Cerebral Aneurysm Clipping Training Simulator using Virtual Reality and Haptics

描述（由申请人提供）：ImmersiveTouch（R）虚拟现实-触觉神经外科手术模拟器：开颅术和动脉瘤夹闭术由ImmersiveTouch（R）Inc.的主要研究者Pat Banerjee博士创建。（韦斯特蒙，伊利诺伊州）是一家小企业，开发完全沉浸式的触觉虚拟现实软件，该软件被设计成硬件工作站，用于培训外科住院医生。该公司的模拟器为住院医生提供了重复的，并置的虚拟现实触觉练习，以加速学习和传授手术室技能，而不会给患者带来风险。脑（颅内）动脉瘤破裂是常见的，并且与高死亡率和发病率相关。动脉瘤的手术治疗具有挑战性，需要长时间的培训。这种培训是强制性的。ACGME神经外科住院医师审查委员会规定，住院医师病例量“应包括创伤、肿瘤、动脉瘤和血管畸形的开颅手术”。由于ImmersiveTouch模拟器已经在脑室造口术方面进行了教育验证，因此我们在此建议验证其用于MCA（大脑中动脉）分叉处的动脉瘤夹闭。传统开颅手术和动脉瘤夹闭术的住院医师培训压力越来越大。这是由于住院医师工作时间减少和动脉瘤夹闭术的病例量减少，超过一半的简单动脉瘤采用血管内方法治疗。现在有必要对神经外科医生进行额外的培训，使其能够胜任动脉瘤夹闭术。在伊利诺伊大学芝加哥分校，这是一个项目的合作伙伴，与芝加哥大学，超过90%的动脉瘤需要夹闭形式的动脉来自颈内动脉，包括MCA在M1-M2分支？该手术通过翼点开颅术进行，然后沿侧裂（MCA、其分支和动脉瘤所在的位置）沿着解剖。模拟将示教翼点开颅术、硬脑膜打开、沿预分离的侧裂沿着导航、动脉瘤夹闭和血流测试，以确保相邻血管的充分夹闭和通畅。第一阶段将患者CT体素数据转换为MCA分叉部动脉瘤和侧裂等的3D虚拟现实触觉模型。我们还在3D中对动脉瘤夹进行了建模。第二阶段的重点是编程模拟器开颅术，硬脑膜开放，动脉瘤夹闭，并确认。

DESCRIPTION (provided by applicant): IMMERSIVETOUCH(R) VIRTUAL REALITY-HAPTIC NEUROSURGERY SIMULATOR: CRANIOTOMY AND ANEURYSM CLIPPING Founded by principal investigator Dr. Pat Banerjee, ImmersiveTouch,(R) 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. The Company's simulator provides residents with repeated, collocated virtual reality-haptic practice needed to accelerate learning and impart skills for the operating room without risk to patients. Brain (intracranial) aneurysm rupture is common and is associated with high mortality and morbidity. The surgical treatment of aneurysms is challenging, requiring a long training period. Such training is mandated. The ACGME Residency Review Committee for Neurological Surgery stipulates that resident case load "should include craniotomies for trauma, neoplasms, aneurysms, and vascular malformations". Since the ImmersiveTouch simulator has already been educationally validated for ventriculostomy, we propose here to validate it for aneurysm clipping at the MCA (middle cerebral artery) bifurcation. There is increasing pressure on resident training in classic microneurosurgery by open craniotomy and aneurysm clipping. This is due to a reduction in resident work hours and a decreasing case load in aneurysm clipping, with more than half of simpler aneurysms treated with endovascular means. Additional means of training neurosurgeons to become competent at aneurysm clipping is now necessary. At University of Illinois at Chicago, which is a project partner along with University of Chicago, more than 90 percent of aneurysms requiring clipping form on arteries that arise from the internal carotid artery, including the MCA at the M1-M2 branch? This surgery is performed through a pterional craniotomy followed by dissection along the Sylvian fissure (where the MCA, its branches, and the aneurysm are located). The simulation will teach a pterional craniotomy, dural opening, navigation along a pre-dissected Sylvian fissure, clipping of the aneurysm and blood flow testing to ensure adequate clipping and patency of the adjacent vessels. Phase I converted patient CT voxel data into a 3D virtual reality-haptic model of an MCA bifurcation aneurysm and the Sylvian fissure, etc. We also modeled aneurysm clips in 3D. Phase II focuses on programming the simulator for craniotomy, dural opening, and aneurysm clipping, and on validation.