TY - JOUR A1 - Maier, Johannes A1 - Perret, Jerome A1 - Simon, Martina A1 - Schmitt-Rüth, Stephanie A1 - Wittenberg, Thomas A1 - Palm, Christoph T1 - Force-feedback assisted and virtual fixtures based K-wire drilling simulation JF - Computers in Biology and Medicine N2 - One common method to fix fractures of the human hand after an accident is an osteosynthesis with Kirschner wires (K-wires) to stabilize the bone fragments. The insertion of K-wires is a delicate minimally invasive surgery, because surgeons operate almost without a sight. Since realistic training methods are time consuming, costly and insufficient, a virtual-reality (VR) based training system for the placement of K-wires was developed. As part of this, the current work deals with the real-time bone drilling simulation using a haptic force-feedback device. To simulate the drilling, we introduce a virtual fixture based force-feedback drilling approach. By decomposition of the drilling task into individual phases, each phase can be handled individually to perfectly control the drilling procedure. We report about the related finite state machine (FSM), describe the haptic feedback of each state and explain, how to avoid jerking of the haptic force-feedback during state transition. The usage of the virtual fixture approach results in a good haptic performance and a stable drilling behavior. This was confirmed by 26 expert surgeons, who evaluated the virtual drilling on the simulator and rated it as very realistic. To make the system even more convincing, we determined real drilling feed rates through experimental pig bone drilling and transferred them to our system. Due to a constant simulation thread we can guarantee a precise drilling motion. Virtual fixtures based force-feedback calculation is able to simulate force-feedback assisted bone drilling with high quality and, thus, will have a great potential in developing medical applications. KW - Handchirurgie KW - Osteosynthese KW - Operationstechnik KW - Lernprogramm KW - Virtuelle Realität KW - Medical training system KW - Virtual fixtures KW - Virtual reality KW - Force-feedback haptic KW - Minimally invasive hand surgery KW - K-wire drilling Y1 - 2019 U6 - https://doi.org/10.1016/j.compbiomed.2019.103473 N1 - Corresponding author: Christoph Palm VL - 114 SP - 1 EP - 10 PB - Elsevier ER -