Practice on an augmented reality/haptic simulator and library of virtual brains improves residents' ability to perform a ventriculostomy

Rachel Yudkowsky, Cristian Luciano, Pat Banerjee, Alan Schwartz, Ali Alaraj, G. Michael Lemole, Fady Charbel, Kelly Smith, Silvio Rizzi, Richard Byrne, Bernard Bendok, David Frim

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

INTRODUCTION: Ventriculostomy is a neurosurgical procedure for providing therapeutic cerebrospinal fluid drainage. Complications may arise during repeated attempts at placing the catheter in the ventricle. We studied the impact of simulation-based practice with a library of virtual brains on neurosurgery residents' performance in simulated and live surgical ventriculostomies. METHODS: Using computed tomographic scans of actual patients, we developed a library of 15 virtual brains for the ImmersiveTouch system, a head- and hand-tracked augmented reality and haptic simulator. The virtual brains represent a range of anatomies including normal, shifted, and compressed ventricles. Neurosurgery residents participated in individual simulator practice on the library of brains including visualizing the 3-dimensional location of the catheter within the brain immediately after each insertion. Performance of participants on novel brains in the simulator and during actual surgery before and after intervention was analyzed using generalized linear mixed models. RESULTS: Simulator cannulation success rates increased after intervention, and live procedure outcomes showed improvement in the rate of successful cannulation on the first pass. However, the incidence of deeper, contralateral (simulator) and third-ventricle (live) placements increased after intervention. Residents reported that simulations were realistic and helpful in improving procedural skills such as aiming the probe, sensing the pressure change when entering the ventricle, and estimating how far the catheter should be advanced within the ventricle. CONCLUSIONS: Simulator practice with a library of virtual brains representing a range of anatomies and difficulty levels may improve performance, potentially decreasing complications due to inexpert technique.

Original languageEnglish (US)
Pages (from-to)25-31
Number of pages7
JournalSimulation in Healthcare
Volume8
Issue number1
DOIs
StatePublished - Feb 2013
Externally publishedYes

Fingerprint

Digital Libraries
Ventriculostomy
Augmented reality
Augmented Reality
Haptics
Brain
brain
Simulator
Simulators
resident
ability
Catheters
Neurosurgery
Anatomy
Complications
Catheterization
Cerebrospinal fluid
Neurosurgical Procedures
performance
Generalized Linear Mixed Model

Keywords

  • Augmented reality
  • Haptics
  • Neurosurgery
  • Simulation
  • Virtual reality

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Epidemiology
  • Education
  • Modeling and Simulation
  • Medicine(all)

Cite this

Practice on an augmented reality/haptic simulator and library of virtual brains improves residents' ability to perform a ventriculostomy. / Yudkowsky, Rachel; Luciano, Cristian; Banerjee, Pat; Schwartz, Alan; Alaraj, Ali; Lemole, G. Michael; Charbel, Fady; Smith, Kelly; Rizzi, Silvio; Byrne, Richard; Bendok, Bernard; Frim, David.

In: Simulation in Healthcare, Vol. 8, No. 1, 02.2013, p. 25-31.

Research output: Contribution to journalArticle

Yudkowsky, R, Luciano, C, Banerjee, P, Schwartz, A, Alaraj, A, Lemole, GM, Charbel, F, Smith, K, Rizzi, S, Byrne, R, Bendok, B & Frim, D 2013, 'Practice on an augmented reality/haptic simulator and library of virtual brains improves residents' ability to perform a ventriculostomy', Simulation in Healthcare, vol. 8, no. 1, pp. 25-31. https://doi.org/10.1097/SIH.0b013e3182662c69
Yudkowsky, Rachel ; Luciano, Cristian ; Banerjee, Pat ; Schwartz, Alan ; Alaraj, Ali ; Lemole, G. Michael ; Charbel, Fady ; Smith, Kelly ; Rizzi, Silvio ; Byrne, Richard ; Bendok, Bernard ; Frim, David. / Practice on an augmented reality/haptic simulator and library of virtual brains improves residents' ability to perform a ventriculostomy. In: Simulation in Healthcare. 2013 ; Vol. 8, No. 1. pp. 25-31.
@article{30db2f87a04246b79582542fdbf59937,
title = "Practice on an augmented reality/haptic simulator and library of virtual brains improves residents' ability to perform a ventriculostomy",
abstract = "INTRODUCTION: Ventriculostomy is a neurosurgical procedure for providing therapeutic cerebrospinal fluid drainage. Complications may arise during repeated attempts at placing the catheter in the ventricle. We studied the impact of simulation-based practice with a library of virtual brains on neurosurgery residents' performance in simulated and live surgical ventriculostomies. METHODS: Using computed tomographic scans of actual patients, we developed a library of 15 virtual brains for the ImmersiveTouch system, a head- and hand-tracked augmented reality and haptic simulator. The virtual brains represent a range of anatomies including normal, shifted, and compressed ventricles. Neurosurgery residents participated in individual simulator practice on the library of brains including visualizing the 3-dimensional location of the catheter within the brain immediately after each insertion. Performance of participants on novel brains in the simulator and during actual surgery before and after intervention was analyzed using generalized linear mixed models. RESULTS: Simulator cannulation success rates increased after intervention, and live procedure outcomes showed improvement in the rate of successful cannulation on the first pass. However, the incidence of deeper, contralateral (simulator) and third-ventricle (live) placements increased after intervention. Residents reported that simulations were realistic and helpful in improving procedural skills such as aiming the probe, sensing the pressure change when entering the ventricle, and estimating how far the catheter should be advanced within the ventricle. CONCLUSIONS: Simulator practice with a library of virtual brains representing a range of anatomies and difficulty levels may improve performance, potentially decreasing complications due to inexpert technique.",
keywords = "Augmented reality, Haptics, Neurosurgery, Simulation, Virtual reality",
author = "Rachel Yudkowsky and Cristian Luciano and Pat Banerjee and Alan Schwartz and Ali Alaraj and Lemole, {G. Michael} and Fady Charbel and Kelly Smith and Silvio Rizzi and Richard Byrne and Bernard Bendok and David Frim",
year = "2013",
month = "2",
doi = "10.1097/SIH.0b013e3182662c69",
language = "English (US)",
volume = "8",
pages = "25--31",
journal = "Simulation in Healthcare",
issn = "1559-2332",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Practice on an augmented reality/haptic simulator and library of virtual brains improves residents' ability to perform a ventriculostomy

AU - Yudkowsky, Rachel

AU - Luciano, Cristian

AU - Banerjee, Pat

AU - Schwartz, Alan

AU - Alaraj, Ali

AU - Lemole, G. Michael

AU - Charbel, Fady

AU - Smith, Kelly

AU - Rizzi, Silvio

AU - Byrne, Richard

AU - Bendok, Bernard

AU - Frim, David

PY - 2013/2

Y1 - 2013/2

N2 - INTRODUCTION: Ventriculostomy is a neurosurgical procedure for providing therapeutic cerebrospinal fluid drainage. Complications may arise during repeated attempts at placing the catheter in the ventricle. We studied the impact of simulation-based practice with a library of virtual brains on neurosurgery residents' performance in simulated and live surgical ventriculostomies. METHODS: Using computed tomographic scans of actual patients, we developed a library of 15 virtual brains for the ImmersiveTouch system, a head- and hand-tracked augmented reality and haptic simulator. The virtual brains represent a range of anatomies including normal, shifted, and compressed ventricles. Neurosurgery residents participated in individual simulator practice on the library of brains including visualizing the 3-dimensional location of the catheter within the brain immediately after each insertion. Performance of participants on novel brains in the simulator and during actual surgery before and after intervention was analyzed using generalized linear mixed models. RESULTS: Simulator cannulation success rates increased after intervention, and live procedure outcomes showed improvement in the rate of successful cannulation on the first pass. However, the incidence of deeper, contralateral (simulator) and third-ventricle (live) placements increased after intervention. Residents reported that simulations were realistic and helpful in improving procedural skills such as aiming the probe, sensing the pressure change when entering the ventricle, and estimating how far the catheter should be advanced within the ventricle. CONCLUSIONS: Simulator practice with a library of virtual brains representing a range of anatomies and difficulty levels may improve performance, potentially decreasing complications due to inexpert technique.

AB - INTRODUCTION: Ventriculostomy is a neurosurgical procedure for providing therapeutic cerebrospinal fluid drainage. Complications may arise during repeated attempts at placing the catheter in the ventricle. We studied the impact of simulation-based practice with a library of virtual brains on neurosurgery residents' performance in simulated and live surgical ventriculostomies. METHODS: Using computed tomographic scans of actual patients, we developed a library of 15 virtual brains for the ImmersiveTouch system, a head- and hand-tracked augmented reality and haptic simulator. The virtual brains represent a range of anatomies including normal, shifted, and compressed ventricles. Neurosurgery residents participated in individual simulator practice on the library of brains including visualizing the 3-dimensional location of the catheter within the brain immediately after each insertion. Performance of participants on novel brains in the simulator and during actual surgery before and after intervention was analyzed using generalized linear mixed models. RESULTS: Simulator cannulation success rates increased after intervention, and live procedure outcomes showed improvement in the rate of successful cannulation on the first pass. However, the incidence of deeper, contralateral (simulator) and third-ventricle (live) placements increased after intervention. Residents reported that simulations were realistic and helpful in improving procedural skills such as aiming the probe, sensing the pressure change when entering the ventricle, and estimating how far the catheter should be advanced within the ventricle. CONCLUSIONS: Simulator practice with a library of virtual brains representing a range of anatomies and difficulty levels may improve performance, potentially decreasing complications due to inexpert technique.

KW - Augmented reality

KW - Haptics

KW - Neurosurgery

KW - Simulation

KW - Virtual reality

UR - http://www.scopus.com/inward/record.url?scp=84873568123&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84873568123&partnerID=8YFLogxK

U2 - 10.1097/SIH.0b013e3182662c69

DO - 10.1097/SIH.0b013e3182662c69

M3 - Article

C2 - 23117306

AN - SCOPUS:84873568123

VL - 8

SP - 25

EP - 31

JO - Simulation in Healthcare

JF - Simulation in Healthcare

SN - 1559-2332

IS - 1

ER -