Chirurgische Ausbildung im digitalen Zeitalter – Virtual Reality, Augmented Reality und Robotik im Medizinstudium

The digital transformation of healthcare is changing the medical profession. Augmented/Virtual Reality (AR/VR) and robotics are being increasingly used in different clinical contexts and require supporting education and training, which must begin within the medical school. There is currently a large discrepancy between the high demand and the number of scientifically proven concepts. The aim of this thesis was the conceptual design and structured evaluation of a newly developed learning/teaching concept for the digital transformation of medicine, with a special focus on the influence of surgical teaching.Thirty-five students participated in three courses of the blended learning curriculum "…

Virtual reality and 3D printing improve preoperative visualization of 3D liver reconstructions-results from a preclinical comparison of presentation modalities and user's preference.

BACKGROUND: Preoperative three-dimensional (3D) reconstructions for liver surgery planning have been shown to be effective in reduction of blood loss and operation time. However, the role of the ‘presentation modality’ is not well investigated. We present the first study to compare 3D PDFs, 3D printed models (PR) and virtual reality (VR) 3D models with regard to anatomical orientation and personal preferences in a high volume liver surgery center. METHODS: Thirty participants, 10 medical students, 10 residents, 5 fellows and 5 hepatopancreatobiliary (HPB) experts, assigned the tumor-bearing segments of 20 different patient’s individual liver reconstructions. Liver models were presented in a…

In Virtual Reality durch die Pandemie: Digitale Lehre mit modernster Technologie in der Leberchirurgie

Erweiterte Hemihepatektomie rechts mit Hepatikusgabelresektion und Rekonstruktion der Pfortadergabel und der linken Lebervene bei cholangiozellulärem Karzinom

ZusammenfassungDie vollständige Resektion gilt bei Patienten mit cholangiozellulärem Karzinom als Therapie der Wahl. Aufgrund der Tumorausdehnung sind hierbei Resektion und Rekonstruktion vaskulärer Strukturen häufig erforderlich. Dreidimensionale Rekonstruktionen der Schnittbildgebung können in diesen Fällen hilfreich für die Resektionsplanung sein. Das vorliegende Video zeigt eine erweiterte Hemihepatektomie rechts mit Hepatikusgabelresektion mit Resektion und Rekonstruktion der Pfortadergabel und einer von 2 linken Lebervenen bei einem intrahepatischen cholangiozellulären Karzinom.

An Interactive Demonstration of Collaborative VR for Laparoscopic Liver Surgery Training

We introduce a collaborative virtual reality (VR) system for planning and simulation in laparoscopic liver surgery training. Patient image data is used for surgical model visualization and simulation. We developed two modes for training in laparoscopic procedures: exploration and surgery mode. Surgical joysticks are used in surgery mode to provide training for psychomotor skills and cooperation between a camera assistant and an experienced surgeon. Continuous feedback from our clinical partner comprised an important part of the development. Our evaluation showed that surgeons were positive about the usability and usefulness of the developed system. For further details, please refer to our f…

Collaborative VR for Liver Surgery Planning using Wearable Data Gloves: An Interactive Demonstration

Preoperative planning for liver surgery is a critical procedure to assess a potential resection and it supports surgeons to define the affected vessels and resection volume. Traditional surgical planning systems are widely used to support the planning with the usage of desktop-based 3D and 2D visualizations. However, desktop-based systems offer limited interactions and visualizations compared to virtual reality (VR) [3]. A suitable technique to support collaboration among surgeons is required. Our previous works [1], [2] illustrate that using collaborative VR is essential to enhance communication, teamwork, and over-distance collaboration. In this work, we present a collaborative VR prototy…

A collaborative virtual reality environment for liver surgery planning

Abstract Surgical planning software is a key component in the treatment of tumor diseases. However, desktop-based systems provide only limited visualization and interaction opportunities. Moreover, collaborative planning among members of a surgical team is only possible to a limited extent. In this work, a collaborative virtual reality (VR) environment to assist liver surgeons in tumor surgery planning is presented. Our aim is to improve virtual resection planning between surgeons in a remote or co-located environment. The system allows surgeons to define and adjust virtual resections on patient-specific organ 3D surfaces and 2D image slices. Changes on both modalities are synchronized, whi…

3D-Druck, Virtual Reality oder regulärer Monitor? Vergleich unterschiedlicher Darstellungsmöglichkeiten dreidimensionaler Leberrekonstruktionen

Educational Team Time Out in der onkologischen Viszeralchirurgie: Ein Konzept zur Optimierung der Weiterbildung

Quality-based assessment of camera navigation skills for laparoscopic fundoplication.

Summary Laparoscopic fundoplication is considered the gold standard surgical procedure for the treatment of symptomatic hiatus hernia. Studies on surgical performance in minimally invasive hiatus hernia repair have neglected the role of the camera assistant so far. The current study was designed to assess the applicability of the structured assessment of laparoscopic assistance skills (SALAS) score to laparoscopic fundoplication as an advanced and commonly performed laparoscopic upper GI procedure. Randomly selected laparoscopic fundoplications (n = 20) at a single institute were evaluated. Four trained reviewers independently assigned SALAS scoring based on synchronized video and voice rec…

Collaborative Virtual Reality for Laparoscopic Liver Surgery Training

Virtual reality (VR) has been used in many medical training systems for surgical procedures. However, the current systems are limited due to inadequate interactions, restricted possibilities of patient data visualization, and collaboration. We propose a collaborative VR system for laparoscopic liver surgical planning and simulation. Medical image data is used for model visualization and manipulation. Additionally, laparoscopic surgical joysticks are used to provide an opportunity for a camera assistant to cooperate with an experienced surgeon in VR. Continuous clinical feedback led us to optimize the visualization, synchronization, and interactions of the system. Laparoscopic surgeons were …

A VR/AR Environment for Multi-User Liver Anatomy Education

We present a Virtual and Augmented Reality multi-user prototype of a learning environment for liver anatomy education. Our system supports various training scenarios ranging from small learning groups to classroom-size education, where students and teachers can participate in virtual reality, augmented reality, or via desktop PCs. In an iterative development process with surgeons and teachers, a virtual organ library was created. Nineteen liver data sets were used comprising 3D surface models, 2D image data, pathology information, diagnosis and treatment decisions. These data sets can interactively be sorted and investigated individually regarding their volumetric and meta information. The …