Virtualreality (VR) is a computer technology that uses virtual reality headsets ormulti-projected environments, sometimes in combination with physicalenvironments or props, to generate realistic images, sounds and othersensations that simulate a user’s physical presence in a virtual or imaginaryenvironment. A person using virtual reality equipment is able to “lookaround” the artificial world, and with high quality VR move around in itand interact with virtual features or items. The effect is commonly created byVR headsets consisting of a head-mounted display with a small screen in frontof the eyes, but can also be created through specially designed rooms withmultiple large screens1.VRsystems that include transmission of vibrations and other sensations to theuser through a game controller or other devices are known as haptic systems.This tactile information is generally known as force feedback in medical, videogaming and military training applications. Virtual reality also refers toremote communication environments which provide a virtual presence of userswith through tele presence and tele-existence or the use of a virtual artifact(VA).
The immersive environment can be similar to the real world in order tocreate a lifelike experience grounded in reality or sci-fi. Augmented realitysystems may also be considered a form of VR that layers virtual informationover a live camera feed into a headset, or through a smart phone or tabletdevice. 1.
2ABOUT VIRTUAL SURGERYAvirtual surgery is a computer-assisted surgical procedure simulation intendedfor training and preparing doctors for actual procedures. This allows surgeonsto practice delicate operations without potentially risking a patient’s life.Along with detailed three-dimensional images of the bodily organs involved inthe operation, advanced setups include haptic technology, a tactile feedbacksystem that simulates the pressure exerted back by the virtual organs. Theresult is a sophisticated simulation in which the user can both see and feelthe virtual surgery to a realistic degree. Mostvirtual surgery procedures utilize a combination of computerized tomography(CT) and magnetic resonance imaging (MRI) scans to create an in-depth three-dimensionalmodel of the organ and the patient.
The combination of scans allows surgeons tosee both the surface and interior of the Organat all times. Motion sensors attached to the operating tools simulate anyaction taken towards the virtual organs, allowing surgeons to manipulate theimage as they would during an actual surgery. Haptic technology devices, on theother hand, simulate the physical experience of the operation through acombination of force, motion, and vibration based on the surgeon’s movements.All these elements combine to allow a surgeon to “touch” a virtualorgan, manipulate it, and feel the results.
Chapter2LITERATURESURVEY Virtual reality (VR) has challenged the way weperceive the world and user experience is being explored to achieve animmersive and effective experience. However, the commercial effects and impactof this technology lacks sufficient research. It is hence uncertain which rolevirtual reality has in information systems nowadays. This systematic literaturereview (SLR) focuses on the commercial impact of virtual reality and whichfield of study this technology is most used. To answer this question, areference manual was used from literature review protocol standards and carriedout. Results show that VR systems have a wide specter of applications and asignificant potential for revolutionizing our everyday life in the digitalworld. The opposing forces of increased training expectations andreduced training resources have greatly impacted health professions education.
Virtual patients (VPs), which take the form of interactive computer-basedclinical scenarios, may help to reconcile this paradox.We summarize research on VPs,highlight the spectrum of potential variation and identify an agenda for futureresearch. We also critically consider the role of VPs in the educationalarmamentarium 1.? We proposethat VPs’ most unique and cost-effective function is to facilitate and assessthe development of clinical reasoning. Clinical reasoning in experts involves anon-analytical process that matures through deliberate practice with multipleand varied clinical cases.
Virtual patients are ideally suited to this task.Virtual patients can also be used in learner assessment, but scoring rubricsshould emphasize non-analytical clinical reasoning rather than completeness ofinformation or algorithmic approaches. Potential variations in VP design arepractically limitless, yet few studies have rigorously explored design issues.More research is needed to inform instructional design and curricularintegration.? Virtual patientsshould be designed and used to promote clinical reasoning skills. More researchis needed to inform how to effectively use VPs. .Chapter3METHODOLOGY3.
1NEED OF VIRTUAL SURGERYIn surgery, the life of the patient is ofutmost importance many patient have lost lives because of surgical errors. VRprovide good tool to experiment the various complications arise during surgery.With the cadaver becoming a rarity and beingconsidered unethical and impractical the virtual surgery system holds a greatpromise. With these kind of systems surgery residents can perform a particularkind of surgery for a zillionth time without the need of an actual patient.As this system shows and also points outmistakes, the aspiring surgeons can always learn from their mistakes gives a newclinician a chance to mess up with a virtual patient (and learn from it) ratherthan messing up with a real patient2. As the touch enabled simulators usedin virtual surgery system allow users to practice their skills on computerswithout the use of costly cadavers, it’s quite cost effective.With the use of forcefeedback system these systems combine the visual and factual information with asense of touch which gives the feel of operating on alive patient.
Research by Yaleuniversity medical professional shows that surgeons trained with virtualsurgery perform 24 pc faster than ordinary surgeons. 3.2VIRTUALSURGERY IN DETAILSIt is a virtual reality technique ofsimulating surgery procedure. It helps surgeons in improving surgery plans. Theypractice surgery process on 3D models. Virtual surgical tools or gloves areconnected to motion sensors where the users can physically feel the differencein simulated tissue and organs.The virtual surgeryworks, when the patient come in forprocedure, they get scanned and a 3D dimensional double is generated With processes like MRI scan ,CT scan theprocess of making a virtual double of you starts. Then after using processeslike VR environment and simulation the process proceeds3.
Then taking standardhuman measurements of male/female body the simulated image is brought to life. Variouscomplex software’s, real-time fluid dynamics theory and SensAble pvt. Technology’sGHOST software’s are needed to move into the final image. 3.2.
1 VIRTUALREALITYVirtual reality isa generalization of the standard visual simulation paradigm where the model andactions used in the simulated world are extracted from various sensors andinformation retrieval system. The resulting visual simulation aims at an exactrepresentation of the real world. With VR space we can navigate, interact, immerse,and feel the presence of the actual material world. It reduces the need of physicalprototype and improves product ergonomics and functionality. And the mostappealing part is that it can present everything in three dimensions. 3.2.
2VIRTUAL REALITY SIMULATION1. 3D Image Simulation Generate a 3D modeldepending upon this simulation needed anatomical images can be derived fromseries of patient’s MRI or video recording, which are 2D images. Images aresegmented and constraints are imposed. Then we construct a reference model. Afterthat obtain final model by deforming the reference model.
Fig 3.1The PHANTOM haptic feedback device (SensAble Technologies, Cambridge MA, USA). The user holds asmall stylus and explores, in this case, a 3D virtual molecular structure 2.
2. Touch SimulationSimulating haptictouch sensation. Calculation of force applied to cut & punchers the varioustissues. Haptic goes a long way to make virtual reality simulators more life-like.Virtual Reality Simulators consist of program run the software to interact withvirtual environment.
The addition of hepatics to virtual environments hasprovided computer users with the ability of expression in multiple dimensions. `3.Force Feedback SystemThese force feedback systems provide the userthe same resistance or reaction from the VR environment as it would haveprovided in an actual environment .Otherwise known as haptic devices, these arecommercially produced by PHANTOM pvt.
Limited, USA .The haptic devices offerhigher fidelity, stronger forces and lower friction to the practicing surgeons.Without these force feedback systems the virtual surgery program would havebecome just like a video game .
These devices reproduce the feeling of moving and manipulating the surgicaltools within the patient’s anatomy and the flexibility to tailor the tactileexperience. Fig4.1 Force Feedback System Chapter 4APPLICATIONSOF VIRTUAL SURGERY4.1 TRAINING AND EDUCATION • There are manystriking similarities between pilots and surgeons. • They are always ready to manage life threateningsituation in an unpredictable environments very dynamically.• The surgeons used to follow text book imagesor cadavers for the training purposes. Today cadavers are limited insupply and generally allowing one time use only, so this virtualsurgery technology is becoming a training method of choices in mostmedical school.
• Thesevirtual reality models enable the use to perform a procedure countlesstimes which help the surgeon to strip away various layer of tissue and muscles to examine each organseparately, which result in a error less surgery. 4.2 SURGICALPLANING• Tradition wise thesurgery was planned, the surgeon inculcated the various parameter and procedure for surgery which heis calculated from his earlierexperiment. • He did not have exact idea how the surgerywas going to result which led to lots of errors and risking of the human life.• This virtual surgery technology helped in reducingthese errors and to plan the surgery in most efficient and reliable manner.4.3 IMAGE GUIDANCE • The integration of advance imagingtechnology, image processing and 3D graphical capabilities has led to greatinterest in image guided and computer- aided surgery. • This techniquehas been proved useful in robotic surgery.
4.4 TELESURGERY Remote surgery also known as telesurgery is the ability for adoctor to perform surgery on a patient even though they are notphysically in the same location. It is a form of telepresence. Arobot surgical system generally consists of one or more arms (controlled by thesurgeon), a master controller console, and a sensory system giving feedback tothe user.
Remote surgery combines elements of robotics, cutting edge communicationtechnology such ashigh-speed data connections and elements of management information systems. While the field of roboticsurgery is fairly well established,most of these robots are controlled by surgeons at the location of the surgery.Remote surgery is essentially advanced telecommuting for surgeons, where thephysical distance between the surgeon and the patient is immaterial.
Itpromises to allow the expertise of specialized surgeons to be available topatients worldwide, without the need for patients to travel beyond their localhospital. Chapter 5 IMAGEGALLERY Fig5.1 Cutting in Deformable Objects 3. Fig5.2 Cutting Deformable Model of Liver 3.
Fig 5.3Virtual Reality to explore a patient’s brain 6. Fig 5.4 The trainee’sview from within the VR environment 1. Chapter 66.1Advantages· Gives theopportunity to practice procedures and learn from mistakes.· Safeenvironment, mistakes aren’t hurting the “patient”.· Has anenjoyable, goal oriented, relaxed environment.
· Entices andintrigues 7 the future generations of doctors.· Programming canbe made to represent rare or new forms of disease or anatomical variations.· Doctors canpractice with these programs before doing the surgery on live patient.· It is realbecause you can get hepatic touch feedback which encourages your technique.· Patients can bebetter prepared for the operations they will undergo.
· Patients can gothrough their procedures, will better understand the trauma, they will be undergoingand realize the amount of recovery time needed. 6.2Disadvantages· Stillextremely expensive as the technology is ne and needs extensive programming.· Costdoesn’t meet widespread demand.· Couldencourage bad habits such as being unfocussed in the operating room· Doctor’sneed to be completely focused and concentrated.
· Thereis no way of virtually teach decision making, knowledge, and communicationskills 7.· Simulationcan’t teach mental aspects of being a surgeon.· Somepatients can find the process unsettling and back-out of operations.
Chapter7CONCLUSIONMedicalvirtual surgery has a long way to go in the coming era. The use of computeraided and image guided technique has helped a lot in the advancement of medical science. Virtual reality in medicine is a subject of active researchis in the area of medicine.
Human-computer interfaces such asforce-feedback and tactile interfaces which are important for medical use .Tissuemodeling techniques for simulation of organs. Display techniques we can expecta new generation of diagnostic medical imaging techniques that utilize virtualreality concepts for effective visualization of human anatomy new telemedicineapplications. Virtual patients should be designedand used to promote clinical reasoning skills.
More research is needed toinform how to effectively use VPs.