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A high-tech simulator lets brain surgeons ?practice? on virtual versions of their patients before the real surgery.
Ryan D'Arcy (left) and Dr. David Clarke pose in front of the neurosurgical simulator developed by NRC.
Brain surgeons around the world are abuzz over a unique virtual-reality neurological simulator, called NeuroTouch.
NeuroTouch was officially introduced at the XIV World Conference of Neurological Surgery held in Boston in late summer 2009. Developed by NRC, the groundbreaking technology enables brain surgeons to rehearse a delicate operation using a realistic three-dimensional, touch-sensitive simulation of a patient's brain prior to performing the actual procedure.
NeuroTouch proved a hit at the conference with neurosurgeons from every continent eagerly trying out the simulator prototype, which had already been used in a medical breakthrough in Canada. In August 2009, Dr. David Clarke, a staff neurosurgeon at the Queen Elizabeth II Health Sciences Centre in Halifax, successfully removed a benign tumour from the brain of 48-year-old Ellen Wright. He perfected his surgical approach a few hours earlier on her anatomically precise ?virtual brain,? generated by NeuroTouch.
?Before the surgery, Wright asked how the rehearsal went, which is amazing when you consider that the technology can give a patient more confidence knowing that the surgeon addressed any problems in advance of a procedure,? says Dr. Ryan D'Arcy, an NRC neuroscientist based in Halifax who helped develop the simulator. ?The surgery demonstrated the immediate impact of research and development ' in this case, on the quality of health care.?
?This project showcases NRC's multidisciplinary strengths. By bringing together NRC experts from across the country in engineering, medical research and computer sciences ? and with the help of our partners ' we've achieved some remarkable results very quickly.?
Dr. Robert DiRaddo, scientific leader, NeuroTouch project, NRC
Dr. D'Arcy describes NeuroTouch as the medical equivalent of a training flight simulator that helps pilots navigate through various virtual scenarios, such as clear-sky conditions and inclement weather, before their first takeoff. NeuroTouch also simulates scenarios by enabling a neuro-oncological surgeon to map out critical functions of the brain and use that information to determine how aggressive to be in excising a brain tumour without disrupting speech, mobility or other functions.
However, NeuroTouch is not a generic simulator ' ?it's patient-specific,? says Dr. D'Arcy. A series of MRI scans are taken of a patient's brain and put into the simulator to generate 3D images. This shows a surgeon such precise detail as a brain pulsating or where bleeding could occur, which helps determine whether there could be complications during surgery.
The surgeon can also feel the texture of the virtual brain through high-resolution haptic hardware that enables a user to interact with virtual objects using motion and touch and makes the virtual tissue behave as it would in actual surgery. When a surgical instrument touches virtual fibrous tissue, the surgeon feels resistance. When soft tissue is touched, the instrument moves smoothly.
NRC has set up a test site for NeuroTouch at the Montreal Neurological Institute, which will be followed by sites at clinical neurosurgical training centres in Halifax, Ottawa, Toronto, London, Winnipeg, Calgary and Vancouver. Each site will be equipped with a NeuroTouch trainer and rehearsal system (the virtual reality simulator) and a NeuroTouch planner ' a software tool that captures a patient's brain images using MRI technology and helps a surgeon visually plan a patient's surgery. In turn, each site will provide feedback that NRC can use to improve upon and fine-tune the simulator and planner, both of which were developed by some 50 scientists in 10 Canadian centres over an 18-month period.
Dr. D'Arcy expects NeuroTouch to become an invaluable learning tool for surgeons to practise advanced procedures in brain surgery and make better use of valuable operating room time. In turn, that training could help reduce the potential for damage to surrounding tissues ? such as functional areas, nerves and blood vessels ' and lessen the possibility of tumour recurrence. 
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