Virtual reality and medicine: from training systems to performance machines

The paper reviews a decade of work in applying virtual reality to medicine. Beginning with a brief history of simulations and surgery, we present a background to surgery simulators and then discuss the problem of limited human body models in past systems. We present our work at developing human body models beginning with the first virtual reality leg simulator in 1989. This model allowed simple tendon transfers and osteotomies with the computer able to predict the resulting mechanics and ability to walk. We also discuss the leg model's evolution into a performance machine which will allow a surgeon to predict position and subsequent function of an Anterior Cruciate Ligament (ACL) repair. This is paralleled by Department of Defense work on a leg model that can have a simulated wound and predicts blood loss and its ability to function. We review computer aided surgery and virtual reality technologies. We then present our work in plastic surgery computer aided planning and predict the importance of this work for surgical training.