Abstract:

Training in surgery is often done by a learning-bydoing technique with a direct involvement in surgical intervention on cadavers, animals and, in the final stage, directly inside the operating room (OR)1. Traditional methods of learning have helped generations of surgeons to familiarize themselves with human anatomy. Nevertheless, even texts with the highest level of accuracy and image quality are limited by the two-dimensional nature of printed material, which cannot impart three-dimensional (3D) views. Video material is similarly limited as to deliver a 3D experience. Another restriction of most traditional methods for the study of anatomy relates to the lack of interactivity and feedback.
The practice of surgery requires a unique blend of quick, high-stake complex decisions, and manual and technological skills related to OR instrumentations. Therefore, surgery is much more than the ability to perform a series of sequential tasks and the trainee must be able to contextualize his knowledge by applying it to a real situation. Interactions in the training process are not usually allowed during a clinical operating session whereas a training session on a virtual reality system makes them feasible without any drawback.
Although surgical planning systems have been adopted a long time ago for special purposes, most of them are intended for surgical planning and training of endoscopic and laparoscopic intervention, and are heavily based upon complex and custom tools. Different studies demonstrated that the training of potentially hazardous procedures could result in a reduction of surgical morbidity and risks1.
In this study we present a 3D software for virtual reality navigation in plastic surgery. VirSSPA software reconstructions have been used in our centre since the year 2007 for a wide number of reconstructive procedures2,3. We consider it has become an extremely valuable tool for the teaching of plastic surgery to residents and interested physicians, as well as for planning complex operations.

Acknowledgements: The VirSSPA project is being developed and financed by the Andalusia Department of Health, Spain

References:
1. Silem W. Surgical education: in need of a shift in paradigm. Surgery 2003;134:399.
2. Gacto P, Barrera F, Sicilia-Castro D, et al. A three-dimensional virtual reality model for limb reconstruction in burned patients. Burns 2008 (in press)
3. Gacto-Sánchez P, Sicilia-Castro D, Gómez-Cía T, et al. Use of a three-dimensional virtual reality model for preoperative imaging in DIEP flap breast reconstruction. J Surg Res 2009 (in press)

Keywords:

computer assisted surgery, virtual reality systems, learning, computer simulation.