixed reality technologies can support practitioners when performing interventional and surgical procedures during real-time daily practice.

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Haptic-enabled virtual training in orthognathic surgery

Cited by 12 publications

References 25 publications

Development of a maxillofacial virtual surgical system based on biomechanical parameters of facial soft tissue

Development of a maxillofacial virtual surgical system based on biomechanical parameters of facial soft tissue

Augmented Reality in Medical Practice: From Spine Surgery to Remote Assistance

Application of Mixed Reality to Ultrasound-guided Femoral Arterial Cannulation During Real-time Practice in Cardiac Interventions

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