Biomedical Engineering Reference
In-Depth Information
8
VIRTUAL REALITY, INTRAOPERATIVE
NAVIGATION, AND
TELEPRESENCE SURGERY
M. Peter Heilbrun
Department of Neurosurgery, Stanford University
Medical Center, Stanford, California
A part of the expertise of the operating surgeon is the practiced development of motor
skills. These skills are attained by practice in multiple environments, including the animal
laboratory and the operating room. The surgeon starts as a surgical assistant and gradu-
ally is granted increased responsibilities in performing the critical portions of operative
procedures. Building on many years of experience using types of radiographic images of
the brain and spine for intraoperative navigation, neurosurgeons, working with bioengi-
neers and computer scientists, have developed methods of image-guided computer-
assisted and computer-directed operative procedures using anatomic and pathologic
structures identified in volumetric three dimension reformatted brain and spine images
co-registered to the physical operative workspace using a variety of three-dimensional
digitizers. With the computation power available today, such image sets can be used to
create a virtual environment within which a surgeon could realistically both practice
skills and attain new skills. This can now be accomplished with partial immersion. It is
realistic to contemplate in the near future a total immersion environment realistically
simulating all of the sensations and forces associated with an actual operative field. We
have termed this development a "surgical holodeck." This chapter reviews the develop-
ment and application of these methods, which are the foundation of a simulation envi-
ronment close to the real operative suite.
Address correspondence to: M. Peter Heilbrun, Professor of Neurosurgery, Department of Neuro-
surgery, Stanford University Medical Center, 300 Pasteur Drive, Room 200, Stanford CA 94305-
5327 (peter.heilbrun@stanford.edu).
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