Cerebral Aneurysm Clipping Training Simulator using Virtual Reality and Haptics

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DESCRIPTION (provided by applicant): ImmersiveTouch, Inc. (Westmont, Illinois) is a small business that develops fully immersive, visio-haptic virtual reality software engineered into a hardware workstation for the training of surgical residents. This workstation, the Company's simulator seeks to provide residents with the repeated, deliberate virtual reality practice that will give them skills for the operating room without risk to patients. ImmersiveTouch R&D relies on a close university-company Partnership: Dr. Banerjee, a professor of Engineering at University of Illinois at Chicago (UIC), is one of the inventors on the patent-pending ImmersiveTouch technology and the patent is assigned to UIC, which licenses the technology to ImmersiveTouch, Inc. A collaborator on this proposal and co-owner of ImmersiveTouch, Dr. Fady Charbel, is head of Neurosurgery at UIC and the inventor of the Charbel Micro- Flowprobe for intracranial surgery, which has been successfully marketed by Transonic Systems, Inc. Today, about 85% of intracranial aneurysms are treated endovascularly, e.g., by aneurysm coiling. There are already commercial virtual reality trainers for aneurysm coiling, such as the Mentice VIST". This means that today, only 15% of cerebral aneurysms are treated by open craniotomy and aneurysm clipping as pioneered by M. G. Yasargil. There is insufficient training time and patient load for residents to be trained or for many attending physicians to retain their skill level in aneurysm clipping. There is no validated simulator for this. The goal of this STTR Phase I application is to produce a new simulation of cerebral aneurysm clipping for training neurosurgeons in the treatment or prevention of subarachnoid hemorrhage and other forms of stroke. ImmersiveTouch already has experience in neurosurgery simulation, having perfected a simulator for ventricular catheter placement (funded by NIST). This simulation has been tested for its construct validity (the simulator accurately measures different levels of OR experience) and is currently funded by the AHRQ for clinical evaluation of its concurrent validity, testing whether simulator skills in ventriculostomy actually translate to the operating room. Within neurosurgery, the Company also has a prototype simulation of pedicle screw placement in spinal surgery funded by NIBIB (R21), and plans to simulate removal of specific brain tumors (e.g., acoustic neuromas). The Company is also active in ophthalmology, with a simulator for capsulorhexis during cataract surgery funded by NEI, and is working on open cholecystectomy. Selection of the particular cerebral aneurysm for simulation. About 80% of the cerebral aneurysms requiring intervention form on arteries that arise from the internal carotid artery: anterior cerebral, anterior communicating, posterior communicating, and middle cerebral artery (MCA). While Phase II of this STTR may focus on aneurysms on all these arteries, Phase I is a proof-of-concept. Therefore for illustration, the proposal focuses on an aneurysm at the bifurcation of the MCA, where its main stem, M1, branches into two secondary arteries, M2 (another aneurysm could be chosen for the final model). This location can be reached by creating an opening in the Sylvian fissure. The two major parts of the surgery are therefore opening the Sylvian fissure to reach the aneurysm and then clipping the aneurysm to ensure that it is fully isolated from the main blood flow and that no surrounding arteries have been accidentally clipped. PUBLIC HEALTH RELEVANCE: ImmersiveTouch Inc. develops innovative augmented virtual reality systems for training of neurosurgical residents. In collaboration with the University of Illinois at Chicago, the Partnership proposes to conduct research to overcome some of the current technical barriers. If successful, following STTR Phases I and II, the ImmersiveTouch-SENSIMMER Neurosurgical Trainer will overcome challenges leading to evaluation of cerebral aneurysm clipping and other derivative neurosurgical procedures,