Spring: A General Framework for Collaborative, Real-time Surgical SimulationKevin Montgomery, Cynthia Bruyns, Joel Brown, Stephen Sorkin, Frederic Mazzella, Guillaume Thonier, Arnaud Tellier, Benjamin Lerman, Anil Menon National Biocomputation Center, 701A Welch Rd, Suite 1128 Stanford, CA 94305Abstract: We describe the implementation details of a real-time surgical simulation systemwith soft-tissue modeling and multi-user, multi-instrument, networked haptics. Thesimulator is cross-platform and runs on various Unix and Windows platforms. It is writtenin C++ with OpenGL for graphics; GLUT, GLUI, and MUI for user interface; and supportsparallel processing. It allows for the relatively easy introduction of patient-specific anatomyand supports many common file formats. It performs soft-tissue modeling, some limitedrigid-body dynamics, and suture modeling. The simulator interfaces to many differentinteraction devices and provides for multi-user, multi-instrument collaboration over theInternet. Many virtual tools have been created and their interactions with tissue have beenimplemented. In addition, a number of extra features, such as voice input/output, real-timetexture-mapped video input, stereo and head-mounted display support, and replicateddisplay facilities are presented.1. IntroductionThe benefits of computer-based surgical simulation have been widely discussed and quantitatively demonstrated by many researchers[1]. The benefits include the ability to broaden surgical training by easily providing different training scenarios, including anatomical variations (gender, size), pathologies (diseases, trauma), and operating environment conditions (emergency room, microgravity, battlefield). In addition to these benefits, the ability to objectively quantify surgical performance[2] and perhaps simulate the result of an intervention has been cited as a major benefit and drawn the attention of surgical societies as a future means of precertification. Besides these benefits, the potential to accelerate the acquisition of baseline surgical skills through the use of computer-based simulation has also been identified[3]. Perhaps the most important feature of all is that computer-based simulation can realize all these benefits without risk to any real patients.Because of these benefits, many research groups in academia, government, and industry have been developing simulators for some time[4-13]. Each group must instill the clinical knowledge of the surgeon through the engineering technology of the computer scientist in order to realize a working and usable system. However, the technical knowledge required to produce such a simulator spans many subdisciplines including graphics, algorithm design, numerical integration methods, collision detection, networking, user interface design, and mechanical engineering. Replicating this wide breadth of technical knowledge is difficult and, for many clinical groups, represents an insurmountable obstacle to the production of a complete, functioning, useful simulator. Moreover, within other groups with broad engineering skills, achieving expertise in each of the areas required and developing their own software for each of these tasks can also increase costs and the time before the realization of a working simulator.If the surgical simulation community instead had a common framework of shared code, then the time to realization of a working simulator would be shortened, and the barrier to entry for clinical groups of more limited engineering resources would be lessened. In essence, the entire surgical simulation community would work together on a common platform, sharing their individual expertise, and thereby accelerate the production, and ultimately adoption, of computer-based surgical simulators.
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