Hip surgery and tumour removal remains the mainstay of treatment for complex hip revisions. However, success is dependent on appropriate planning, which includes using computer tomography (CT) among other imaging techniques such as magnetic resonance imaging (MRI) scans to visualise the bone, tissues, the tumour and its characteristics. At present this provides a 2-D image of a 3-D problem. Virtual Reality (VR) makes it now possible to construct visual and physical 3D models of individual patient's anatomy including the tumour. By incorporating techniques, which analyse signal characteristics, highly accurate models can be created that facilitate the addition of physical interaction such as haptic (tactile and kinaesthetic) feedback to the model.
This will result in a highly accurate model providing far greater detail for surgical planning and also allowing a surgical 'dry-run' before the actual procedure, which will improve patient outcomes and encourage simulation training for more junior surgeons. These models could also be used to inform patients during their pre-surgery consultations allowing them to have a better understanding of the cancer and what the surgery entails. Although the idea of both virtual and augmented reality has been in the public consciousness for some time, there is little evidence of it being used beyond the acquisition of basic surgical techniques. Recently technological advances have allowed the development of haptic feedback that creates a more realistic surgical environment by being able to mimic tissue textures, weight and dynamics.
The subsequent models that have been created have proven to be useful in developing further novel surgical skills. These concepts can be made more clinically relevant by directly applying expertise from computer programming and engineering to build personalised models of a patient's anatomy. This means that pre-operative surgical planning can be more individualised and allow surgeons to better understand the oncological and surgical anatomy (how to create the best maps to guide the surgeon's drill to avoid damaging other tissue), which underpin the success of surgery and survival outcomes. Currently there is no model developed that simulates complex revision hip surgery and due to the steep learning curve a realistic interactive model incorporating bone and soft tissues will be a valuable tool to aid in training.
Aim and objectives
The project aim is to develop an immersive VR system for the training of complex revision hip surgery that will:
- Use CT/MRI data to create the first patient-specific interactive virtual (and augmented) reality model for surgical planning and training;
- Provide realistic step-by-step 3D visualisation and tactile feel of the tissues to the user through a high-fidelity haptic feedback robotic system;
- Assess the model and VR operation accuracy and utility against the patient's recorded surgery in a live clinical environment.
Supervisors:
Rui Loureiro
Alister Hart