基于虚拟现实技术的显微血管吻合虚拟手术系统的研究

Study on virtual surgery system of microvascular anastomosis based on virtual reality technology

目的研发一种基于虚拟现实技术的显微断指血管吻合手术系统，探索一种显微外科临床手术教学及培训的新方法。方法从本院手术室和科室采集各类数据，通过3 d MAX和Autodesk Maya进行建模，血管模型管径仅为1 mm，建立显微镜模块，放大倍数为15×，然后在Unreal Engine 4中制作和运行虚拟手术软件，并使用OBS STUDIO制作手术直播单元。选择来自本科室的医师和外科住培学员，并将住培学员分为培训组和未培训组，培训组接受虚拟手术系统操作训练后，与未培训组及专家组对比，进行统计学处理。结果使用3 d MAX和Autodesk Maya建造的模型保真度高，使用Unreal Engine 4制作的虚拟手术系统可真实还原显微镜下断指血管吻合的手术流程，精确度可达到毫米级。该系统中的手术直播单元可提供由细节到整体的手术观摩。培训组与未培训组之间的差异有统计学意义（P＝0.003）；而培训组与专家组之间的差异无统计学意义（P＝0.170）；未培训组与专家组之间差异有统计学意义（P＝0.016）。结论该系统在显微外科手术培训及教学上有应用价值，有助于训练无显微镜下微小血管吻合经验的外科医师，可以让使用者在短时间内提高虚拟手术操作技能。

Objective To explore a new teaching and training method of microsurgery based on virtual reality technology.MethodsAll data were collected from our operation room and department, these data were modeled by 3d MAX and Autodesk Maya, the diameter of vessel model was only 1 mm, and a microscope which had a magnification of 15× was also modeled. Then the virtual operation software was produced and operated by the Unreal Engine 4, and OBS STUDIO was used to produce the surgery broadcast unit. Surgeons and interns were randomly chosen from our department. After training by the virtual surgery system, the training group was compared with the control group and expert group, and the results were statistically processed.ResultsThe models built by 3 d MAX and Autodesk Maya were of high fidelity and the real operation process of microvascular anastomosis was reproduced by the virtual operation software in the Unreal Engine 4, and the accuracy reached millimeters. The details to the overall view of the operation could be provided by the operation broadcast unit in this system. There was significant difference between control group and training group （P=0.003）, however, there was no significant difference between training group and expert group （P=0.170）. There was also significant difference between control group and expert group （P=0.016）.ConclusionThis system is of application value in training and teaching of Microsurgery, it is helpful to surgeons without much experience in microscopic microvascular anastomosis, and allows users to improve virtual surgery skills in a short period of time.