Virtual in reality or sci-fi. Augmented reality systems

reality (VR) is a computer technology that uses virtual reality headsets or
multi-projected environments, sometimes in combination with physical
environments or props, to generate realistic images, sounds and other
sensations that simulate a user’s physical presence in a virtual or imaginary
environment. A person using virtual reality equipment is able to “look
around” the artificial world, and with high quality VR move around in it
and interact with virtual features or items. The effect is commonly created by
VR headsets consisting of a head-mounted display with a small screen in front
of the eyes, but can also be created through specially designed rooms with
multiple large screens1.

systems that include transmission of vibrations and other sensations to the
user through a game controller or other devices are known as haptic systems.
This tactile information is generally known as force feedback in medical, video
gaming and military training applications. Virtual reality also refers to
remote communication environments which provide a virtual presence of users
with through tele presence and tele-existence or the use of a virtual artifact
(VA). The immersive environment can be similar to the real world in order to
create a lifelike experience grounded in reality or sci-fi. Augmented reality
systems may also be considered a form of VR that layers virtual information
over a live camera feed into a headset, or through a smart phone or tablet

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virtual surgery is a computer-assisted surgical procedure simulation intended
for training and preparing doctors for actual procedures. This allows surgeons
to practice delicate operations without potentially risking a patient’s life.
Along with detailed three-dimensional images of the bodily organs involved in
the operation, advanced setups include haptic technology, a tactile feedback
system that simulates the pressure exerted back by the virtual organs. The
result is a sophisticated simulation in which the user can both see and feel
the virtual surgery to a realistic degree.



virtual surgery procedures utilize a combination of computerized tomography
(CT) and magnetic resonance imaging (MRI) scans to create an in-depth three-dimensional
model of the organ and the patient. The combination of scans allows surgeons to
see both the surface and interior of the


at all times. Motion sensors attached to the operating tools simulate any
action taken towards the virtual organs, allowing surgeons to manipulate the
image as they would during an actual surgery. Haptic technology devices, on the
other hand, simulate the physical experience of the operation through a
combination of force, motion, and vibration based on the surgeon’s movements.
All these elements combine to allow a surgeon to “touch” a virtual
organ, manipulate it, and feel the results.







Virtual reality (VR) has challenged the way we
perceive the world and user experience is being explored to achieve an
immersive and effective experience. However, the commercial effects and impact
of this technology lacks sufficient research. It is hence uncertain which role
virtual reality has in information systems nowadays. This systematic literature
review (SLR) focuses on the commercial impact of virtual reality and which
field of study this technology is most used. To answer this question, a
reference manual was used from literature review protocol standards and carried
out. Results show that VR systems have a wide specter of applications and a
significant potential for revolutionizing our everyday life in the digital
world. The opposing forces of increased training expectations and
reduced training resources have greatly impacted health professions education.
Virtual patients (VPs), which take the form of interactive computer-based
clinical scenarios, may help to reconcile this paradox.

We summarize research on VPs,
highlight the spectrum of potential variation and identify an agenda for future
research. We also critically consider the role of VPs in the educational
armamentarium 1.

? We propose
that VPs’ most unique and cost-effective function is to facilitate and assess
the development of clinical reasoning. Clinical reasoning in experts involves a
non-analytical process that matures through deliberate practice with multiple
and varied clinical cases. Virtual patients are ideally suited to this task.
Virtual patients can also be used in learner assessment, but scoring rubrics
should emphasize non-analytical clinical reasoning rather than completeness of
information or algorithmic approaches. Potential variations in VP design are
practically limitless, yet few studies have rigorously explored design issues.
More research is needed to inform instructional design and curricular

? Virtual patients
should be designed and used to promote clinical reasoning skills. More research
is needed to inform how to effectively use VPs.






In surgery, the life of the patient is of
utmost importance many patient have lost lives because of surgical errors. VR
provide good tool to experiment the various complications arise during surgery.

With the cadaver becoming a rarity and being
considered unethical and impractical the virtual surgery system holds a great
promise. With these kind of systems surgery residents can perform a particular
kind of surgery for a zillionth time without the need of an actual patient.

As this system shows and also points out
mistakes, the aspiring surgeons can always learn from their mistakes  gives a new
clinician a chance to mess up with a virtual patient (and learn from it) rather
than messing up with a real patient2.

 As the touch enabled simulators used
in virtual surgery system allow users to practice their skills on computers
without the use of costly cadavers, it’s quite cost effective.

With the use of force
feedback system these systems combine the visual and factual information with a
sense of touch which gives the feel of operating on alive patient.

Research by Yale
university medical professional shows that surgeons trained with virtual
surgery perform 24 pc faster than ordinary surgeons.








It is a virtual reality technique of
simulating surgery procedure. It helps surgeons in improving surgery plans. They
practice surgery process on 3D models. Virtual surgical tools or gloves are
connected to motion sensors where the users can physically feel the difference
in simulated tissue and organs.

The virtual surgery
works, when the patient come  in for
procedure, they get scanned and a 3D dimensional double is generated  With processes like MRI scan ,CT scan the
process of making a virtual double of you starts. Then after using processes
like VR environment and simulation the process proceeds3. Then taking standard
human measurements of male/female body the simulated image is brought to life. Various
complex software’s, real-time fluid dynamics theory and SensAble pvt. Technology’s
GHOST software’s are needed to move into the final image.


 3.2.1 VIRTUAL

Virtual reality is
a generalization of the standard visual simulation paradigm where the model and
actions used in the simulated world are extracted from various sensors and
information retrieval system. The resulting visual simulation aims at an exact
representation of the real world. With VR space we can navigate, interact, immerse,
and feel the presence of the actual material world. It reduces the need of physical
prototype and improves product ergonomics and functionality. And the most
appealing part is that it can present everything in three dimensions.








1. 3D Image Simulation

Generate a 3D model
depending upon this simulation needed anatomical images can be derived from
series of patient’s MRI or video recording, which are 2D images. Images are
segmented and constraints are imposed. Then we construct a reference model. After
that obtain final model by deforming the reference model.


Fig 3.1
The PHANTOM haptic feedback device (SensAble Technologies,        Cambridge MA, USA). The user holds a
small stylus and explores, in this case, a 3D virtual molecular structure 2.


2. Touch Simulation

Simulating haptic
touch sensation. Calculation of force applied to cut & punchers the various
tissues. Haptic goes a long way to make virtual reality simulators more life-like.
Virtual Reality Simulators consist of program run the software to interact with
virtual environment. The addition of hepatics to virtual environments has
provided computer users with the ability of expression in multiple dimensions.



Force Feedback System

These force feedback systems provide the user
the same resistance or reaction from the VR environment as it would have
provided in an actual environment .Otherwise known as haptic devices, these are
commercially produced by PHANTOM pvt. Limited, USA .The haptic devices offer
higher fidelity, stronger forces and lower friction to the practicing surgeons.
Without these force feedback systems the virtual surgery program would have
become just like a video game .These 
devices reproduce the feeling of moving and manipulating the surgical
tools within the patient’s anatomy and the flexibility to tailor the tactile


4.1 Force Feedback System






Chapter 4



•      There are many
striking similarities between pilots and surgeons.

•        They are always ready to manage life threatening
situation in an unpredictable  
environments very dynamically.

•        The surgeons used to follow text book images
or cadavers for the training purposes. Today cadavers are limited in
supply and generally allowing one time use only, so this virtual
surgery technology is becoming a training method of choices in most
medical      school.

virtual reality models enable the use to perform a procedure countless
times which help the surgeon to strip away various layer of  tissue and muscles to examine each organ
separately, which result in a error less surgery.


•      Tradition wise the
surgery was planned, the surgeon inculcated the various parameter  and procedure for surgery which he
is   calculated from his earlier

•        He did not have exact idea how the surgery
was going to result which led to lots of  
errors and risking of the human life.

•        This virtual surgery technology helped in reducing
these errors and to plan the surgery in most efficient and reliable manner.


 The integration of advance imaging
technology, image processing and 3D graphical capabilities has led to great
interest in image guided and computer- aided surgery.

  This technique
has been proved useful in robotic surgery.



Remote surgery also known as telesurgery is the ability for a
doctor to perform surgery on a patient even though they are not
physically in the same location. It is a form of tele
presence. A
robot surgical system generally consists of one or more arms (controlled by the
surgeon), a master controller console, and a sensory system giving feedback to
the user. Remote surgery combines elements of robotics, cutting edge communication
technology such as
high-speed data connections and elements of management information systems.

While the field of robotic
surgery is fairly well established,
most of these robots are controlled by surgeons at the location of the surgery.
Remote surgery is essentially advanced telecommuting for surgeons, where the
physical distance between the surgeon and the patient is immaterial. It
promises to allow the expertise of specialized surgeons to be available to
patients worldwide, without the need for patients to travel beyond their local














Chapter 5



5.1 Cutting in Deformable Objects 3.



5.2 Cutting Deformable Model of Liver 3.



                                          Fig 5.3
Virtual Reality to explore a patient’s brain 6.



                                      Fig 5.4 The trainee’s
view from within the VR environment 1.






Chapter 6


Gives the
opportunity to practice procedures and learn from mistakes.

environment, mistakes aren’t hurting the “patient”.

Has an
enjoyable, goal oriented, relaxed environment.

Entices and
intrigues 7 the future generations of doctors.

Programming can
be made to represent rare or new forms of disease or anatomical variations.

Doctors can
practice with these programs before doing the surgery on live patient.

It is real
because you can get hepatic touch feedback which encourages your technique.

Patients can be
better prepared for the operations they will undergo.

Patients can go
through their procedures, will better understand the trauma, they will be undergoing
and realize the amount of recovery time needed.



extremely expensive as the technology is ne and needs extensive programming.

doesn’t meet widespread demand.

encourage bad habits such as being unfocussed in the operating room

need to be completely focused and concentrated.

is no way of virtually teach decision making, knowledge, and communication
skills 7.

can’t teach mental aspects of being a surgeon.

patients can find the process unsettling and back-out of operations.








virtual surgery has a long way to go in the coming era. The use of computer
aided and image guided technique has helped a lot in the advancement of   medical science.

Virtual reality in medicine is a subject of active research
is in the area of medicine.  Human-computer interfaces such as
force-feedback and tactile interfaces which are important for medical use .Tissue
modeling techniques for simulation of organs. Display techniques we can expect
a new generation of diagnostic medical imaging techniques that utilize virtual
reality concepts for effective visualization of human anatomy new telemedicine
applications. Virtual patients should be designed
and used to promote clinical reasoning skills. More research is needed to
inform how to effectively use VPs.