Virtual reality simulation of robotic transsphenoidal brain tumor resection: Evaluating dynamic motion scaling in a master-slave system

Background: Integrating simulators with robotic surgical procedures could assist in designing and testing of novel robotic control algorithms and further enhance patient-specific pre-operative planning and training for robotic surgeries. 

Methods: A virtual reality simulator, developed to perform the transsphenoidal resection of pituitary gland tumours, tested the usability of robotic interfaces and control algorithms. It used position-based dynamics to allow soft-tissue deformation and resection with haptic feedback; dynamic motion scaling control was also incorporated into the simulator. 

Results: Neurosurgeons and residents performed the surgery under constant and dynamic motion scaling conditions (CMS vs DMS). DMS increased dexterity and reduced the risk of damage to healthy brain tissue. Post-experimental questionnaires indicated that the system was well-evaluated by experts. 

Conclusion: The simulator was intuitively and realistically operated. It increased the safety and accuracy of the procedure without affecting intervention time. Future research can investigate incorporating this simulation into a real micro-surgical robotic system.