A Presentation for Medicine Meets Virtual Reality III
San Diego, California
January 19-22, 1995
John S. McDonald, Department of Anesthesiology
The Ohio State University Hospitals
Louis B. Rosenberg, Immersion Corporation
Don Stredney, Ohio Supercomputer Center
Epidural analgesia is one of the most frequently used techniques for the relief of pain during surgery. In most hospitals with an obstetric anesthesia service, epidural analgesia is the most prominently used anesthesia technique for vaginal childbirth and cesarean section. The procedure involves the injection of a local anesthetic or an opiod into the epidural space of the spinal column. Although a single degree-of-freedom task, it is a delicate manual operation that requires the operator to place a catheter into the epidural space using only haptic cues to guide the needle. By feeling the resistive forces of the needle passing through the various tissues, the physician must maneuver the tip of the needle into the correct space without damaging the spinal cord in the process.
There is no method of training residents on this delicate and dangerous manual task except on live patients. In addition, teaching this technique has a highly intensive tutorial demand and presents a significant learning curve in regard to understanding exact placement of the needle.
On January 21, 1995, at the Medicine Meets Virtual Reality III conference, Dr. McDonald will present a system for learning the epidural technique that has been created through the application and integration of virtual technologies. He will demonstrate the system's components, which include:
- a graphics workstation capable of stereo display,
- a voice recognition system,
- and a one-dimensional haptic probe.
The probe is capable of reflecting the resistive forces of penetrated tissues. The system enables the operator to investigate various three-dimensional reconstructed data sets in a non-threatening environment and to verbally cue the system to provide a cross-sectional view of the structures encountered which includes the plane of the needle. Furthermore, the system provides the necessary components to set up a master/slave scenario in which the student can see and "feel" the technique as performed by the expert. Finally, we will present our methods for testing the technical and learning efficacy of the system during system integration and design iteration.
