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Real-Time Haptic-Based Soft Body Suturing in Virtual Open Surgery Simulations
George Westergaard1, Mark Ellis1, Jacob Barker2
1Department of Computer Science, Florida Polytechnic University, Lakeland, Florida, USA.
Computers & Graphics
|December 17, 2025
Summary
This study introduces a real-time virtual reality surgical simulator for soft-tissue suturing, offering bimanual haptic feedback. The system demonstrates stable physics and high frame rates, providing a low-cost, high-fidelity training tool for surgeons.
Area of Science:
- Medical Simulation
- Virtual Reality in Surgery
- Surgical Training Technologies
Background:
- Surgical training requires realistic practice environments.
- Current virtual reality (VR) tools often lack sufficient haptic feedback and complex physics simulation for suturing.
- There is a need for accessible, high-fidelity simulation platforms for open surgical procedures.
Purpose of the Study:
- To develop and evaluate a real-time VR-based open surgery simulator for soft-tissue suturing.
- To assess the system's performance in simulating various suturing techniques with bimanual haptic feedback.
- To investigate user perceptions of anatomical realism and haptic feedback effectiveness in surgical trainees and experts.
Main Methods:
- Development of a VR simulator utilizing eXtended Position-Based Dynamics (XPBD) for soft body and suture thread simulation.
- Implementation of bimanual haptic feedback for realistic interaction during suturing.
- Performance testing across four common suturing techniques (purse-string, Connell, stay, Lembert) to measure frame rates and particle simulation capacity.
- Conducting a user study with 24 participants using the Virtual Colorectal Surgery Trainer - Rectal Prolapse simulator.
Main Results:
- The simulator achieved high frame rates (50-80 FPS) with up to 4,155 particles, demonstrating stable real-time performance for complex suturing tasks.
- 71% of users rated anatomical realism as moderate to very high.
- 50% found force feedback realistic, and 54% found it useful, indicating effective immersion but also room for haptic fidelity improvement.
Conclusions:
- The developed VR simulator offers a low-cost, high-fidelity platform for practicing open surgical suturing.
- The system effectively simulates complex interactions like continuous sutures and knot tying with stable real-time physics.
- Findings highlight the potential of VR simulation for surgical education while underscoring the importance of advanced haptic feedback for enhanced training outcomes.
