Virtual reality based hybrid simulation for functional endoscopic sinus surgery

Advances in Virtual Reality (VR) technology warrants the improvement of the training system to replicate surgical procedures. The VR-based training system has proved to be useful for surgical training by decreasing operative time and increasing patient safety. For example, Functional Endoscopic Sinus Surgery (FESS) is challenging due to the confined operating space surrounded by critical structures such as the eye, brain, and major blood vessels. Image-guided surgery in FESS enables the use of real-time navigation of surgical instruments to preoperative imaging. This paper demonstrates the development of a surgical simulator which facilitates trainees in three-fold. First, the identification and segmentation of critical structures in head and neck become achievable through the VR-based simulator. Second, the simulator supports to rehearse the surgical steps on a model of patient-specific anatomy. Finally, experiencing VR cues during surgical training facilitates faster recognition of anatomical landmarks. Standard computed tomography (CT) medical imaging data were utilized to develop a VR-based hybrid simulation. The validation study reveals that haptic feedback and visual/audio cues in the simulator supports the enhancement of operational accuracy and efficiency. Moreover, the proposed system works as a training tool, which will reduce patient morbidity and mortality.