Surgical Simulation - Needle Insertion
Motivation: The development of complex surgical procedures coupled with more stringent regulations on medical education has recently promoted the need for developing reality-based surgical simulators for medical training. Regulations on the maximum working hours permitted (80 hours per week) for medical residents limits the amount of time available to practice common surgical tasks such as needle insertion, probing, and electrocauterizing tissue. Additionally, fatalities related to surgical procedures constitute the seventh highest mortality rate in the United States. In light of these facts, surgical simulators need to be developed to provide thorough training for common surgical tasks. Currently there exists a large divide between two types of simulators: those with superior visualization (such as LapSim and SurgicalSim systems) and those with superior haptic interfaces (such as LapMentor and Reachin systems). The joining of these two technology areas would provide a far superior platform to instill the knowledge and expertise needed for successful surgical training.
- Ex vivo needle insertion and RF Ablation experiments on pig breast tissues: We have constructed a 1-DOF device that can accurately insert a needle into a soft tissue sample while acquiring the forces acting on the needle under continuous magnetic resonance imaging (MRI). Experiments will be performed on pig breast tissue with embedded fiducials for tracking the soft tissue deformation during the needle insertion tasks. We will be performing the experiments with a surgical needle used for radiofrequency (RF) ablation. The MRI will also be used to construct temperature maps during a RF ablation procedure to determine the effect of the ablation procedure on the tissue.
- Modeling of needle insertion and RF Ablation procedure: The data from the ex vivo experiments performed in MRI will be used to generate models for tissue deformation during needle insertion and heat transfer during a typical (RF) ablation procedure. The needle insertion task will be split into the following subtasks for modeling purposes: deformation prior to puncture, insertion following puncture, tissue relaxation, and withdrawal. The ex vivo models with subsequently be modified to incorporate differences between ex vivo and in vivo tissue response.
- Development of a real-time simulator for needle insertion and RF Ablation: A real-time simulator will be developed with realistic visualization and haptic display. The simulator will incorporate both the needle insertion procedure and RF ablation on breast tissue for the purpose of surgical training. The graphic display will capable of presenting both 3D models and a representation similar to current MRI images in both ex vivo and in vivo states.
- James T. Hing, Ari D. Brooks, and Jaydev P. Desai, “A Biplanar Fluoroscopic Approach for the Measurement, Modeling, and Simulation of Needle and Soft tissue Interaction”, Medical Image Analysis, pp. 62-78, Volume 11, Issue 1, February 2007.