Real-time Haptic Modeling and Simulation for Prosthetic Insertion
In this work a surgical simulator is produced which
enables a training otologist to conduct a virtual, real-time prosthetic
insertion. The simulator provides the Ear, Nose and Throat surgeon
with real-time visual and haptic responses during virtual cochlear
implantation into a 3D model of the human Scala Tympani (ST). The
parametric model is derived from measured data as published in the
literature and accounts for human morphological variance, such as
differences in cochlear shape, enabling patient-specific pre- operative
assessment. Haptic modeling techniques use real physical data and
insertion force measurements, to develop a force model which
mimics the physical behavior of an implant as it collides with the ST
walls during an insertion. Output force profiles are acquired from the
insertion studies conducted in the work, to validate the haptic model.
The simulator provides the user with real-time, quantitative insertion
force information and associated electrode position as user inserts the
virtual implant into the ST model. The information provided by this
study may also be of use to implant manufacturers for design
enhancements as well as for training specialists in optimal force
administration, using the simulator. The paper reports on the methods
for anatomical modeling and haptic algorithm development, with
focus on simulator design, development, optimization and validation.
The techniques may be transferrable to other medical applications
that involve prosthetic device insertions where user vision is
obstructed.
[1] B. Pflesser, A. Petersik, U. Tiede, K. H. Hohne and R Leuwer, "Volume
cutting for virtual petrous bone surgery," Computer Aided Surgery, vol.
7, pp. 74-83, 2002.
[2] J. Wiet, D. Stredney, D. Sessanna, J. A. Bryan, D. B. Welling and P.
Schmalbrock, "Virtual temporal bone dissection: an interactive surgical
simulator," Otolaryngology - Head and Neck Surgery, vol. 127, pp. 79-
83, 2002.
[3] A. Petersik, B. Pflesser, U. Tiede, K. H. Hohne and R. Leuwer,
"Realistic haptic interaction in volume sculpting for surgery simulation,"
Surgery Simulation and Soft Tissue Modeling, International Symposium
(IS4TH 2003), pp. 194-202, 2003.
[4] W. John, N. Thacker, M. Pokric, et al., "An integrated simulator for
surgery of the petrous bone," Medicine Meets Virtual Reality 2001, pp.
218-224, 2001.
[5] M. Agus, A. Giachetti, E. Gobbetti, G. Zanetti and A. Zorcolo, "Realtime
haptic and visual simulation of bone dissection," Presence, vol. 12,
pp. 110-122, 2003.
[6] M. Hutchins, S. O'Leary, D. Stevenson, C. Gunn and A. Krumpholz., "A
networked haptic virtual environment for teaching temporal bone
surgery," Medicine Meets Virtual Reality (MMVR) 13, pp. 204-207,
2005.
[7] A. Pommert, K. H. Höhne, E. Burmester, S. Gehrmann, R. Leuwer, A.
Petersik, B. Pflesser and U. Tiede, "Computer-based anatomy: a
prerequisite for computer-assisted radiology and surgery," Academic
Radiology, vol. 13, pp. 104-112, 2006.
[8] Kim, S. De and M. A. Srinivasan, "Computationally efficient techniques
for real time surgical simulation with force feedback," Proceedings of
the 10th Symp. On Haptic Interfaces for Virtual Envir. & Teleoperator
Systs. (Haptics '02), pp. 51-57, 2002.
[9] G. Burdea, G. Patounakis, V. Popescu and R. E. Weiss, "Virtual realitybased
training for the diagnosis of prostate cancer," IEEE Transactions
on Biomedical Engineering, vol. 46, pp. 1253-1260, 1999.
[10] A. Chanda and T. Kesavadas, "Real-time volume haptic rendering of
non-linear viscoelastic behavior of soft tissue through dynamic atomic
unit approach," Medicine Meets Virtual Reality 12, Newport Beach,
California, pp. 16-17, 2004.
[11] Y. Kuroda, M. Nakao, T. Kuroda, H. Ovama and M. Komori,
"Interaction model between elastic objects for haptic feedback
considering collisions of soft tissue," Computer Methods and Programs
in Biomedicine, vol. 80, pp. 216-224, 2005.
[12] Y.-J. Lim and S. De, "Nonlinear tissue response modeling for physically
realistic virtual surgery using PAFF," First Joint Eurohaptics
Conference and Symposium on Haptic Interfaces for Virtual
Environment and Teleoperator Systems (WHC 2005), pp. 479-480, 2005.
[13] M. O. Alhalabi, V. Daniulaitis, H. Kawasaki and T. Hori, "Medical
training simulation for palpation of subsurface tumor using HIRO," First
Joint Eurohaptics Conference and Symposium on Haptic Interfaces for
Virtual Environment and Teleoperator Systems (WHC 2005), pp. 623-
624, 2005.
[14] S. P. DiMaio and S. E. Salcudean, "Interactive simulation of needle
insertion models," IEEE Transactions on Biomedical Engineering, vol.
52, pp. 1167-1179, 2005.
[15] K.-U. Kyung, D.-S. Kwon, S.-M. Kwon, H. S. Kang and J. B. Ra, "Force
feedback for a spine biopsy simulator with volume graphic model," IEEE
International Conference on Intelligent Robots and Systems, pp. 1732-
1737, 2001.
[16] E. Gobbetti, M. Tuveri, G. Zanetti and A. Zorcolo, "Catheter insertion
simulation with co-registered direct volume rendering and haptic
feedback," Medicine Meets Virtual Reality 2000 - Envisioning Healing:
Interactive Technology and the Patient-Practioner Dialogue, pp. 96-98,
2000.
[17] X. Wang and A. Fenster, "A virtual reality based 3D real-time interactive
brachytherapy simulation of needle insertion and seed implantation,"
IEEE International Symposium on Biomedical Imaging: Macro to Nano,
pp. 280-283, 2004.
[18] P.-A. Heng and T.-T. Wong, "Intelligent inferencing and haptic
simulation for chinese acupuncture learning and training," IEEE
Transactions on Information Technology in Biomedicine, pp. 1-1, 2005.
[19] F. P. Vidal, N. Chalmers, D. A. Gould, A. E. Healey and N. W. John,
"Developing a needle guidance virtual environment with patient-specific
data and force feedback," International Congress Series, vol. 1281, pp.
418-423, 2005.
[20] W. Chou and T. Wang, "Human-computer interactive simulation for the
training of minimally invasive neurosurgery," IEEE International
Conference on Systems, Man and Cybernetics, pp. 1110-1115, 2003.
[21] P. Gorman, T. Krummel, R. Webster, M. Smith and D. Hutchens, "A
prototype haptic lumbar puncture simulator," Medicine Meets Virtual
Reality (MMVR), pp. 106-109, 2000.
[22] A. Zorcolo, E. Gobbetti, G. Zanetti and M. Tuveri, "A volumetric virtual
environment for catheter insertion simulation," Virtual Environments
2000, Proceedings of the Eurographics Workshop, Amsterdam, the
Netherlands, 2000.
[23] Aloisio, L. Barone, M. Bergamasco, C. A. Avizzano, L. T. De Paolis, M.
Franceschini, A. Mongelli, G. Pantile, L. Provenzano and M. Raspolli,
"Computer-based simulator for catheter insertion training," Medicine
Meets Virtual Reality 12, pp. 4-6, 2004.
[24] M. Brahim and Y. Amirat, "Interactive navigation control with haptic
rendering of endovascular treatment," IEEE Conference on Robotics,
Automation and Mechatronics, pp. 60-64, 2004.
[25] D. d'Aulignac, R. Balaniuk and C. Laugier, "A haptic interface for a
virtual exam of the human thigh," IEEE International Conference on
Robotics and Automation (ICRA), pp. 2452-2457, 2000.
[26] U. K├╝hnapfel, H. K. ├çakmak and H. Maaß, "Endoscopic surgery training
using virtual reality and deformable tissue simulation," Computers &
Graphics, vol. 24, pp. 671-682, 2000.
[27] G. Gopalakrishnan and V. Devarajan, "StapSim: A virtual reality-based
stapling simulator for laparoscopic herniorrhaphy," Medicine Meets
Virtual Reality 12, Newport Beach, California, pp. 111-113, 2004.
[28] C. Basdogan, C.-H. Ho and M. A. Srinivasan, "Virtual environments for
medical training: graphical and haptic simulation of laparoscopic
common bile duct," IEEE/ASME Transactions on Mechatronics, vol. 6,
pp. 269-285, 2001.
[29] Zhang 2004 H. Zhang, S. Payandeh, J. Dill and A. J. Lomax, "Acquiring
laparoscopic manipulative skills: a virtual tissue dissection training
module," Medicine Meets Virtual Reality 12, pp. 419-421, 2004.
[30] C. Gunn, M. Hutchins, M. Adcock and R. Hawkins, "Surgical training
using haptics over long internet distances," Medicine Meets Virtual
Reality 12, pp. 121-123, 2004.
[31] M. P. Ottensmeyer, E. Ben-Ur and J. K. Sailsbury, "Input and output for
surgical simulation: devices to measure tissue properties in vivo and a
haptic interface for laparoscopy simulators," Medicine Meets Virtual
Reality, pp. 236-242, 2000.
[32] H. Maaß, H. ├çakmak, U. K├╝hnapfel, C Trantakis and G. Strauss,
"Providing more possibilities for haptic devices in surgery simulation,"
International Congress Series, vol. 1281, pp. 725-729, 2005.
[33] M. Bro-Nielsen, D. Helfrick, B. Glass, X. Zeng and H. Connacher, "VR
simulation of abdominal trauma surgery," Medicine Meets Virtual
Reality (MMVR), pp. 117-123, 1998.
[34] B. K. Chen, G. M. Clark and R. Jones, "Evaluation of trajectories and
contact pressures for the straight nucleus cochlear implant electrode
array - a two-dimensional application of finite element analysis,"
Medical Engineering & Physics, vol. 25, pp. 141-147, 2003.
[35] S. K. Yoo, G. Wang, J. T. Rubinstein and M. W. Vannier, "Threedimensional
geometric modeling of the cochlea using helico-spiral
approximation," IEEE Transactions on Biomedical Engineering, vol. 47,
pp. 1392-1402, 2000.
[36] D. R. Ketten, M. W. Skinner, G. Wang and M. W. Vannier, "In vivo
measures of cochlear length and insertion depth of nucleus cochlear
implant electrode arrays," Annals of Otology, Rhinology & Laryngology,
vol. 107, pp. 1-16, 1998.
[37] L. T. Cohen, J. Xu, S. A. Xu and G. M. Clark, "Improved and simplified
methods for specifying positions of the electrode bands of a cochlear
implant array," The American Journal of Otology, vol. 17, pp. 859-865,
1996.
[38] A. Kawano, H. L. Seldon and G. M. Clark, "Computer-aided threedimensional
reconstruction in human cochlear maps: measurement of the
lengths of organ of corti, outer wall, inner wall, and rosenthal's canal,"
Annals of Otology, Rhinology & Laryngology, vol. 105, pp. 701-709,
1996.
[39] J. T. Vrabec, S. W. Champion, J. D. Gomez, R. F. Johnson Jr, G.
Chaljub, "3D CT imaging method for measuring temporal bone
aeration", Acta Oto-Laryngologica, vol. 122, no. 8, pp. 831-835, 2002.
[40] E. Givelberg and J. Bunn, "Computational experiments with a threedimensional
model of the cochlea," Technical Report, California
Institute of Technology, Caltech CACR, 2004.
[41] S.-I. Hatsushika, R. K. Shepherd, Y. C. Tong, G. M. Clark and S.
Funasaka, "Dimensions of the scala tympani in the human and cat with
reference to cochlear implants," Annals of Otology, Rhinology &
Laryngology, vol. 99, pp. 871-876, 1990.
[42] H. M. Ladak, "Finite-element modelling of middle-ear prostheses in
cats", Masters Thesis, Montreal, Canada, McGill University, 1993.
[43] R. Lakes, H. S. Yoon and J. L. Katz, "Ultrasonic wave propagation and
attenuation in wet bone," Journal of Biomedical Engineering, vol. 8, pp.
143-148, 1986.
[44] J. Raethjen, F. Pawlas, M. Lindemann, R. Wenzelburger and G. Deuschl,
"Determinants of physiologic tremor in a large normal population,"
Clinical Neurophysiology, vol. 111, pp. 1825-1837, 2000.
[45] H. N. Kha, B. K. Chen, G. M. Clark and R. Jones, "Stiffness properties
for nucleus standard straight and contour electrode arrays," Medical
Engineering & Physics, vol. 26, pp. 677-685, 2004.
[1] B. Pflesser, A. Petersik, U. Tiede, K. H. Hohne and R Leuwer, "Volume
cutting for virtual petrous bone surgery," Computer Aided Surgery, vol.
7, pp. 74-83, 2002.
[2] J. Wiet, D. Stredney, D. Sessanna, J. A. Bryan, D. B. Welling and P.
Schmalbrock, "Virtual temporal bone dissection: an interactive surgical
simulator," Otolaryngology - Head and Neck Surgery, vol. 127, pp. 79-
83, 2002.
[3] A. Petersik, B. Pflesser, U. Tiede, K. H. Hohne and R. Leuwer,
"Realistic haptic interaction in volume sculpting for surgery simulation,"
Surgery Simulation and Soft Tissue Modeling, International Symposium
(IS4TH 2003), pp. 194-202, 2003.
[4] W. John, N. Thacker, M. Pokric, et al., "An integrated simulator for
surgery of the petrous bone," Medicine Meets Virtual Reality 2001, pp.
218-224, 2001.
[5] M. Agus, A. Giachetti, E. Gobbetti, G. Zanetti and A. Zorcolo, "Realtime
haptic and visual simulation of bone dissection," Presence, vol. 12,
pp. 110-122, 2003.
[6] M. Hutchins, S. O'Leary, D. Stevenson, C. Gunn and A. Krumpholz., "A
networked haptic virtual environment for teaching temporal bone
surgery," Medicine Meets Virtual Reality (MMVR) 13, pp. 204-207,
2005.
[7] A. Pommert, K. H. Höhne, E. Burmester, S. Gehrmann, R. Leuwer, A.
Petersik, B. Pflesser and U. Tiede, "Computer-based anatomy: a
prerequisite for computer-assisted radiology and surgery," Academic
Radiology, vol. 13, pp. 104-112, 2006.
[8] Kim, S. De and M. A. Srinivasan, "Computationally efficient techniques
for real time surgical simulation with force feedback," Proceedings of
the 10th Symp. On Haptic Interfaces for Virtual Envir. & Teleoperator
Systs. (Haptics '02), pp. 51-57, 2002.
[9] G. Burdea, G. Patounakis, V. Popescu and R. E. Weiss, "Virtual realitybased
training for the diagnosis of prostate cancer," IEEE Transactions
on Biomedical Engineering, vol. 46, pp. 1253-1260, 1999.
[10] A. Chanda and T. Kesavadas, "Real-time volume haptic rendering of
non-linear viscoelastic behavior of soft tissue through dynamic atomic
unit approach," Medicine Meets Virtual Reality 12, Newport Beach,
California, pp. 16-17, 2004.
[11] Y. Kuroda, M. Nakao, T. Kuroda, H. Ovama and M. Komori,
"Interaction model between elastic objects for haptic feedback
considering collisions of soft tissue," Computer Methods and Programs
in Biomedicine, vol. 80, pp. 216-224, 2005.
[12] Y.-J. Lim and S. De, "Nonlinear tissue response modeling for physically
realistic virtual surgery using PAFF," First Joint Eurohaptics
Conference and Symposium on Haptic Interfaces for Virtual
Environment and Teleoperator Systems (WHC 2005), pp. 479-480, 2005.
[13] M. O. Alhalabi, V. Daniulaitis, H. Kawasaki and T. Hori, "Medical
training simulation for palpation of subsurface tumor using HIRO," First
Joint Eurohaptics Conference and Symposium on Haptic Interfaces for
Virtual Environment and Teleoperator Systems (WHC 2005), pp. 623-
624, 2005.
[14] S. P. DiMaio and S. E. Salcudean, "Interactive simulation of needle
insertion models," IEEE Transactions on Biomedical Engineering, vol.
52, pp. 1167-1179, 2005.
[15] K.-U. Kyung, D.-S. Kwon, S.-M. Kwon, H. S. Kang and J. B. Ra, "Force
feedback for a spine biopsy simulator with volume graphic model," IEEE
International Conference on Intelligent Robots and Systems, pp. 1732-
1737, 2001.
[16] E. Gobbetti, M. Tuveri, G. Zanetti and A. Zorcolo, "Catheter insertion
simulation with co-registered direct volume rendering and haptic
feedback," Medicine Meets Virtual Reality 2000 - Envisioning Healing:
Interactive Technology and the Patient-Practioner Dialogue, pp. 96-98,
2000.
[17] X. Wang and A. Fenster, "A virtual reality based 3D real-time interactive
brachytherapy simulation of needle insertion and seed implantation,"
IEEE International Symposium on Biomedical Imaging: Macro to Nano,
pp. 280-283, 2004.
[18] P.-A. Heng and T.-T. Wong, "Intelligent inferencing and haptic
simulation for chinese acupuncture learning and training," IEEE
Transactions on Information Technology in Biomedicine, pp. 1-1, 2005.
[19] F. P. Vidal, N. Chalmers, D. A. Gould, A. E. Healey and N. W. John,
"Developing a needle guidance virtual environment with patient-specific
data and force feedback," International Congress Series, vol. 1281, pp.
418-423, 2005.
[20] W. Chou and T. Wang, "Human-computer interactive simulation for the
training of minimally invasive neurosurgery," IEEE International
Conference on Systems, Man and Cybernetics, pp. 1110-1115, 2003.
[21] P. Gorman, T. Krummel, R. Webster, M. Smith and D. Hutchens, "A
prototype haptic lumbar puncture simulator," Medicine Meets Virtual
Reality (MMVR), pp. 106-109, 2000.
[22] A. Zorcolo, E. Gobbetti, G. Zanetti and M. Tuveri, "A volumetric virtual
environment for catheter insertion simulation," Virtual Environments
2000, Proceedings of the Eurographics Workshop, Amsterdam, the
Netherlands, 2000.
[23] Aloisio, L. Barone, M. Bergamasco, C. A. Avizzano, L. T. De Paolis, M.
Franceschini, A. Mongelli, G. Pantile, L. Provenzano and M. Raspolli,
"Computer-based simulator for catheter insertion training," Medicine
Meets Virtual Reality 12, pp. 4-6, 2004.
[24] M. Brahim and Y. Amirat, "Interactive navigation control with haptic
rendering of endovascular treatment," IEEE Conference on Robotics,
Automation and Mechatronics, pp. 60-64, 2004.
[25] D. d'Aulignac, R. Balaniuk and C. Laugier, "A haptic interface for a
virtual exam of the human thigh," IEEE International Conference on
Robotics and Automation (ICRA), pp. 2452-2457, 2000.
[26] U. K├╝hnapfel, H. K. ├çakmak and H. Maaß, "Endoscopic surgery training
using virtual reality and deformable tissue simulation," Computers &
Graphics, vol. 24, pp. 671-682, 2000.
[27] G. Gopalakrishnan and V. Devarajan, "StapSim: A virtual reality-based
stapling simulator for laparoscopic herniorrhaphy," Medicine Meets
Virtual Reality 12, Newport Beach, California, pp. 111-113, 2004.
[28] C. Basdogan, C.-H. Ho and M. A. Srinivasan, "Virtual environments for
medical training: graphical and haptic simulation of laparoscopic
common bile duct," IEEE/ASME Transactions on Mechatronics, vol. 6,
pp. 269-285, 2001.
[29] Zhang 2004 H. Zhang, S. Payandeh, J. Dill and A. J. Lomax, "Acquiring
laparoscopic manipulative skills: a virtual tissue dissection training
module," Medicine Meets Virtual Reality 12, pp. 419-421, 2004.
[30] C. Gunn, M. Hutchins, M. Adcock and R. Hawkins, "Surgical training
using haptics over long internet distances," Medicine Meets Virtual
Reality 12, pp. 121-123, 2004.
[31] M. P. Ottensmeyer, E. Ben-Ur and J. K. Sailsbury, "Input and output for
surgical simulation: devices to measure tissue properties in vivo and a
haptic interface for laparoscopy simulators," Medicine Meets Virtual
Reality, pp. 236-242, 2000.
[32] H. Maaß, H. ├çakmak, U. K├╝hnapfel, C Trantakis and G. Strauss,
"Providing more possibilities for haptic devices in surgery simulation,"
International Congress Series, vol. 1281, pp. 725-729, 2005.
[33] M. Bro-Nielsen, D. Helfrick, B. Glass, X. Zeng and H. Connacher, "VR
simulation of abdominal trauma surgery," Medicine Meets Virtual
Reality (MMVR), pp. 117-123, 1998.
[34] B. K. Chen, G. M. Clark and R. Jones, "Evaluation of trajectories and
contact pressures for the straight nucleus cochlear implant electrode
array - a two-dimensional application of finite element analysis,"
Medical Engineering & Physics, vol. 25, pp. 141-147, 2003.
[35] S. K. Yoo, G. Wang, J. T. Rubinstein and M. W. Vannier, "Threedimensional
geometric modeling of the cochlea using helico-spiral
approximation," IEEE Transactions on Biomedical Engineering, vol. 47,
pp. 1392-1402, 2000.
[36] D. R. Ketten, M. W. Skinner, G. Wang and M. W. Vannier, "In vivo
measures of cochlear length and insertion depth of nucleus cochlear
implant electrode arrays," Annals of Otology, Rhinology & Laryngology,
vol. 107, pp. 1-16, 1998.
[37] L. T. Cohen, J. Xu, S. A. Xu and G. M. Clark, "Improved and simplified
methods for specifying positions of the electrode bands of a cochlear
implant array," The American Journal of Otology, vol. 17, pp. 859-865,
1996.
[38] A. Kawano, H. L. Seldon and G. M. Clark, "Computer-aided threedimensional
reconstruction in human cochlear maps: measurement of the
lengths of organ of corti, outer wall, inner wall, and rosenthal's canal,"
Annals of Otology, Rhinology & Laryngology, vol. 105, pp. 701-709,
1996.
[39] J. T. Vrabec, S. W. Champion, J. D. Gomez, R. F. Johnson Jr, G.
Chaljub, "3D CT imaging method for measuring temporal bone
aeration", Acta Oto-Laryngologica, vol. 122, no. 8, pp. 831-835, 2002.
[40] E. Givelberg and J. Bunn, "Computational experiments with a threedimensional
model of the cochlea," Technical Report, California
Institute of Technology, Caltech CACR, 2004.
[41] S.-I. Hatsushika, R. K. Shepherd, Y. C. Tong, G. M. Clark and S.
Funasaka, "Dimensions of the scala tympani in the human and cat with
reference to cochlear implants," Annals of Otology, Rhinology &
Laryngology, vol. 99, pp. 871-876, 1990.
[42] H. M. Ladak, "Finite-element modelling of middle-ear prostheses in
cats", Masters Thesis, Montreal, Canada, McGill University, 1993.
[43] R. Lakes, H. S. Yoon and J. L. Katz, "Ultrasonic wave propagation and
attenuation in wet bone," Journal of Biomedical Engineering, vol. 8, pp.
143-148, 1986.
[44] J. Raethjen, F. Pawlas, M. Lindemann, R. Wenzelburger and G. Deuschl,
"Determinants of physiologic tremor in a large normal population,"
Clinical Neurophysiology, vol. 111, pp. 1825-1837, 2000.
[45] H. N. Kha, B. K. Chen, G. M. Clark and R. Jones, "Stiffness properties
for nucleus standard straight and contour electrode arrays," Medical
Engineering & Physics, vol. 26, pp. 677-685, 2004.
@article{"International Journal of Medical, Medicine and Health Sciences:49236", author = "Catherine A. Todd and Fazel Naghdy", title = "Real-time Haptic Modeling and Simulation for Prosthetic Insertion", abstract = "In this work a surgical simulator is produced which
enables a training otologist to conduct a virtual, real-time prosthetic
insertion. The simulator provides the Ear, Nose and Throat surgeon
with real-time visual and haptic responses during virtual cochlear
implantation into a 3D model of the human Scala Tympani (ST). The
parametric model is derived from measured data as published in the
literature and accounts for human morphological variance, such as
differences in cochlear shape, enabling patient-specific pre- operative
assessment. Haptic modeling techniques use real physical data and
insertion force measurements, to develop a force model which
mimics the physical behavior of an implant as it collides with the ST
walls during an insertion. Output force profiles are acquired from the
insertion studies conducted in the work, to validate the haptic model.
The simulator provides the user with real-time, quantitative insertion
force information and associated electrode position as user inserts the
virtual implant into the ST model. The information provided by this
study may also be of use to implant manufacturers for design
enhancements as well as for training specialists in optimal force
administration, using the simulator. The paper reports on the methods
for anatomical modeling and haptic algorithm development, with
focus on simulator design, development, optimization and validation.
The techniques may be transferrable to other medical applications
that involve prosthetic device insertions where user vision is
obstructed.", keywords = "Haptic modeling, medical device insertion, real-time
visualization of prosthetic implantation, surgical simulation.", volume = "5", number = "1", pages = "1-9", }
