Dynamic generation of surgery specific simulators -- a feasibility study

Most of the current surgical simulators rely on preset anatomical virtual environments (VE). The functionality of a simulator is typically fixed to anatomy-based specific tasks. This rigid design principle makes it difficult to reuse an existing simulator for different surgeries. It also makes it difficult to simulate procedures for specific patients, since their anatomical features or anomalies cannot be easily replaced in the VE. In this paper, we demonstrate the reusability of a modular skill-based simulator, LapSkills, which allows dynamic generation of surgery-specific simulations. Task and instrument modules are easily reused from LapSkills and the three-dimensional VE can be replaced with other anatomical models. We build a nephrectomy simulation by reusing the simulated vessels and the clipping and cutting task modules from LapSkills. The VE of the kidney is generated with our anatomical model generation tools and then inserted into the simulation (while preserving the established tasks and evaluation metrics). An important benefit for the created surgery and patient-specific simulations is that reused components remain validated. We plan to use this faster development process to generate a simulation library containing a wide variety of laparoscopic surgical simulations. Incorporating the simulations into surgical training programs will help collect data for validating them.