Paracentesis modeling and VR-based interactive simulation with haptic display for clinical skill training and assessment

In this paper we describe the development of an interactive virtual reality (VR) system that aims to realistically simulate specific paracentesis clinical procedures (particularly the procedure involved in the catheterization of the subclavian vein). Two elastostatic finite element (FE) models are developed to enable physically based simulation of the deformable tissues, particularly skin deflection during needle insertion. The first one is a two-dimensional approximation FE model, while the second one is a further simplified 1D model with inhomogeneous properties. Simulation results from both FE models are compared to real experimental data available in the literature (reporting on human skin deformation profiles) and demonstrate their applicability for realtime interactive applications under the specific constraints and assumptions of the paracentesis simulation application considered in this paper. Furthermore, a haptic feedback device is coupled with the VR-based simulation to provide the user with realistic feeling of the interaction forces applied during the simulated paracentesis procedure. The system described in this paper is developed in the frames of a research project aiming to develop a larger-scale virtual environment simulator of emergency room scenarios and protocols for clinical skill training and assessment.