A Virtual-Based Haptic Endoscopic Sinus Surgery (ESS) Training System: from Development to Validation

With the integration of robotic systems in surgery, the adaptability and success rate of surgery has improved noticeably, allowing for surgeons to automate repetitive tasks, reduce the manpower in the OR, as well as reduce the risk posed to the patient by directly alleviating surgeon fatigue (Taylor et al 1995) (Casals 1998) (Michel 2021). Another critical factor that is addressed through the introduction of robotics in surgery is the high level of skill that is demanded from the surgeon; highly delicate surgeries require years of training, in addition to an exceptional understanding of the human anatomy. ESS, characteristically a minimally invasive Endoscopic Sinus Surgery, is one of such surgeries (Fried et al 2005) (Zhao et al 2021) (Lourijsen et al 2022). Given the tight spatial and visual constraints, the increased complexity of the procedure demands the ability to navigate around intraoperative issues such as visual perception, anatomy recognition, and nonhomogeneous 2 Medical and Healthcare Robotics anatomical makeup, not to mention the real-time identification of presence of critical regions like brain tissue, carotid artery, optic nerve, and other intracranial structures (Fried et al 2004). Thus, the importance of extensive practice and training is undoubtedly high for increasing the success rate for such a surgery.