Haptic interaction for needle insertion training in medical applications: The state-of-the-art.

Computer-based simulation for medical procedures training has been gaining relevance, as well the use of haptic devices for developing fine motor skills in such simulations. The purpose of this paper is to present a review of the state-of-the-art in virtual needle insertion training simulation based on haptic interaction. A systematic review method was applied to gather documentation that enables a rigorous audit of the process stages and results. We established a classification system based on certain characteristics of the studies analyzed, including: main procedures and target body regions in medical applications; ways to generate haptic feedback; devices; types of environment; and user validation. In addition, the review aimed to identify challenges and trends in the field, indicating research opportunities. Results showed the predominance of Virtual Reality and commercial haptic devices in simulations. Since most studies are based on subjective tests, finding ways to objectively evaluate haptic interaction perception represents a promising research field. We also found that devices and ways to generate haptic feedback and to represent tissue and needle behavior pose limitations and challenges for computer simulation. Finally, the realism provided is a constant concern in the validation process, which brings another problem: defining and performing suitable user tests.

Virtual Reality simulator for dental anesthesia training in the inferior alveolar nerve block.

OBJECTIVES: This study shows the development and validation of a dental anesthesia-training simulator, specifically for the inferior alveolar nerve block (IANB). The system developed provides the tactile sensation of inserting a real needle in a human patient, using Virtual Reality (VR) techniques and a haptic device that can provide a perceived force feedback in the needle insertion task during the anesthesia procedure. MATERIAL AND METHODS: To simulate a realistic anesthesia procedure, a Carpule syringe was coupled to a haptic device. The Volere method was used to elicit requirements from users in the Dentistry area; Repeated Measures Two-Way ANOVA (Analysis of Variance), Tukey post-hoc test and averages for the results' analysis. A questionnaire-based subjective evaluation method was applied to collect information about the simulator, and 26 people participated in the experiments (12 beginners, 12 at intermediate level, and 2 experts). The questionnaire included profile, preferences (number of viewpoints, texture of the objects, and haptic device handler), as well as visual (appearance, scale, and position of objects) and haptic aspects (motion space, tactile sensation, and motion reproduction). RESULTS: The visual aspect was considered appropriate and the haptic feedback must be improved, which the users can do by calibrating the virtual tissues' resistance. The evaluation of visual aspects was influenced by the participants' experience, according to ANOVA test (F=15.6, p=0.0002, with p<0.01). The user preferences were the simulator with two viewpoints, objects with texture based on images and the device with a syringe coupled to it. CONCLUSION: The simulation was considered thoroughly satisfactory for the anesthesia training, considering the needle insertion task, which includes the correct insertion point and depth, as well as the perception of tissues resistances during the insertion.

Virtual Reality simulator for dental anesthesia training in the inferior alveolar nerve block

Abstract Objectives This study shows the development and validation of a dental anesthesia-training simulator, specifically for the inferior alveolar nerve block (IANB). The system developed provides the tactile sensation of inserting a real needle in a human patient, using Virtual Reality (VR) techniques and a haptic device that can provide a perceived force feedback in the needle insertion task during the anesthesia procedure. Material and Methods To simulate a realistic anesthesia procedure, a Carpule syringe was coupled to a haptic device. The Volere method was used to elicit requirements from users in the Dentistry area; Repeated Measures Two-Way ANOVA (Analysis of Variance), Tukey post-hoc test and averages for the results' analysis. A questionnaire-based subjective evaluation method was applied to collect information about the simulator, and 26 people participated in the experiments (12 beginners, 12 at intermediate level, and 2 experts). The questionnaire included profile, preferences (number of viewpoints, texture of the objects, and haptic device handler), as well as visual (appearance, scale, and position of objects) and haptic aspects (motion space, tactile sensation, and motion reproduction). Results The visual aspect was considered appropriate and the haptic feedback must be improved, which the users can do by calibrating the virtual tissues' resistance. The evaluation of visual aspects was influenced by the participants' experience, according to ANOVA test (F=15.6, p=0.0002, with p<0.01). The user preferences were the simulator with two viewpoints, objects with texture based on images and the device with a syringe coupled to it. Conclusion The simulation was considered thoroughly satisfactory for the anesthesia training, considering the needle insertion task, which includes the correct insertion point and depth, as well as the perception of tissues resistances during the insertion.