Neurosurgical virtual reality simulation metrics to assess psychomotor skills during brain tumor resection

  • Hamed Azarnoush
  • Gmaan Alzhrani
  • Alexander Winkler-Schwartz
  • Fahad Alotaibi
  • Nicholas Gelinas-Phaneuf
  • Valérie Pazos
  • Nusrat Choudhury
  • Jawad Fares
  • Robert DiRaddo
  • Rolando F. Del Maestro
Original Article

Abstract

Purpose

   Virtual reality simulator technology together with novel metrics could advance our understanding of expert neurosurgical performance and modify and improve resident training and assessment. This pilot study introduces innovative metrics that can be measured by the state-of-the-art simulator to assess performance. Such metrics cannot be measured in an operating room and have not been used previously to assess performance.

Methods

   Three sets of performance metrics were assessed utilizing the NeuroTouch platform in six scenarios with simulated brain tumors having different visual and tactile characteristics. Tier 1 metrics included percentage of brain tumor resected and volume of simulated “normal” brain tissue removed. Tier 2 metrics included instrument tip path length, time taken to resect the brain tumor, pedal activation frequency, and sum of applied forces. Tier 3 metrics included sum of forces applied to different tumor regions and the force bandwidth derived from the force histogram.

Results

   The results outlined are from a novice resident in the second year of training and an expert neurosurgeon. The three tiers of metrics obtained from the NeuroTouch simulator do encompass the wide variability of technical performance observed during novice/expert resections of simulated brain tumors and can be employed to quantify the safety, quality, and efficiency of technical performance during simulated brain tumor resection. Tier 3 metrics derived from force pyramids and force histograms may be particularly useful in assessing simulated brain tumor resections.

Conclusion

   Our pilot study demonstrates that the safety, quality, and efficiency of novice and expert operators can be measured using metrics derived from the NeuroTouch platform, helping to understand how specific operator performance is dependent on both psychomotor ability and cognitive input during multiple virtual reality brain tumor resections.

Keywords

Performance metrics Virtual reality neurosurgical simulation Haptic feedback Brain tumor resection Neurosurgical oncology NeuroTouch 

Abbreviations

NRC

National Research Council

VR

Virtual reality

PGY

Postgraduate year

cc

Cubic centimeters

3D

Three-dimensional

Supplementary material

Supplementary material 1 (wmv 4794 KB)

Supplementary material 2 (avi 7285 KB)

11548_2014_1091_MOESM3_ESM.avi (5 mb)
Supplementary material 3 (avi 5134 KB)
11548_2014_1091_MOESM4_ESM.doc (10 kb)
Supplementary material 4 (doc 10 KB)

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Copyright information

© CARS 2014

Authors and Affiliations

  • Hamed Azarnoush
    • 1
    • 3
  • Gmaan Alzhrani
    • 1
    • 4
  • Alexander Winkler-Schwartz
    • 1
  • Fahad Alotaibi
    • 1
    • 4
  • Nicholas Gelinas-Phaneuf
    • 1
  • Valérie Pazos
    • 2
  • Nusrat Choudhury
    • 2
  • Jawad Fares
    • 1
  • Robert DiRaddo
    • 2
  • Rolando F. Del Maestro
    • 1
  1. 1.Neurosurgical Simulation Research Center, Department of Neurosurgery and Neurology, 2nd Floor, Montreal Neurological Institute and HospitalMcGill UniversityMontrealCanada
  2. 2.National Research Council CanadaBouchervilleCanada
  3. 3.Department of Biomedical EngineeringTehran PolytechnicTehranIran
  4. 4.National Neuroscience InstituteKing Fahad Medical CityRiyadhSaudi Arabia

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