Introduction - Microsurgery: Advances, Simulations, and Applications - page 10

for laparoscopic surgery relying on virtual reality environment and
motion capture with inertia sensors in [32].
Global Rating Index for Technical Skills for medical training were
introduced for laparoscopic surgery in [24] and extended later on
in [25], both of them consider irst evaluation criteria the respect
for tissue. The technology for simulator-based training in medicine
is being developed to correspond to the technological advances
in minimally invasive surgery. The beneits of simulator-based
training has been shown for endovascular intervention by [26]
and for endoscopic intervention by [27]. They found that the use
of simulators during training improves the resident's performance,
decreases the risk to the patient's safety during supervised practice,
and reduces the instruction time. However, it still needed to develop
a quantitative evaluation method based on GRITS for endovascular
surgery simulation.
Simulators for endovascular intervention may be classiied
into two groups corresponding to the approach used for human
vasculature modeling: hardware or software. Simulators based on
virtual reality environments for blood vessel modeling reproduce
also in software the motion of the catheters and guide wires as well as
other intravascular tools deployment. The intravascular devices and
blood vessel interaction is transmitted to the operator using force
feedback at the insertion port. These ports accept a limited number
of standard catheter and guide wires without lubrication; contrast
media injection is simulated by air injection in a secondary port.
However, inside the virtual reality, a large number of intravascular
devices and blood vessel morphologies and diseases are selectable
[26]. In early stages, vasculature modeling in hardware was done
using glass [28]. Then merging to softer and transparent materials,
models of human vasculature were built from corrosion cast of
vascular lumen of diseased human specimen [29]. Nowadays most
advanced modeling techniques are based on silicone elastomer
and enable DICOM data fusion, reproduce the human vasculature,
and will be presented in detail in the following chapters [1]. These
simulators offer the advantage that enables to insert any standard
intravascular devices into the silicone vasculature and offers a
realistic representation of the interaction between these devices,
human blood vessel morphology, and low circulation (Fig. 1.7).
Modeling human vasculature with transparent photoelastic
materials enables stress visualization and analysis during the