Digital Design of a Surgical Simulator for Interventional Magnetic Resonance Imaging

We present the design of a simulator for a prototype interventional magnetic resonance imaging scanner. This MRI scanner is integrated with an operating theater, enabling new techniques in minimally invasive surgery. The simulator is designed with a threefold purpose: (1) to provide a rehearsal apparatus for practicing and modifying conventional procedures for use in the magnetic environment, (2) to serve as a visualization workstation for procedure planning and previewing as well as a post-operative review, and (3) to form the foundation of a laboratory workbench for the development of new surgical tools and procedures for minimally invasive surgery. The simulator incorporates preoperative data, either MRI or CT exams, as well as plans generated from a commercial surgical planning product to provide visual feedback during simulated procedures. Dynamic control of the simulation and interactive display of preoperative data in lieu of intra-operative data is handled via an opto-electronic tracking system. The resulting system is contributing insights into how best to perform visualization for this new surgical environment. 1 Introduction In an effort to control the spiraling costs of health care, medicine is looking more and more toward minimally invasive surgical techniques. Such methods lead to smaller incisions, reduced chance of infection, more rapid recovery, and better quality of life for the patient. The need for image guidance during procedures through interventional radiology has led to the development of the General Electric Medical Systems Signa SP, a supercooled superconducting 0.5 Tesla MRI system designed to permit simultaneous surgery and MR imaging. This system allows surgeons and other practitioners to guide their interventions when visual access must be balanced for the need for minimal disturbance. Most neurosurgical procedures fall into this category. The Signa SP can be used to verify that tumors and other lesions are completely removed before incisions are closed, reducing the need for repeated operations. Beyond the imaging capabilities, this type of operating room scanner creates new opportunities for flexible and demanding image guided procedures not possible through other technologies. In order to explore new methods and procedures, to develop new protocols, and to help design new instrumentation for this environment, we have designed and built a digital simulation of the Signa SP. The simulator includes visualization capabilities beyond those found in the current surgical environment. Related work includes a variety of surgical planning systems as well as digital simulations of other procedures or clinical treatment methods. There are recently …