Application of Virtual Reality Techniques for Treatment of Anorectal Malformations

盆腔结构的三维(3D)图像有助于立体地了解肛门直肠畸形患者手术前后的解剖状态。基于积累的知识和3D解剖学考虑，我们已经开始开发手术模拟软件。本研究的目的是基于X线、CT或MRI获得肛门直肠畸形患者盆腔结构的三维图像数据，并应用虚拟现实处理等计算机图形技术开发实用的手术仿真软件。在开发有用的计算机化手术模拟系统时，程序工程师和外科医生之间的密切合作是不可或缺的。从外科医生的角度来看，这种协作需要图像处理。为此，本研究通过传输数据文件和程序文件利用互联网进行交流，并于1997年建立了校际间通过互联网进行交流的协作系统，并发表了临床考虑和初步结果。1998年，在程序员和外科医生的密切磋商下，为先天性肛门直肠疾病患者开发了可在个人计算机上运行的手术模拟软件。在开发的程序中。实现了用于外科手术的图像处理，包括通过渲染、去除或切割手术模拟组织来改善图像。在虚拟现实技术的应用方面，人们尝试了基本的图像处理，但计算机的能力阻碍了将该技术应用于临床环境，这被认为是下一步要实现的目标。

Three-dimensional (3D) images of the pelvic structure have been shown useful to apprehend pre- and postoperative anatomical state stereoscopically of the patients with anorectal malformation. Based upon accumulated knowledge and 3D anatomical consideration, we had had started developing surgical simulation softwares. The purpose of the research was to obtain three-dimensional image data of the pelvic structure of the patients with anorectal malformation based upon X-ray CT or MRI and to apply computer graphic techniques such as virtual reality processings to develope a useful surgical simulation softwares. In developing a useful computerized surgical simulation system, it is indispensable for program engineers and surgeons to collaborate intimately. Such collaboration would necessitate image processings which are requested from the surgeon's point of view. Thus the research was carried out by communicating with each other using internet by transferring data files and program files.In 1997, collaborateing system was established between schools by communicating via Internet and the clinical considerations and preliminary results were published. In 1998, surgical simulation softwares which work in personal computers for patients with congenital anorectal disease were developed with close consultations between progranmers and a surgeon. In the program developed. image processings useful for surgery which include improving images by rendering, removing or cutting tissues for the surgical simulation were achiebved. In terms of applying the virtual reality techniques, basic image processing was attempted but the computer's power hindered applying the technique for clinical settings, which is considered to be the next goal to be achieved.