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Virtual Reality Tumor Resection: The Force Pyramid Approach.

Robin Sawaya¹, Abdulgadir Bugdadi^1,2, Hamed Azarnoush^1,3

¹Neurosurgical Simulation Research and Training Centre, Department of Neurosurgery, Montréal Neurological Institute and Hospital, McGill University, Montréal, Québec, Canada.

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|September 30, 2017

Summary

The study introduces the force pyramid to visualize surgical instrument forces. Findings reveal how handedness and ergonomics impact force application during simulated brain tumor resection, aiding surgical training.

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Area of Science:

Neurosurgery
Surgical Simulation
Ergonomics

Background:

The force pyramid is a new method for visualizing instrument forces in surgery.
This study applies the force pyramid to analyze hand forces during virtual reality brain tumor resection.

Purpose of the Study:

To investigate the influence of ergonomics and handedness on force pyramid structure.
To compare dominant and nondominant hand force pyramids.
To analyze force distribution in tumor quadrants and differentiate expert vs. novice performance.

Main Methods:

Neurosurgeons and residents used the CAE NeuroVR platform to resect virtual tumors.
Simulated aspirator (dominant) and sucker (nondominant) were used.
Position and force data generated force pyramids and quantified tumor quadrant force distribution.

Main Results:

Handedness and ergonomics significantly affect psychomotor performance in simulated resections.
Dominant hand forces formed a crescent in the lower right quadrant; nondominant hands showed central force peaks.
Bimanual force pyramids illustrated combined hand impacts, with variations based on tumor characteristics.

Conclusions:

Force pyramids effectively delineate surgical areas needing advanced psychomotor skills.
This visualization can enhance resident technical skills training for tumor resection.