Virtual Neurosurgery- training for the future Michael Vloeberghs1, Tony Glover2, Steve Benford
Real-time simulation of Neurosurgery
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Real-time simulation of NeurosurgeryIn practice, neurosurgical operations are limited to a small part of the exposed brain, which is identified from pre-operative imaging e.g. magnetic Resonance Imaging (MRI). MRI images can be imported directly into the original visualisation software. Only this part of the brain is rendered with a fine 3D mesh, while the other parts can remain relatively coarse meshed to save computing time. BE algorithms were developed by the authors for simulating the pushing, pulling, cutting e.g. using a bipolar forceps, retracting and two handed operating generally used in Neurosurgery. When the haptic device is moved by the user, a contact search algorithm detects which points are in contact. If the haptic device penetrates the virtual surface, the penetration displacement is used as a displacement in the BE software. The feedback forces are simultaneously computed as reaction forces and fed back to the user via the haptic device. The graphics are updated accordingly in real time.
An especially challenging aspect of simulating surgery is the real-time simulation of the surgical cutting i.e. incising the cortex with a bipolar forceps. The initial cut is created as a gap between existing surface elements. New surface elements are created in the direction of the cutting plane, without altering the original surface mesh. (Figures 2-6) 
(a) Pulling action 
(b) Pushing action Figure 2: Examples showing pulling and pushing actions 
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