Towards Realistic Surgical Simulation and Training Systems

目前，外科住院医师主要通过在动物、身体和病人身上进行试验来获得和发展动手技能。然而，这些传统的训练方法有明显的缺点：动物的解剖结构与人类不同；身体无法提供适当的生理反应；学生在病人身上练习是有风险的。随着触觉和计算机图形学的最新进展，基于视觉现实的手术模拟正在迅速出现，并越来越多地被视为传统训练方法的有价值的补充或替代。模拟器可以生成具有真实人体解剖和生理反应的虚拟患者，潜在地提供了一个无风险的训练环境，有可能对广泛的病理学进行无限制的训练。除了这些好处，新的复杂的手术程序可以在对患者进行操作之前在模拟器上安全地进行练习；学生可以按照自己的时间表进行练习；培训课程可以存储起来，稍后由医生审查。*虽然少数公司开始提供质量不同的手术模拟培训系统，但没有一家模拟器能够提供足够高的相似性来模拟现实生活中的手术。仍然存在许多根本性的挑战和技术困难，如触觉界面的灵巧性、虚拟患者模型的准确性、碰撞建模、手术场景的实时和沉浸式可视化等。*在本研究中，我们建议开发实现高真实感手术模拟所必需的原理、算法和工具，使医疗机构能够使用模拟器培训外科医生。由于潜在研究主题的广泛范围，我们将我们的努力限制在以下问题的子集上：1.触觉反馈、2.组织建模和3.验证标准。最终，预期结果将通过环甲切开术模拟器的开发进行整合和验证。*

At present, surgical residents acquire and develop hands-on skills mainly through trials on animals, cadavers and patients. There are, however, obvious disadvantages to these conventional training approaches: animals have different anatomies from humans; cadavers are unable to provide appropriate physiological responses; it is risky when students practice on patients.****    With recent advances in haptics and computer graphics, visual reality based surgical simulation is rapidly emerging and increasingly perceived as a valuable addition to, or replacement of, traditional training methods. Simulators can generate virtual patients with realistic human anatomy and physiological responses, potentially providing a risk-free training environment with the possibility of unlimited training over a wide range of pathologies. In addition to these benefits, new and complex surgical procedures can be practiced safely on a simulator before proceeding to patients; students can practice on their own schedules; training sessions can be stored and later reviewed by physicians.****    While a small number of companies are starting to offer surgical simulation training systems of varying quality, no simulators are able to provide a sufficiently high degree of resemblance to real-life surgery. There still exist numerous fundamental challenges and technical difficulties, such as the dexterity of haptic interfaces, accuracy of virtual patient models, collision modelling, real-time and immersive visualization of the operating scene, etc. ***    In this research, we propose to develop principles, algorithms and tools that are essential to realize highly realistic surgical simulation, enabling medical institutions to train surgeons using simulators. Due to the broad scope of potential research topics, we limit our efforts to a subset of problems including: 1. haptic feedback, 2. tissue modelling, and 3.validation criteria. At the end, the anticipated results will be integrated and validated by the development of a cricothyroidotomy simulator.***