Simple Virtual Simulation neuronavigator

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Simple Virtual Simulation neuronavigator

• Col.Supakijs Sanguandekul M.D.
• Neurosurgeon PMK hospital

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Content

• Objective
• Excellence surgery
• Virtual reality simulation
• Projector base navigator
• Matherial Method
• Result
• Benefit
• Future development

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Objective

• To create
• 1.)The simple (projector based)neuronavigator
• 2.) The neurosurgical virtual reality
  simulation(Demonstrate the brain abscess
  resection) and report the successful result

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Objective

• Multipurpose of new simple VR neuronavigator
• 1. Assist operationNavigator
• 2. Preoperative planning
• 3. Informconsent with simulation
• 4. Neurosurgical operative skill training
• 5. Telesurgical education(CAIComputer Assist
  Operation) via internet

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Objective

• Understanding of
• Excellence surgery
• Virtual reality simulation of
  neurosurgical procedure(demonstrate by Brain
  abscess resection)
• Simple neuronavigator
• Neurosurgical operative
• Neurosurgical skill training

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3 In 1 Simple neuronavigator

• CAI Navigator
  Simulator

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Excellence Surgery

• 1.High success rate
• Patient safety,No surgical mortality
• Low morbidity,mortality,complication
• maximized recovery,Short length of stay in
  hospital, Validity,Accuracy, Cost-Effective,
  Standard of treatment
• 2.Human right,Ethic
• 3.Good Surgical Service
• 4Good Surgical education
• Good knowledge , Surgical skill, Ethic
• 5.Continuous researchdevelopment)

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Excellence Surgery
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The virtual reality simulation of neurosugical
procedure

• For surgical skill training with real operative
  situation
• 1.Simple neuronavigator ?????????????????????????
  ??????????????????? (Projector VR) ??????????
  Preoperative planning operative
  simulation,Intraoperative navigator
• 2.Neurosurgical practice model Brain abscess
  ?????????????????????
• 3.Computer Assist Instruction Surgical operation
  at surgical site??????????????????????????????????
  ??????????????????????????????????????????????????
  ??????????????????????????????????????????

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Virtual reality neurosurgical operative simulation
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Virtual reality simulation

• ??????????????????????
• 1.)???????????????????????????(Real person to
  Cyber simulation)
• ????????????????????????????3????????????
  ????????(Head mount),????????????????????????????(
  Monitor),?????????????(Projector),????
  ???????????????3????(Theatre or Cyber space)
• 2.)?????????????????????????(Cyber simulation to
  real person)
• ???????????????????????????????????????????(C
  yber to real)????????????????????????????
  ??????????????????? ??????????????????????????????
  ??????????????????????????????????????????????????
  ??????????????? ??????????????????????????????????
  (Projector)???????????? ??????????????????????????
  ????????(Internal viewing (see through)Simulation)
  ,???????????(External coveringStealth)
  ????????????????????????????(Cyber
  construction)?????????(???????,?????,???????,?????
  ?????????? ???????)

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Cyber simulation to real person
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Neuronavigator

• Framebased stereotactic surgery
• Frameless stereotactic surgery
• Robot arm
• Infrared based
• Virtual
  simulation
• Simple VR neuronavigator
• ???????????????????????(Project
  or base Virtual reality simulation)
  ??????????????????????????????????
  (?????????2???? ???3????)?????????????????????????
  ??????????????????????????????????????????????(Int
  ernal viewing,See through image fusion
  simulation) ?????????????????????
  ??????????????????????????????????????????????
  ????(?????????????????????????????????????????????
  ?????????????????????? )?????????????????

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Simple neuronavigator
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Advantage of simple VR neuronavigator

• Advantage
• Easy,small,portable,wireless,cheap,Intracrani
  al simulation show on real human site,combine
  with surgical model for operative simulation,use
  in anywhere and time and multipurpose
  informconsent,preoperative planning,operative
  navigator,simple(not need to do MRI 2times as
  infrared base navigator)
• 3in1 Navigator,Simulator,Computer Assist
  Instruction(CAI)

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Simple navigator

• Composition
• 1)Portable Projector
• 2)Note book or netbook
• 3)2-3D simulation program
• 4)Camera or VDO recording
• 5)CT or MRI,MRA,MRV

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Method of Simple neuronavigatorsimulator

• 1.) ??????????????????(2-3D construction)?????????
  ????????????????????????? ?????????
  ??????????????????????????CT,MRI
• 2.)????????????(Pre operative planning)
  ?????????????????????????? ?????????????(Target
  pointing)????????????????????????????????
  ?????????????????????????????????????
  ?????????????????????????????? ???????????????????
  ????? ??????????????????????????????????????
  ???????????????????????????????????????????
  ????????????????????????????????????????
• 3.)????????????????????????(Construct surgical
  operative model) ????????????? ???????????????????
  ?????????
• 4.)??????????????????????????????????????????????
  ?????????????????????(Virtual reality practice
  for Preoperative surgical simulation)
  ???????????????????????????????
• 5.)?????????????????????????????????????????????
  ??????????????????????????????????????????????(CAI
  at surgical sitesimulator movie)???????????
  ???????????????????????????????????????????
• 6.)??????????Projector ?????????????????????????
  ?????????????????????????????????
  ????????????????????????? ?????????????????
• 7.)?????????????????? ??????????,??????????,????
  ???????

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Preoperative planning by simple neuronavigator

• Planning process
• 1.Input image
• 2.Image reconstruction
• Target Pathologic lesion
• Eloquent area
• Entry pointTarget point
• Approach Direction
• Scalp incision
• Cranial openning line
  
• 3.Output image Via Projector

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Target pointing planing
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Operative planning

• Patient head position drappingaseptic
  preparation ofskin
• Surgical approach
• Bleeding control
• Anatomical barrier opening
• Scalp incision
• Skull opening
• Dura opening
• Cranial opening via transgyrus,transsul
  cus,transcistern
• Pathological resection
• Anatomical barrier Closing

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Neurosurgical operative models

• ??????????????????????????????????????????????????
  ? (Neurosurgical operative model)
  ?????????????????????2006?????????????????????????
  ??????????????????????? Reduced Iatrogenic
  complication,UsefulReal practice ,easyReady to
  use ,Cheap,Recycle,Innitiation innovation(not
  copy),Continuous development of quality of
  innovation,Instead of cadaver,animal
• ??????????????????????????????????????????????????
  ?????????????????? (Virtual reality Simple
  neuronavigator neurosurgical model for
  neurosurgical operative simulation)???????????????
  ???????????????????????????? ????????????????????
  ????????????????????????????????????????CT brain
• ??????????????? ???????????????(Extracranial
  structure),????????????????????(Intracranial
  structure),?????????(Pathological lesion)
• ??????????????????????????????????????????

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Artificial skullbrain
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Operative navigator at surgical site
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Surgical virtual simulation
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Setting of navigator

• Set distance for proper image fiting with real
  head
• Project the image at the appropriate part of head
• Mark the entry point and target point

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InformConsent with navigator

• Show the real operative simulation at the real
  patients surgical site (head)

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CAI NEUROSURGICAL OPERATIVE SIMULATION

• Show the neurosurgical operative simulation
  motion picture at the surgical site(head)

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Brain abscess resection procedure

• Head position
• Target point
• Drapping
• Scalp opening
• Skull opening (Craniotomy)
• Dural opening
• Cotical (Transulcus )dissection
• Pus aspiration
• Abscess resection
• Dura skull skin closure

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Result

• New neuronavigator is easy to use and have
  accurately demonstrate lesion that can see
  through skin at the patient head(model), The
  Virtual simulation of brain abscess resection was
  completely performed .The projector base
  navigation assist the operation without error.No
  iatrogenic complication was detected,Resident and
  staff were appliciated to used it.

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Benefit

• 1.)simple portable navigator create and use
• 2.)low cost
• 3.)New concept of multipurpose,everywhere,time
• 4)Improve Quality of surgical education and
  surgical skill practice
• 5) Excellence surgery for all human being

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Future development

• Low cost ,high technologyReal time Internal
  viewing by multimodal internal body
  scanning,small size multifunction projector
• Fetal surgery
• New wireless endoscope
• Excellence surgery

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Thank you

• Problem leading to Development
• Present planning for future Success
• Every movement have its target
• Excellence surgery for all human being