Virtual Reality Based Training of Lumbar Punctures Using a 6DOF Haptic Device

Abstract

The lumbar puncture is performed by inserting a needle into the spinalchord of the patient to inject medicaments or to extract liquor. Thisprocedure is usually trained on the patient guided by experiencedsupervisors. A virtual reality lumbar puncture simulator has beendeveloped in order to enhance the training by providing new insight intoa virtual patient and in order to minimize the patient's risk. We use ahaptic device with six degrees of freedom (6DOF) to feedback forces thatresist needle insertion and rotation. An improved haptic volumerendering approach is used to calculate the forces for the hapticfeedback. A real time 3D visualization with optional stereo view givesan overview of the punctured region. 2D visualizations of orthogonalslices enable a detailed impression of the anatomical context. In afirst evaluation the visible human male data has been used to generatethe virtual body. Several users with different medical experience testedthe lumbar puncture trainer. The simulator gives a good haptic andvisual impression of the needle insertion and the haptic volumerendering technique enables the feeling of segmented and unsegmentedstructures.