Virtual Reality for Supporting Surgical Planning

Virtual Reality for Supporting Surgical Planning

Sandra Leal (University Hospitals‘Virgen del Rocío’, Spain), Cristina Suarez (University Hospitals‘Virgen del Rocío’, Spain), J. M. Framinan (University of Seville, Spain), Carlos Luis Parra (University Hospitals‘Virgen del Rocío’, Spain) and Tomás Gómez (University Hospitals ‘Virgen del Rocío’, Spain)
DOI: 10.4018/978-1-61520-670-4.ch029
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Nowadays many surgical procedures are still carried out based on the skills and manual dexterity of each surgeon. The complexity and variability of the operations (very dependent on anatomical and functional personal characteristics), the difficulty of sharing and transferring the acquired knowledge, and the problems for surgeons to train in a realistic context make up a very complex scenario. In this sense, Virtual Reality (VR) provide supporting for surgical training and planning. VR permits modeling, simulation and visualization techniques using 3-D, anatomical predictive models, which are based on realistic models of tissues and organs. The usage of these technologies as a support for surgical planning results in a reduction of the uncertainty in the surgical process, a decrease in the risks for the patients, as well as an improvement of the results. This chapter presents a case of study of a Virtual Reality tool for supporting surgical planning, called VirSSPA, that has been already successfully applied in the University Hospital “Virgen del Rocio” (Seville-Spain).
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In this Section we describe the state-of-the-art regarding the application of VR in healthcare by first presenting the applications of this technique in the surgical context, and secondly by showing its main technical issues.

Key Terms in this Chapter

Business Process Management: A systematic approach to improving an organization’s business processes. The objective is to align an organization with the wants and needs of clients. It is a holistic management approach that promotes business effectiveness and efficiency while striving for innovation, flexibility and integration with technology. As organizations strive for attainment of their objectives, Business Process Management attempts to continuously improve processes - the process to define, measure and improve your processes – a ‘process optimization’ process. The border between this term and Business Process Modelling (described below) is usually confused.

Finite Element Analysis: Finite Element Analysis (FEA) was first developed in 1943 by R. Courant, who utilized the Ritz method of numerical analysis and minimization of variational calculus to obtain approximate solutions to vibration systems. FEA consists of a computer model of a material or design that is stressed and analyzed for specific results. It is used in new product design, and existing product refinement. There are generally two types of analysis that are used in industry: 2-D modeling, and 3-D modeling. While 2-D modeling conserves simplicity and allows the analysis to be run on a relatively normal computer, it tends to yield less accurate results. 3-D modeling, however, produces more accurate results while sacrificing the ability to run on all but the fastest computers effectively. Within each of these modeling schemes, the programmer can insert numerous algorithms (functions) which may make the system behave linearly or non-linearly. Linear systems are far less complex and generally do not take into account plastic deformation. Non-linear systems do account for plastic deformation, and many also are capable of testing a material all the way to fracture.

Metrica Version 3: Is a methodology of planning, development and maintenance of information systems. It has been promoted by the Ministry of Public Administrations of the Government of Spain for the systematization of activities of the life cycle of the software projects in the scope of the public administrations. This own methodology is based on the model of processes of the life cycle of development ISO/IEC 12207 (Information Technology - Software Life Cycle Processes) as well as on norm ISO/IEC 15504 SPICE (Software Process Improvement And Assurance Standards Capability Determination).

Simulation: Simulation is the imitation of some real thing, state of affairs, or process. The act of simulating something generally entails representing certain key characteristics or behaviours of a selected physical or abstract system. Simulation is used in many contexts, including the modeling of natural systems or human systems in order to gain insight into their functioning. Other contexts include simulation of technology for performance optimization, safety engineering, testing, training and education. Simulation can be used to show the eventual real effects of alternative conditions and courses of action. Key issues in simulation include acquisition of valid source information about the referent, selection of key characteristics and behaviours, the use of simplifying approximations and assumptions within the simulation, and fidelity and validity of the simulation outcomes. In this case, the simulation allows surgeons to know the optimal solution for the surgical intervention, since they could plan the patient interventions

Business Process Modelling (BPM): In the field of Business Process Management, Business Process Modelling techniques and methodologies enable a better process description, considering all the involved factors (resource, activities, workflow, organization, etc.). BPM alows capturing a general scheme of activities and business procedures, and defining all their elements (i.e. objectives, inputs, outputs, resources, activity sequences and events). In systems engineering and software engineering is the activity of representing processes of an enterprise, so that the current (“as is”) process may be analyzed and improved in future (“to be”). BPM is typically performed by business analysts and managers who are seeking to improve process efficiency and quality.

Rapid Prototyping (RP): Is the automatic construction of physical objects using solid freeform fabrication. Rapid prototyping takes virtual designs from computer aided design (CAD) or animation modeling software, transforms them into thin, virtual, horizontal cross-sections and then creates each cross-section in physical space, one after the next until the model is finished. Medical researchers are using rapid prototyping technology to produce artificial limbs, prosthetic implants, and surgical-planning models of internal body structures faster and more accurately than ever before.

Segmentation: The aim of image segmentation is the partition of the image in homogeneous regions. Segmentation refers to the process of partitioning a digital image into multiple segments (sets of pixels). The goal of segmentation is to simplify and/or change the representation of an image into something that is more meaningful and easier to analyze. Image segmentation is typically used to locate objects and boundaries (lines, curves, etc.) in images. More precisely, image segmentation is the process of assigning a label to every pixel in an image such that pixels with the same label share certain visual characteristics. The result of image segmentation is a set of segments that collectively cover the entire image, or a set of contours extracted from the image (see edge detection). Each of the pixels in a region are similar with respect to some characteristic or computed property, such as color, intensity, or texture. Adjacent regions are significantly different with respect to the same characteristic(s). Appendix A shows the bone segmentation of the image.

Reconstructive Operation: Reconstruction operation is one kind of the surgery that helps patients of all ages and types - whether it’s a child with a birth defect, a young adult injured in an accident, or an older adult with a problem caused by aging. The goals of reconstructive surgery differ from those of cosmetic surgery. Reconstructive surgery is performed on abnormal structures of the body, caused by birth defects, developmental abnormalities, trauma or injury, infection, tumors, or disease. It is generally performed to improve function, but may also be done to approximate a normal appearance. Cosmetic surgery is performed to reshape normal structures of the body to improve the patient’s appearance and self-esteem. There are two basic categories of patients of reconstructive surgery: those who have congenital deformities, otherwise known as birth defects, and those with developmental deformities, acquired as a result of accident, infection, disease, or in some cases, aging. Some common examples of congenital abnormalities are birthmarks; cleft-lip and palate deformities; hand deformities such as syndactyly (webbed fingers), or extra or absent fingers; and abnormal breast development. Burn wounds, lacerations, growths, and aging problems are considered acquired deformities. Large, sagging breasts are one example of a deformity that develops as a result of genetics, hormonal changes, or disease. Breast reduction, or reduction mammaplasty, is the reconstructive procedure designed to give a woman smaller, more comfortable breasts in proportion with the rest of her body.

DIC OM: Digital Imaging and Communications in Medicine is a standard for handling, storing, printing, and transmitting information in medical imaging. It includes a file format definition and a network communications protocol. The communication protocol is an application protocol that uses TCP/IP to communicate between systems. DICOM files can be exchanged between two entities that are capable of receiving image and patient data in DICOM format.

Virtual Reality (VR): Is the simulation of a real or imagined environment that can be experienced visually in the three dimensions of width, height, and depth and that may additionally provide an interactive experience visually in full real-time motion with sound and possibly with tactile and other forms of feedback. In others words, is the Collection of technologies that allow people to interact efficiently with 3D computerized databases in real time using their natural senses and skills.

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