Abstract：Physicians educated with traditional surgical training modes cannot meet the current surge in demand for knee joint patients. The aim of this work is to develop a simulation system based on virtual reality technology for the personalized knee replacement surgery. The virtual geometric models of knee joint and instruments were established by 3D reconstruction and CAD modeling technology respectively. We studied the voxelization algorithm and applied it to generate the virtual physical models. By using coordinate match method, the force model of the instrument was established between the device interface and the proxy. The AABB bounding box hierarchy tree was used as the collision detection model, we applied the overlapped intersect way to simulate deformation of tissue and the single point constraint force rendering to simulate the operation process. By setting up the hardware platform consisting of Phantom Omni and computer, and configuring the software environment CHAI 3D and OpenGL, the virtual knee replacement surgery simulation system was constructed. We compared the training time of the actual surgical operation of the professionals who experienced system with that of the control group, and used a questionnaire survey to make assessment of the system. Results showed that the system achieved the simulation of tissue deformation and force haptic feedback of drilling and osteotomy along the planned path in TKA, and the real-time performance of the system was excellent, the visual and haptic update frequency was maintained at 60 Hz and 1000 Hz respectively. The statistical results illustrated that there was a statistically significant difference (P=0.04) in the actual operation time between the two groups, the questionnaire results were all above the average excellent level (P<0.05). The constructed simulation system provides a safe, reliable and effective mode for medical training and preoperative drilling of TKA.
王春娟, 刘非, 张维杰, 马建兵, 姚舒馨, 肖琳, 程咏华, 徐显辉, 连芩, 王琦, 张明娇. 支持力反馈的个性化膝关节置换虚拟手术仿真系统的研究与构建[J]. 中国生物医学工程学报, 2018, 37(6): 694-704.
Wang Chunjuan, Liu Fei, Zhang Weijie, Ma Jianbing, Yao Shuxin, Xiao Lin, Cheng Yonghua, Xu Xianhui, Lian Qin, Wang Qi, Zhang Mingjiao. Research and Development of Virtual Surgery Simulation System with Haptic Feedback for Personalized TKA. Chinese Journal of Biomedical Engineering, 2018, 37(6): 694-704.
[1] Kurtz SM, Ong KL, Lau E, et al. International survey of primary and revision total knee replacement[J]. International Orthopaedics, 2011, 35 (12): 1783-1789. [2] Liu Fei, Tennessee UO. Research progress in the total knee arthroplasty[J]. Chinese Journal of Bone & Joint, 2016, 5 (10): 757-764. [3] 裴福兴. 中国髋、膝关节置换的现状及展望[J]. 中国骨与关节杂志, 2012, (1): 4-8. [4] Satava RM. Medical virtual reality: The current status of the future[J]. Studies in Health Technology & Informatics, 1996, 29: 100-100. [5] 程强强, 刘小平, 徐少平. 虚拟手术训练系统中软组织切割模型的研究进展[J]. 中国生物医学工程学报, 2015, 34 (4): 464-474. [6] 陈卫东, 赵成龙, 朱奇光,等. 虚拟手术中软组织形变建模及力反馈算法研究[J]. 中国生物医学工程学报, 2013, 32 (1): 114-118. [7] 徐少平, 李春泉, 江顺亮,等. 基于无网格的软组织切割模型的研究进展[J]. 中国生物医学工程学报, 2012, 31 (1): 123-128. [8] Coles T, Meglan D, John NW. The role of haptics in medical training simulators: a survey of the state of the art [J]. IEEE Transactions on Haptics, 2010, 4 (1): 51-66. [9] Hamza-Lup FG, Bogdan CM, Popovici DM, et al. A survey of visuo-haptic simulation in surgical training[C]//The 3rd International Conference on Mobile, Hybrid, and On-line Learning. Guadeloupe:IARIA, 2011: 57-62. [10] Wu Fule, Chen Xiaojun, Lin Yanping, et al. A virtual training system for maxillofacial surgery using advanced haptic feedback and immersive workbench[J]. International Journal of Medical Robotics & Computer Assisted Surgery, 2014, 10 (1): 78-87. [11] 于歌, 王党校, 张玉茹. 面向牙齿钻削手术仿真的体建模方法[J]. 高技术通讯, 2010, 20 (3): 314-319. [12] 王涛. 虚拟胆囊手术仿真系统相关技术研究[D]. 哈尔滨: 哈尔滨工程大学, 2014. [13] Wu Jun, Yu Ge, Wang Dangxiao, et al. Voxel-based interactive haptic simulation of dental drilling[C]// ASME 2009 International Design Engineering Technical Conferences &Computers and Information in Engineering. San Diego:ASME, 2009: 39-48. [14] Morris D, Sewell C, Barbagli F, et al. Visuohaptic simulation of bone surgery for training and evaluation[J]. IEEE Computer Graphics & Applications, 2006, 26 (6): 48-57. [15] Morris D. Haptics and physical simulation for virtual bone surgery[D]. California: Stanford University, 2006. [16] 盛国栋, 曹其新. 基于力反馈的虚拟脊柱手术模拟系统的构建[J]. 电子技术应用, 2013, 39 (12): 129-131. [17] 廖登宏, Alidad F, 廖书恒, 等. 基于力反馈的个性化口腔种植钻孔手术仿真系统研发[J]. 中国数字医学, 2017, 12 (3): 18-20. [18] Lin Yangping, Wang Xudong, Wu Fule, et al. Development and validation of a surgical training simulator with haptic feedback for learning bone-sawing skill[J]. Journal of Biomedical Informatics, 2014, 48 (2): 122-129. [19] 吴福乐. 颅颌面外科虚拟培训与手术导航关键技术研究及应用系统开发[D]. 上海: 上海交通大学, 2014. [20] Arbabtafti M, Moghaddam M, Nahvi A, et al. Physics-based haptic simulation of bone machining[J]. IEEE Transactions on Haptics, 2011, 4 (1): 39-50. [21] Arbabtafti M, Moghaddam M, Nahvi A, et al. Virtual bone surgery using a haptic robot[J]. International Journal of Robotics, 2009, 1 (1): 1-11. [22] Chan S, Li P, Locketz G, et al. High-fidelity haptic and visual rendering for patient-specific simulation of temporal bone surgery[J]. Computer Assisted Surgery, 2016, 21 (1): 85-101. [23] Hsieh, Ming-Shium, Ming-Dar Tsai, and Yi-Der Yeh. An amputation simulator with bone sawing haptic interaction[J]. Biomedical Engineering Applications Basis & Communications, 2012, 18 (5): 229-236. [24] Pinto ML, Sabater JM, Sofrony J, et al. Haptic simulator for training of Total Knee Replacement[C]// The 3rd IEEE RAS and EMBS International Conference on Biomedical Robotics and Biomechatronics. New York: IEEE, 2010: 221-226. [25] Massie TH. The PHANTOM haptic interface:A device for probing virtual objects[C]//Proceedings of the ASME Winter Meeting, Symposium on Haptic Interfaces for Virtual Environment and Teleoperator Systems. San Diego:ASME, 1994:295-301. [26] Conti F, Barbagli F, Dan M, et al. CHAI: An Open-Source Library for the Rapid Development of Haptic Scenes[C]//IEEE World Haptics. New York: IEEE, 2005:1-1.
