NeuroTouch: a physics-based virtual simulator for cranial microneurosurgery training.

BACKGROUND A virtual reality neurosurgery simulator with haptic feedback may help in the training and assessment of technical skills requiring the use of tactile and visual cues. OBJECTIVE To develop a simulator for craniotomy-based procedures with haptic and graphics feedback for implementation by universities and hospitals in the neurosurgery training curriculum. METHODS NeuroTouch was developed by a team of more than 50 experts from the National Research Council Canada in collaboration with surgeons from more than 20 teaching hospitals across Canada. Its main components are a stereovision system, bimanual haptic tool manipulators, and a high-end computer. The simulation software engine runs 3 processes for computing graphics, haptics, and mechanics. Training tasks were built from magnetic resonance imaging scans of patients with brain tumors. RESULTS Two training tasks were implemented for practicing skills with 3 different surgical tools. In the tumor-debulking task, the objective is complete tumor removal without removing normal tissue, using the regular surgical aspirator (suction) and the ultrasonic aspirator. The objective of the tumor cauterization task is to remove a vascularized tumor with an aspirator while controlling blood loss using bipolar electrocautery. CONCLUSION NeuroTouch prototypes have been set up in 7 teaching hospitals across Canada, to be used for beta testing and validation and evaluated for integration in a neurosurgery training curriculum.