Child's Nervous System

, Volume 29, Issue 8, pp 1235–1244 | Cite as

Virtual reality simulation: basic concepts and use in endoscopic neurosurgery training

  • Alan R. CohenEmail author
  • Subash Lohani
  • Sunil Manjila
  • Suriya Natsupakpong
  • Nathan Brown
  • M. Cenk Cavusoglu
Original Paper



Virtual reality simulation is a promising alternative to training surgical residents outside the operating room. It is also a useful aide to anatomic study, residency training, surgical rehearsal, credentialing, and recertification.


Surgical simulation is based on a virtual reality with varying degrees of immersion and realism. Simulators provide a no-risk environment for harmless and repeatable practice. Virtual reality has three main components of simulation: graphics/volume rendering, model behavior/tissue deformation, and haptic feedback. The challenge of accurately simulating the forces and tactile sensations experienced in neurosurgery limits the sophistication of a virtual simulator. The limited haptic feedback available in minimally invasive neurosurgery makes it a favorable subject for simulation.


Virtual simulators with realistic graphics and force feedback have been developed for ventriculostomy, intraventricular surgery, and transsphenoidal pituitary surgery, thus allowing preoperative study of the individual anatomy and increasing the safety of the procedure. The authors also present experiences with their own virtual simulation of endoscopic third ventriculostomy.


Virtual reality Simulation Neuroendoscopy Training Endoscopic third ventriculostomy 



M. Cenk Cavusoglu is on the scientific advisory board of the start-up company, Surgical Theater, LLC, based in Cleveland, OH, USA, which is developing a virtual reality open neurosurgical surgical rehearsal simulator. The other authors report no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Alan R. Cohen
    • 1
    Email author
  • Subash Lohani
    • 1
  • Sunil Manjila
    • 2
  • Suriya Natsupakpong
    • 3
  • Nathan Brown
    • 4
  • M. Cenk Cavusoglu
    • 5
  1. 1.Minimally Invasive Neurosurgery Laboratory, Department of NeurosurgeryBoston Children’s HospitalBostonUSA
  2. 2.Minimally Invasive Neurosurgery Laboratory, Department of NeurosurgeryUniversity Hospitals of ClevelandClevelandUSA
  3. 3.Institute of Field RoboticsKing Mongkut’s University of Technology ThonburiBangkokThailand
  4. 4.Department of Electrical and Computer EngineeringNaval Postgraduate SchoolMontereyUSA
  5. 5.Department of Electrical Engineering and Computer Science, Case School of EngineeringCase Western Reserve UniversityClevelandUSA

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