Highly immersive virtual reality laparoscopy simulation: development and future aspects

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Virtual reality (VR) applications with head-mounted displays (HMDs) have had an impact on information and multimedia technologies. The current work aimed to describe the process of developing a highly immersive VR simulation for laparoscopic surgery.


We combined a VR laparoscopy simulator (LapSim) and a VR-HMD to create a user-friendly VR simulation scenario. Continuous clinical feedback was an essential aspect of the development process. We created an artificial VR (AVR) scenario by integrating the simulator video output with VR game components of figures and equipment in an operating room. We also created a highly immersive VR surrounding (IVR) by integrating the simulator video output with a \(360{^{\circ }}\) video of a standard laparoscopy scenario in the department’s operating room.


Clinical feedback led to optimization of the visualization, synchronization, and resolution of the virtual operating rooms (in both the IVR and the AVR). Preliminary testing results revealed that individuals experienced a high degree of exhilaration and presence, with rare events of motion sickness. The technical performance showed no significant difference compared to that achieved with the standard LapSim.


Our results provided a proof of concept for the technical feasibility of an custom highly immersive VR-HMD setup. Future technical research is needed to improve the visualization, immersion, and capability of interacting within the virtual scenario.

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The authors thank S. Rohde, B. Golla, and M. Kosta (University of Magdeburg) for technical support. Additionally, we appreciate the support from and discussions with H. Hecht, Department of General Experimental Psychology, Johannes Gutenberg University, Mainz.

Funding Financial support for the laparoscopy simulator was provided by the medical education project, “MAICUM,” from the Medical Center of the Johannes Gutenberg University of Mainz. Funding for the additional immersive virtual reality hardware was provided by intramural funding from the Medical Center of the Johannes Gutenberg University of Mainz, Germany, and educational intramural funding by the Otto-von-Guericke University Magdeburg, Germany.

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Correspondence to Tobias Huber.

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The authors TH, TW, MP, HL, WK and CH declare no conflicts of interest or financial ties related to this study.

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For this type of study, formal consent was not required. This study did not include patients or animals.

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Huber, T., Wunderling, T., Paschold, M. et al. Highly immersive virtual reality laparoscopy simulation: development and future aspects. Int J CARS 13, 281–290 (2018).

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  • Surgical training
  • Virtual reality
  • Laparoscopic surgery
  • Human–computer interaction
  • Visualization