introducing a robotic lumbar puncture simulator with force feedback: lp sim

Purpose: lumbar puncture (lp) is widely used for spinal and epidural anesthesia or cerebrospinal fluid (csf) sampling procedures. as this procedure is highly complicated and needs high experience to be performed correctly, it is necessary to teach this skill to the physicians. considering the limitation of number of usage of rubber models and advantages of virtual reality (vr) environment for digital training of skills, we tried to investigate the capability of vr environment to train the lp procedures. materials and methods: geometrical model of the lumbar area of l2 to l5 are extracted from fusion of mr and ct imaging modalities. also physical model of resistance of each layers against needle insertion at lumbar area are investigated through specially designed sensorized handle for lp needle and recorded from a 41-year-old female patient. then geometrical and physical models of lumbar area are fused together and the vr model of it, with insertion force rendering capability is extracted. then the model is integrated with a haptic device and the complete vr environment is investigated. results: in this work we introduced a robotic lumbar puncture simulator (lp sim) with force feedback which may be used for training the lp procedures. using the lp sim, when a trainee inserts the needle inside the lumbar area at the provided virtual reality environment, he/she may feel the insertion forces against his/her movement inside the virtual lumbar area.conclusion: the lp sim is a virtual reality-enabled environment, with force feedback, that provides an appropriate framework for training this skill.