A virtual environment for training in microsurgery

Microsurgery is a well-established medical field, and involves repair of approximately 1mm vessels and nerves under an operating microscope in order to reattach severed fingers or transfer tissues for reconstruction. Initial skills in microvascular surgery are usually developed in the animal lab and subsequently in the operating room. Development of these skills typically requires about 6 months of animal based training before additional learning takes place in the operating room. We have developed a virtual reality computer system that allows the user to realistically simulate vessel anastomosis and is able to monitor the progress of the trainee as well as compare the performance to an experienced microsurgeon. The system consists of a graphics workstation with stereo glasses. Real microsurgery instruments were adapted and used as input devices so that the surgeons experience would be as realistic as possible. An electromagnetic tracking device was mounted on these instruments to provide 3-D localization and orientation. Using a physically based model, two vessels were simulated in the virtual environment. Through the tracked instruments the user is able to perform microsurgical anastomoses. The system evaluates the surgeon's performance based on a number of heuristics.