Virtual Reality Simulator for the Training of Lumbar Punctures

Lumbar punctures are performed for diagnosis and therapy by inserting a needle into the spinal chord of the patient to inject medicaments or extract liquor. The training of this procedure is usually done guided by experienced supervisors directly in contact with the patient. A virtual reality lumbar puncture simulator has been developed in order to minimize the training costs and the patients risk and to give new insights into the human anatomy.

We use a haptic device with six degrees of freedom (6DOF) to feedback forces that resist needle insertion and rotation. An improved haptic volume rendering approach is used to calculate the forces. This approach makes use of label data of relevant structures like skin, bone, muscles or fat and original CT data that contributes information about structures that can not be segmented.

A realtime 3D visualization with optional stereo view gives an overview of the punctured region. 2D visualizations of orthogonal slices enable a detailed impression of the anatomical context. The input data consisting of CT and label data and surface models of relevant structures is stored in an XML file together with haptic rendering and visualization parameters. In a first step the Visible Human Male and the Visible Korean Human data sets have been used to generate the virtual bodies.

Several users with different medical experience tested the lumbar puncture trainer. The simulator gives a good haptic and visual impression of the needle insertion and the haptic volume rendering technique enables the feeling of unsegmented structures. Especially, the restriction of transversal needle movement together with rotation constraints enabled by the 6DOF device facilitate a realistic needle behavior.

Selected Publications

  1. Matthias Färber, Julika Heller, Heinz Handels
    Simulation and Training of Lumbar Punctures Using Haptic Volume Rendering and a 6DOF Haptic Device,
    In: Cleary K.R., Miga M.I. (eds.), Visualization, Image-Guided Procedures, and Display, SPIE Medical Imaging 2006, San Diego, SPIE Vol. 6509, 0F1-0F8, 2007
  2. Matthias Färber, Julika Heller, Hummel F., Gerloff C. Heinz Handels
    Virtual Reality based Training of Lumbar Punctures using a 6DOF Haptic Device,
    In: Buzug T., Holz D., Weber W., Bongartz J., Kohl-Bareis M., Hartmann U. (eds.), Advances in Medical Engineering, Springer Verlag, Berlin, 236-240, 2007

Project Manager

 Prof. Dr. Heinz Handels