Virtual Reality Based Training of Lumbar Punctures Using a 6DOF Haptic Device

The lumbar puncture is performed by inserting a needle into the spinal chord of the patient to inject medicaments or to extract liquor. This procedure is usually trained on the patient guided by experienced supervisors. A virtual reality lumbar puncture simulator has been developed in order to enhance the training by providing new insight into a virtual patient and in order to minimize the patient's risk. 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 for the haptic feedback. A real time 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. In a first evaluation the visible human male data has been used to generate the virtual body. 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 segmented and unsegmented structures.