New York University Med. Cntr., New York, NY, USA.
PURPOSE: Education in plastic surgery has been augmented beyond the printed page by the use of multimedia such as audio, video and, most recently, by three dimensional surgical animation. The next logical step in surgical education is a surgical simulator based educational environment. The student surgeon interacts directly with the surgical problem to be studied in a multimedia, virtual reality environment.
METHODS: A Windows(R) based surgical simulation environment was created using the C++ language. Tools were developed to make incisions, lift flaps, retract and suture tissue edges. In addition audio and video files can be triggered during playback of a "history" file created by an expert surgeon. Internet based multiuser capability has been built into the program.
RESULTS: A Hogan lateral port control pharyngeal flap is demonstrated using the simulator. This has been integrated with nasal endoscopy, audio, surgical video and animation during user directed playback of the procedure done by an expert.
CONCLUSION: Virtual reality techniques can be used to significantly augment the surgical education process. The commercial drive to develop video games has driven the cost down for such an effort. Expert surgical choreography of difficult procedures can be recorded and mixed into a multimedia surgical experience. Internet based surgical symposia can be conducted with several centers all operating on the same virtual patient at the same time.