VR and AR simulator for neurosurgical training

The placement of an external ventricular drain is one of the most commonly performed neurosurgical procedures, and consequently, is an essential skill to be mastered by neurosurgical trainees. The optimal placement of the drain involves choosing an appropriate burr hole on the skull and blindly placing a catheter through the burr hole to intersect a lateral ventricle in order to drain cerebrospinal fluid and relieve intracranial pressure. Undesirable trajectories lead to multiple tries in order to hit the ventricle, with potential risk of damaging eloquent brain areas. In this paper, we describe the development of a simulation environment to train residents on the acquisition of these targeting skills before attempting the placement on live patients. The platform is coupled with an augmented reality image-guidance tool, developed in our lab, to help with the visualization of the ventricles in the patient´s head. Performance is evaluated using Fitts´ methodology (Fitts, 1954), which respects the users ability to trade-off speed and accuracy.