Feasibility and Acceptability of Game-Based Cortical Priming and Functional Lower Limb Training in a Remotely Supervised Home Setting for Chronic Stroke: A Case Series.

Background: Movement-based priming has been increasingly investigated to accelerate the effects of subsequent motor training. The feasibility and acceptability of this approach at home has not been studied. We developed a game-based priming system (DIG-I-PRIME) that engages the user in repeated ankle movements using serious games.

Preliminary Evaluation of a Novel Neural Network-Based Hybrid Simulator for Surgical Training and Performance Assessment of Neonatal Thoracentesis.

Introduction: Tension pneumothorax is a rare and life-threatening situation in neonates requiring immediate intervention through thoracentesis. Significant complications can arise while performing thoracentesis in the case of inadequate skill level or exposure to the condition. Although simulation-based training (SBT) has proven to be effective in learning surgical skills, training sessions are long, subjective, and expensive, because of which they cannot be held regularly.

Evaluation of Artificial Intelligence-Based Intraoperative Guidance Tools for Phacoemulsification Cataract Surgery.

Importance: Complications that arise from phacoemulsification procedures can lead to worse visual outcomes. Real-time image processing with artificial intelligence tools can extract data to deliver surgical guidance, potentially enhancing the surgical environment.

Objective: To evaluate the ability of a deep neural network to track the pupil, identify the surgical phase, and activate specific computer vision tools to aid the surgeon during phacoemulsification cataract surgery by providing visual feedback in real time.

CathSym: Device and Method to Bring Haptic Feedback to Urinary Catheterization Training.

Urinary catheterization is one of the most widely taught procedures in the medical field. Current simulation-based training methods allow the students to be trained on non-realistic mannequins that do not adequately develop their psychomotor skills. This lack of proper training translates into increased likelihood of the medical professional causing damage to the patients' urethra in the form of false passages when faced with a difficult catheterization.

Psychomotor skills development for Veress needle placement using a virtual reality and haptics-based simulator.

Purpose: Veress needle (VN) insertion, if not correctly performed, could cause severe injuries to intra-abdominal organs and vessels. Therefore, cognitive and psychomotor skills training is needed. Virtual reality (VR) and haptic technologies have the potential to offer realistic simulations.

Game-based movement facilitates acute priming effect in stroke.

Objective: Cortical priming is an emerging strategy to enhance motor recovery after stroke, however, limited information exists on the neuromodulatory effects of lower limb movement-based priming to facilitate corticomotor excitability after stroke. In this study, we investigated the feasibility and effectiveness of game-based ankle movement priming using the DIG-I-PRIME™ on corticomotor excitability and motor performance in chronic stroke survivors.

Methods: Nineteen stroke survivors participated in a 20-min session of game-based priming.

Design of a navigational catheter system for the targeted delivery of therapeutics within the suprachoroidal space.

Diseases of the posterior segment of the eye are common causes of blindness and can be difficult to treat due to their location. Recently, there has been increased interest in the use of the suprachoroidal space to deliver therapeutics to the posterior segment. This space is accessible through a trans-scleral approach and blunt dissection of the adjacent scleral and choroidal tissues.

Augmented reality and artificial intelligence-assisted surgical navigation: Technique and cadaveric feasibility study.

Purpose: Augmented reality-based image overlay of virtual bony spine anatomy can be projected onto real spinal anatomy using computer tomography-generated DICOM images acquired intraoperatively. The aim of the study was to develop a technique and assess the accuracy and feasibility of lumbar vertebrae pedicle instrumentation using augmented reality-assisted surgical navigation.

Subjects And Methods: An augmented reality and artificial intelligence (ARAI)-assisted surgical navigation system was developed.

Autonomous image segmentation and identification of anatomical landmarks from lumbar spine intraoperative computed tomography scans using machine learning: A validation study.

Purpose: Machine-learning algorithms are a subset of artificial intelligence that have proven to enhance analytics in medicine across various platforms. Spine surgery has the potential to benefit from improved hardware placement utilizing algorithms that autonomously and accurately measure pedicle and vertebral body anatomy. The purpose of this study was to assess the accuracy of an autonomous convolutional neural network (CNN) in measuring vertebral body anatomy utilizing clinical lumbar computed tomography (CT) scans and automatically segment vertebral body anatomy.

Filling the gap between the OR and virtual simulation: a European study on a basic neurosurgical procedure.

Background: Currently available simulators are supposed to allow young neurosurgeons to hone their technical skills in a safe environment, without causing any unnecessary harm to their patients caused by their inexperience. For this training method to be largely accepted in neurosurgery, it is necessary to prove simulation efficacy by means of large-scale clinical validation studies.

Methods: We correlated and analysed the performance at a simulator and the actual operative skills of different neurosurgeons (construct validity).

Evaluation of Sensory and Motor Skills in Neurosurgery Applicants Using a Virtual Reality Neurosurgical Simulator: The Sensory-Motor Quotient.

Objective: Manual skill is an important attribute for any surgeon. Current methods to evaluate sensory-motor skills in neurosurgical residency applicants are limited. We aim to develop an objective multifaceted measure of sensory-motor skills using a virtual reality surgical simulator.

Usefulness of a Virtual Reality Percutaneous Trigeminal Rhizotomy Simulator in Neurosurgical Training.

Background: Simulation-based training may be incorporated into neurosurgery in the future.

Objective: To assess the usefulness of a novel haptics-based virtual reality percutaneous trigeminal rhizotomy simulator.

Methods: A real-time augmented reality simulator for percutaneous trigeminal rhizotomy was developed using the ImmersiveTouch platform.

The use of a virtual reality surgical simulator for cataract surgical skill assessment with 6 months of intervening operating room experience.

Purpose: To evaluate a haptic-based simulator, MicroVisTouch™, as an assessment tool for capsulorhexis performance in cataract surgery. The study is a prospective, unmasked, nonrandomized dual academic institution study conducted at the Wilmer Eye Institute at Johns Hopkins Medical Center (Baltimore, MD, USA) and King Khaled Eye Specialist Hospital (Riyadh, Saudi Arabia).

Methods: This prospective study evaluated capsulorhexis simulator performance in 78 ophthalmology residents in the US and Saudi Arabia in the first round of testing and 40 residents in a second round for follow-up.

Virtual reality cerebral aneurysm clipping simulation with real-time haptic feedback.

Background: With the decrease in the number of cerebral aneurysms treated surgically and the increase of complexity of those treated surgically, there is a need for simulation-based tools to teach future neurosurgeons the operative techniques of aneurysm clipping.

Objective: To develop and evaluate the usefulness of a new haptic-based virtual reality simulator in the training of neurosurgical residents.

Methods: A real-time sensory haptic feedback virtual reality aneurysm clipping simulator was developed using the ImmersiveTouch platform.

Neurosurgical tactile discrimination training with haptic-based virtual reality simulation.

Objective: To determine if a computer-based simulation with haptic technology can help surgical trainees improve tactile discrimination using surgical instruments.

Material And Methods: Twenty junior medical students participated in the study and were randomized into two groups. Subjects in Group A participated in virtual simulation training using the ImmersiveTouch simulator (ImmersiveTouch, Inc.

Virtual reality spine surgery simulation: an empirical study of its usefulness.

Objective: This study explores the usefulness of virtual simulation training for learning to place pedicle screws in the lumbar spine.

Methods: Twenty-six senior medical students anonymously participated and were randomized into two groups (A = no simulation; B = simulation). Both groups were given 15 minutes to place two pedicle screws in a sawbones model.

Virtual reality simulator for vitreoretinal surgery using integrated OCT data.

Operative practice using surgical simulators has become a part of training in many surgical specialties, including ophthalmology. We introduce a virtual reality retina surgery simulator capable of integrating optical coherence tomography (OCT) scans from real patients for practicing vitreoretinal surgery using different pathologic scenarios.

A novel virtual reality simulation for hemostasis in a brain surgical cavity: perceived utility for visuomotor skills in current and aspiring neurosurgery residents.

Objective: To understand the perceived utility of a novel simulator to improve operative skill, eye-hand coordination, and depth perception.

Methods: We used the ImmersiveTouch simulation platform (ImmersiveTouch, Inc., Chicago, Illinois, USA) in two U.

Sensory and motor skill testing in neurosurgery applicants: a pilot study using a virtual reality haptic neurosurgical simulator.

Background: Manual skill is important for surgeons, but current methods to evaluate sensory-motor skills in applicants to a surgical residency are limited.

Objective: To develop a method of testing sensory-motor skill using objective and reproducible virtual reality simulation.

Methods: We designed a set of tests on a 3-dimensional surgical simulator with head and arm tracking, colocalization, and haptic feedback: (1) "trajectory planning in a simulated vertebra," ie, 3-dimensional memory and orientation; "hemostasis in the brain," ie, motor planning, sequence, timing, and precision; and "choose the softest object," ie, haptic perception.

Percutaneous spinal fixation simulation with virtual reality and haptics.

Background: In this study, we evaluated the use of a part-task simulator with 3-dimensional and haptic feedback as a training tool for percutaneous spinal needle placement.

Objective: To evaluate the learning effectiveness in terms of entry point/target point accuracy of percutaneous spinal needle placement on a high-performance augmented-reality and haptic technology workstation with the ability to control the duration of computer-simulated fluoroscopic exposure, thereby simulating an actual situation.

Methods: Sixty-three fellows and residents performed needle placement on the simulator.

Role of cranial and spinal virtual and augmented reality simulation using immersive touch modules in neurosurgical training.

Recent studies have shown that mental script-based rehearsal and simulation-based training improve the transfer of surgical skills in various medical disciplines. Despite significant advances in technology and intraoperative techniques over the last several decades, surgical skills training on neurosurgical operations still carries significant risk of serious morbidity or mortality. Potentially avoidable technical errors are well recognized as contributing to poor surgical outcome.

Practice on an augmented reality/haptic simulator and library of virtual brains improves residents' ability to perform a ventriculostomy.

Introduction: Ventriculostomy is a neurosurgical procedure for providing therapeutic cerebrospinal fluid drainage. Complications may arise during repeated attempts at placing the catheter in the ventricle. We studied the impact of simulation-based practice with a library of virtual brains on neurosurgery residents' performance in simulated and live surgical ventriculostomies.

Comparison of Algorithms for Haptic Interaction With Isosurfaces Extracted From Volumetric Datasets.

Combinations of graphics and haptics libraries are used in medical simulations for simultaneous visualization and tactile interaction with complex 3D anatomy models. The minimum frame rate of 1 kHz for haptics rendering makes it a nontrivial problem when dealing with complex and highly detailed polygonal models. Multiple haptics algorithms based on polygonal mesh rendering, volume haptics, and intermediate representation are evaluated in terms of their servoloop rendering time, client thread rendering time, and quality of force feedback.

Virtual reality training in neurosurgery: Review of current status and future applications.

Background: Over years, surgical training is changing and years of tradition are being challenged by legal and ethical concerns for patient safety, work hour restrictions, and the cost of operating room time. Surgical simulation and skill training offer an opportunity to teach and practice advanced techniques before attempting them on patients. Simulation training can be as straightforward as using real instruments and video equipment to manipulate simulated "tissue" in a box trainer.

Learning retention of thoracic pedicle screw placement using a high-resolution augmented reality simulator with haptic feedback.

Background: We evaluated the use of a part-task simulator with 3D and haptic feedback as a training tool for a common neurosurgical procedure--placement of thoracic pedicle screws.

Objective: To evaluate the learning retention of thoracic pedicle screw placement on a high-performance augmented reality and haptic technology workstation.

Methods: Fifty-one fellows and residents performed thoracic pedicle screw placement on the simulator.