scholarly journals Development of a performance model for virtual reality tumor resections

2019 ◽  
Vol 131 (1) ◽  
pp. 192-200 ◽  
Author(s):  
Robin Sawaya ◽  
Ghusn Alsideiri ◽  
Abdulgadir Bugdadi ◽  
Alexander Winkler-Schwartz ◽  
Hamed Azarnoush ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Brain Tumor ◽  
Medical Students ◽  
Direct Contact ◽  
Tumor Volume ◽  
Tumor Resection ◽  
Performance Model ◽  
Hypothetical Model ◽  
Study Results ◽  
And Task

OBJECTIVEPrevious work from the authors has shown that hand ergonomics plays an important role in surgical psychomotor performance during virtual reality brain tumor resections. In the current study they propose a hypothetical model that integrates the human and task factors at play during simulated brain tumor resections to better understand the hand ergonomics needed for optimal safety and efficiency. They hypothesize that 1) experts (neurosurgeons), compared to novices (residents and medical students), spend a greater proportion of their time in direct contact with critical tumor areas; 2) hand ergonomic conditions (most favorable to unfavorable) prompt participants to adapt in order to optimize tumor resection; and 3) hand ergonomic adaptation is acquired with increasing expertise.METHODSIn an earlier study, experts (neurosurgeons) and novices (residents and medical students) were instructed to resect simulated brain tumors on the NeuroVR (formerly NeuroTouch) virtual reality neurosurgical simulation platform. For the present study, the simulated tumors were divided into four quadrants (Q1 to Q4) to assess hand ergonomics at various levels of difficulty. The spatial distribution of time expended, force applied, and tumor volume removed was analyzed for each participant group (total of 22 participants).RESULTSNeurosurgeons spent a significantly greater percentage of their time in direct contact with critical tumor areas. Under the favorable hand ergonomic conditions of Q1 and Q3, neurosurgeons and senior residents spent significantly more time in Q1 than in Q3. Although forces applied in these quadrants were similar, neurosurgeons, having spent more time in Q1, removed significantly more tumor in Q1 than in Q3. In a comparison of the most favorable (Q2) to unfavorable (Q4) hand ergonomic conditions, neurosurgeons adapted the forces applied in each quadrant to resect similar tumor volumes. Differences between Q2 and Q4 were emphasized in measures of force applied per second, tumor volume removed per second, and tumor volume removed per unit of force applied. In contrast, the hand ergonomics of medical students did not vary across quadrants, indicating the existence of an “adaptive capacity” in neurosurgeons.CONCLUSIONSThe study results confirm the experts’ (neurosurgeons) greater capacity to adapt their hand ergonomics during simulated neurosurgical tasks. The proposed hypothetical model integrates the study findings with various human and task factors that highlight the importance of learning in the acquisition of hand ergonomic adaptation.

scholarly journals P.079 Development of a performance model for virtual reality tumor resections

2018 ◽  
Vol 45 (s2) ◽  
pp. S37-S37 ◽  
Author(s):  
R Sawaya ◽  
G Alsideiri ◽  
A Bugdadi ◽  
A Winkler-Schwartz ◽  
H Azarnoush ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Brain Tumor ◽  
Medical Students ◽  
Tumor Volume ◽  
Performance Model ◽  
Total Force ◽  
Haptic Information ◽  
Tumor Removal ◽  
Hypothetical Model ◽  
And Task

Background: This work proposes a hypothetical model that integrates human factors (e.g. inherent ability and acquired expertise) and task factors (e.g. pre-procedural data, visual and haptic information) to better understand the hand ergonomics adaptation needed for optimal safety and efficiency during simulated brain tumor resections. Methods: Hand ergonomics of neurosurgeons, residents and medical students were assessed during simulated brain tumors resection on the NeuroVR virtual reality neurosurgical simulation platform. Spatial distribution of time expended, force applied, and tumor volume removed, and other metrics were analyzed in each tumor quadrant (Q1 to Q4). Results: Significant differences were observed between the most favorable hand ergonomics condition (Q2) and the unfavorable hand ergonomics condition (Q4). Neurosurgeons applied more total force, more mean force, and removed less tumor per unit of force applied in Q4. However, total volume removed was not significant between the two quadrants indicating hand ergonomics adaptation in order to maximize tumor removal. In comparison, hand ergonomics of medical students remained unchanged in all quadrants, indicating a learning phenomenon. Conclusions: Neurosurgeons are more capable of adapting their hand ergonomics during simulated brain tumor resections. Our proposed hypothetical model integrates our findings with the literature and highlights the importance of experience in the acquisition of adaptive hand ergonomics.

Neurosurgical virtual reality simulation metrics to assess psychomotor skills during brain tumor resection

2014 ◽  
Vol 10 (5) ◽  
pp. 603-618 ◽  
Author(s):  
Hamed Azarnoush ◽  
Gmaan Alzhrani ◽  
Alexander Winkler-Schwartz ◽  
Fahad Alotaibi ◽  
Nicholas Gelinas-Phaneuf ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Brain Tumor ◽  
Tumor Resection ◽  
Psychomotor Skills ◽  
Virtual Reality Simulation ◽  
Brain Tumor Resection

Tremor Assessment during Virtual Reality Brain Tumor Resection

2020 ◽  
Vol 77 (3) ◽  
pp. 643-651
Author(s):  
Samaneh Siyar ◽  
Hamed Azarnoush ◽  
Saeid Rashidi ◽  
Rolando F. Del Maestro
Keyword(s):  
Virtual Reality ◽  
Brain Tumor ◽  
Tumor Resection ◽  
Brain Tumor Resection

scholarly journals Virtual reality simulation of robotic transsphenoidal brain tumor resection: Evaluating dynamic motion scaling in a master-slave system

2018 ◽  
Vol 15 (1) ◽  
pp. e1953 ◽  
Author(s):  
Saúl A. Heredia-Pérez ◽  
Kanako Harada ◽  
Miguel A. Padilla-Castañeda ◽  
Murilo Marques-Marinho ◽  
Jorge A. Márquez-Flores ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Brain Tumor ◽  
Tumor Resection ◽  
Slave System ◽  
Virtual Reality Simulation ◽  
Dynamic Motion ◽  
Brain Tumor Resection ◽  
Motion Scaling ◽  
Master Slave System

scholarly journals P.215 Tumor Heatmaps – Feedback Tool for Virtual Reality Neurosurgical Simulation

2021 ◽  
Vol 48 (s3) ◽  
pp. S82-S82
Author(s):  
R Sawaya ◽  
R Yilmaz ◽  
A Bugdadi ◽  
A Winkler-Schwartz ◽  
H Azarnoush ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Spatial Distribution ◽  
Medical Students ◽  
Tumor Volume ◽  
Performance Metrics ◽  
Operative Procedures ◽  
Tumor Removal ◽  
Critical Areas ◽  
Competency Based ◽  
Junior Residents

Background: Performance Heatmaps were designed to visualize the spatial distribution of performance metrics during resection of complex tumors. This novel methodology provides experts (neurosurgeons) and trainees (residents and medical students) with visual feedback on their neurosurgical performance during operative procedures. Methods: Neurosurgeons (NS), senior residents (SR), junior residents (JR) and medical students (MS) performed resection of a complex tumor on the NeuroVR simulation platform. Metrics including time spent, force applied, and tumor volume removed were used to create Performance Heatmaps for each group. Results: During complex operative procedures, greater expertise correlated increased time spent in critical areas (NS = 121.0 s, SR = 103.0 s, JR = 86.1 s, MS = 84.9 s), increased force application (NS = 387 N, SR = 317 N, JR = 340 N, MS = 304 N), and increased tumor removal (NS = .096 cc, SR = .081 cc, JR = .074 cc, MS = .069 cc). Conclusions: Performance Heatmaps further our understanding of neurosurgical expertise by identifying key differences between experts (neurosurgeons) and trainees (residents and medical students). With the adoption of competency-based curricula, intuitive feedback tools will prove essential for trainees seeking surgical mastery.

scholarly journals Subjective anxiety ratings before and after stressful neurosurgical virtual reality tumor resection task

2015 ◽  
Vol 42 (S1) ◽  
pp. S42-S42
Author(s):  
A Winkler-Schwartz ◽  
J Fares ◽  
B Khalid ◽  
M Baggiani ◽  
S Christie ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Medical Students ◽  
Tumor Resection ◽  
Tumor Removal ◽  
Surgical Performance ◽  
Surgical Simulators ◽  
Surgical Expertise ◽  
Before And After ◽  
Operative Performance ◽  
Junior Residents

Background: The availability of virtual reality (VR) surgical simulators affords the opportunity to assess the influence of stress on neurosurgical operative performance in a controlled laboratory environment. This study sought to examine the effect of a stressful VR neurosurgical task on the subjective anxiety ratings of participants with varying levels of surgical expertise. Methods: Twenty four participants comprised of six staff neurosurgeons, six senior neurosurgical residents (PGY4-6), six junior neurosurgical residents (PGY1-3), and six senior medical students took part in a bimanual VR tumor removal task with a component of sudden uncontrollable intra-operative bleeding. State Trait Anxiety Inventory (STAI) questionnaires were completed immediately pre and post the stress stimulus. The STAI questionnaire consisted of six items (calm, tense, upset, relaxed, content and worried) measured on a Likert scale. Results: Significant increases in subjective anxiety ratings were noted in junior residents (p=0.005) and medical students (p=0.025) while no significant changes were observed for staff and senior neurosurgical residents. Conclusions: Staff and senior residents more effectively mitigate stress compared to junior colleagues in a VR operative environment. Further physiological correlates are needed to determine whether this increased anxiety is paralleled by physiological arousal and altered surgical performance.

Assessing performance in brain tumor resection using a novel virtual reality simulator

2013 ◽  
Vol 9 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Nicholas Gélinas-Phaneuf ◽  
Nusrat Choudhury ◽  
Ahmed R. Al-Habib ◽  
Anne Cabral ◽  
Etienne Nadeau ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Brain Tumor ◽  
Tumor Resection ◽  
Virtual Reality Simulator ◽  
Brain Tumor Resection

The force pyramid: a spatial analysis of force application during virtual reality brain tumor resection

2017 ◽  
Vol 127 (1) ◽  
pp. 171-181 ◽  
Author(s):  
Hamed Azarnoush ◽  
Samaneh Siar ◽  
Robin Sawaya ◽  
Gmaan Al Zhrani ◽  
Alexander Winkler-Schwartz ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Medical Student ◽  
Spatial Analysis ◽  
Medical Students ◽  
Brain Tumors ◽  
Tumor Resection ◽  
Study Groups ◽  
Student Groups ◽  
Force Application ◽  
Tier 3

OBJECTIVEVirtual reality simulators allow development of novel methods to analyze neurosurgical performance. The concept of a force pyramid is introduced as a Tier 3 metric with the ability to provide visual and spatial analysis of 3D force application by any instrument used during simulated tumor resection. This study was designed to answer 3 questions: 1) Do study groups have distinct force pyramids? 2) Do handedness and ergonomics influence force pyramid structure? 3) Are force pyramids dependent on the visual and haptic characteristics of simulated tumors?METHODSUsing a virtual reality simulator, NeuroVR (formerly NeuroTouch), ultrasonic aspirator force application was continually assessed during resection of simulated brain tumors by neurosurgeons, residents, and medical students. The participants performed simulated resections of 18 simulated brain tumors with different visual and haptic characteristics. The raw data, namely, coordinates of the instrument tip as well as contact force values, were collected by the simulator. To provide a visual and qualitative spatial analysis of forces, the authors created a graph, called a force pyramid, representing force sum along the z-coordinate for different xy coordinates of the tool tip.RESULTSSixteen neurosurgeons, 15 residents, and 84 medical students participated in the study. Neurosurgeon, resident and medical student groups displayed easily distinguishable 3D “force pyramid fingerprints.” Neurosurgeons had the lowest force pyramids, indicating application of the lowest forces, followed by resident and medical student groups. Handedness, ergonomics, and visual and haptic tumor characteristics resulted in distinct well-defined 3D force pyramid patterns.CONCLUSIONSForce pyramid fingerprints provide 3D spatial assessment displays of instrument force application during simulated tumor resection. Neurosurgeon force utilization and ergonomic data form a basis for understanding and modulating resident force application and improving patient safety during tumor resection.

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