JP6104288B2 - Method for generating surgical simulation model, surgical simulation method, and surgical simulator - Google Patents

Description

  The present invention relates to a method for generating a surgical simulation model for performing a surgical simulation before performing an operation under an endoscope, a surgical simulation method, and a surgical simulator.

With advances in medical technology and medical equipment, many abdominal operations have been performed laparoscopically. In laparoscopic surgery, a three-dimensional operation is performed while looking at a two-dimensional image display device, so training is essential for learning. In actual laparoscopic surgery, the number and running of blood vessels and the positional relationship of organs, such as the position and size of a tumor, differ for each patient, and surgery corresponding to each is required.
In order to enable preoperative simulation, a simulator can be considered based on individual patient information.
It is common to use medical image data such as CT and MRI in order to incorporate individual patient information, but such images cannot be recognized because the membrane tissue around the surgical organ is not reflected, There are problems such as inability to model, and models without them are incomplete as preoperative simulations. In addition, it is conceivable to set the physical and mechanical conditions of the organ to be operated linearly, but in this case, the deformation of the organ is greatly different from the actual one, which is unsatisfactory as a preoperative simulation.

  Moreover, although there exists a thing as described in international publication 2008/032875 as a simulation, this is related with platelet thrombus formation simulation, and the force added to the spring to be used simulates the force by the viscosity of blood. However, the technical field and the object to be simulated differ from the object and the means of realization in that the invention of the present application relates to a surgical simulation and the force applied to the spring of the present application simulates the force from the simulated surgical tool as will be described later. It is.

International Publication No. 2008/032875

  The problem to be solved by the present invention is to provide a method for generating a simulation model in accordance with a surgical situation from a medical image, a surgical simulation method, and a surgical simulator.

In the method for generating a surgical simulation model according to claim 1, in the volume data construction unit, geometric information is acquired from the original data of the medical image of the surgical subject stored in the medical image data storage unit, and the medical image Necessary organs included in the original data are extracted two-dimensionally, arranged according to the determined connection relationship of each organ, and these sliced images are stacked to construct the three-dimensional volume data of the necessary organs A first step of performing meshing on the generated three-dimensional volume data organ in the volume data construction unit after the first step, and covering the meshed organ in the volume data construction unit a third step of forming a simulated film multiple layers that can not be recognized by the medical image, in the volume data forming unit, the meshing Between each node spring constant is set to a non-linear connected by meshing of the organ that is, from, characterized in that comprising a fourth step of forming a virtual spring arrangement for generating a force corresponding to the simulated surgical instrument It is characterized by.

The surgical simulation method according to claim 2 includes: a force sense simulation process in which a force sense device generates a reaction force according to a position of a surgical operation tool operated by an operator and a contact position with a simulated living body; Is an operation target, and the volume data construction unit needs to acquire geometric information from the original data of the medical image of the operation target person stored in the medical image data storage unit and be included in the original data of the medical image. the organ was extracted two-dimensionally, arranged according to the connection relationship defined of each organ, the further constructed meshing organs and meshing organ as a three-dimensional volume data by laminating these sliced images cover, from a medical image each node between the spring constants connected by meshing the simulated a plurality of films that can not be recognized is set to a non-linear, to generate a force corresponding to the simulated surgical instrument Obtain model data for surgical simulation to be formed and arranged with imaginary springs, and calculate the reaction force due to the movement of the surgical operation tool and the contact between the surgical operation tool and the simulated living body through the force simulation process and give it to the force simulation process And a simulated motion calculation process for calculating the motion of the simulated living body and the reaction, an image generating process for generating a simulated image of the simulated living body imaged from the simulated endoscope, and an image display device for the image And an image display process for displaying an image generated by the generation process.

  The surgical simulation method according to claim 3 is the one according to claim 2, wherein in the simulated motion calculation process, the positional deformation that is the reaction of the simulated living body due to the applied force is reflected in the change in physical property value of the living body The reaction force is calculated based on the reflected physical property value.

The operation simulator according to claim 5 is an operation target, and the volume data construction unit acquires geometric information from the original data of the medical image of the operation target person stored in the medical image data storage unit, and the medical image Necessary organs included in the original data are extracted two-dimensionally, arranged according to the determined connection relation of each organ, and further, these sliced images are stacked and constructed as three-dimensional volume data and meshed. A virtual spring that covers the organs and meshed organs and that has a non-linear spring constant between nodes connected by meshing to multiple layers of simulated membranes that cannot be recognized from medical images, and generates force according to the simulated surgical tool The surgical simulation model data to be obtained and stored in the surgical simulation model data section to be stored and the surgical operation operated by the operator A force sensation device that generates a reaction force according to the position of the tool and the contact position of the simulated living body, and obtaining surgical simulation model data from the surgical simulation model data section, and moving the surgical operation tool by the force sense device; A simulated motion calculation device that calculates reaction force due to contact between a surgical operation tool and a simulated living body and applies the reaction force to the force sense device and calculates a motion with a reaction of the simulated living body; It comprises an image generation device that generates a simulated image of a simulated living body imaged from a endoscope, and an image display device that displays an image generated by the image generation device.

  According to a sixth aspect of the present invention, in the surgical simulator according to the fifth aspect, the simulated motion calculation device reflects the position deformation, which is a reaction of the simulated living body due to the applied force, in the change in the physical property value of the living body. The reaction force is calculated from the physical property value.

According to the method for generating a surgical simulation model according to claim 1, each node connected by meshing a plurality of layers of simulated membranes covering the organ and the organ and not recognizable from a medical image is formed and arranged by a virtual spring. A model that covers the organs and the organs, and the elasticity of the spring works on the multiple layers of the simulated membrane that cannot be recognized from medical images , improves the deformation simulation accuracy of the organ, and enables a surgical simulation with high training effect Can be generated.

According to the surgery simulation method according to claim 2, the simulation motion calculation process obtains model data for surgery simulation, and calculates the reaction force due to the movement of the surgery operation tool by the force sense simulation process and the contact between the surgery operation tool and the simulated living body. Then, it gives to the haptic process and calculates the reaction and movement of the simulated living body. Since this time, model data for surgical simulation covers the organs and organ is surgery subject, formed arranged in virtual springs between each node connected by meshing the simulated a plurality of films that can not be recognized by the medical image, organs and The elasticity of the spring acts on a plurality of layers of simulated membranes that cannot be recognized from a medical image covering the organ, improving the accuracy of organ deformation simulation, and enabling a surgical simulation with a high training effect.

  According to the surgical simulation method according to claim 3, the position deformation, which is a reaction of the simulated living body due to the applied force, is reflected in the change in the physical property value of the living body, and the reaction force is calculated based on the reflected physical property value. Therefore, it is possible to improve the accuracy of organ deformation simulation and to enable a surgical simulation with a high training effect.

According to the surgical simulator according to claim 5, the surgical simulation model data stored in the surgical simulation model data section covers the organs and organs to be operated on, and is formed by meshing a plurality of simulated membranes that cannot be recognized from medical images. Since each connecting node is formed and arranged with a virtual spring, the elasticity of the spring works on the simulated membrane of multiple layers that cover the organ and the organ and cannot be recognized from medical images, and can improve the deformation simulation accuracy of the organ Enables surgical simulation with high training effect.

  According to the surgery simulator according to claim 6, the position deformation, which is a reaction of the simulated living body due to the applied force, is reflected in the change in the physical property value of the living body, and the reaction force is calculated based on the reflected physical property value. The accuracy of organ deformation simulation can be improved, and surgical simulation with high training effect can be realized.

FIG. 1 is a flowchart for explaining a first embodiment of a method for generating a surgical simulation model. FIG. 2 is a flowchart for explaining a second embodiment of the method for generating the surgical simulation model. FIG. 3 is a flowchart for explaining the first embodiment of the surgical simulation method. FIG. 4 is a flowchart for explaining a second embodiment of the surgical simulation method. FIG. 5 is a functional block diagram for explaining an embodiment of the surgery simulator. FIG. 6 is a diagram for explaining the film structure. FIG. 7 is a diagram for explaining a finite element model of an organ. FIG. 8 is a diagram for explaining the characteristics of the virtual spring. FIG. 9 is a diagram illustrating the relationship between <K _f >, <K (<U>)>, and <U>.

FIG. 1 is a flowchart illustrating a first embodiment of a method for generating a surgical simulation model, FIG. 2 is a flowchart illustrating a second embodiment of a method for generating a surgical simulation model, and FIG. 3 is a surgical simulation method. FIG. 4 is a flowchart for explaining the second embodiment of the surgical simulation method, and FIG. 5 is a functional block diagram for explaining the embodiment of the surgical simulator.
In FIG. 5, 501 is a medical image data storage unit, 502 is a volume data construction unit, 503 is an image generation device, 504 is an image display device, 505 is a model data unit for surgery simulation, 506 is a force sense device, and 507 is a simulation. Numeral 508 is a surgical operation tool, 509 is a simulated endoscope, and 510 is a simulated forceps.

First, a method for generating a surgical simulation model will be described.
The medical image data storage unit 501 stores, for example, original data of a medical image of a surgical subject. The original data of the medical image is captured by, for example, CT, MRI or the like. The medical image data is generated by the image generation device 503 in the volume data construction unit 502. This is based on the geometric information of the medical image data obtained by slicing the cross section of the person to be operated while being displayed on the image display device 504 and photographing the part of the living body including the organ. ) Are two-dimensionally extracted and arranged according to the determined connection relationship of each organ, and these sliced images are stacked to form three-dimensional volume data (P101 in FIG. 1). The three-dimensional volume data is stored in a storage area different from the original data of the medical image in the medical image data storage unit 501.

The operator reads out medical image data of the surgical subject from the medical image data storage unit 501. The volume data construction unit 502 and the image generation device 503 extract each organ within a predetermined range including the read target organ and display it on the image display device 504 with a predetermined positional relationship. The operator moves / rotates the target organ from the organs displayed on the image display device 504 as necessary.
The volume data is assigned an ID for each organ, the original volume data is multiplied by ID = F (x, y, z), and the processed data is multiplied by ID = G (x, r, z). When this movement / posture conversion is represented by a matrix R _ID , the relationship between F and G is R _ID F = G, and therefore G can be obtained as G = R _ID ⁻¹ F. This movement position data is recorded in the surgical simulation model data section 505.
Next, another organ connected to the target organ is generated in accordance with the movement of the target organ. The other organ model data is recorded in the surgical simulation model data unit 505.
Next, geometric information is input to the volume data, and a finite element model is generated by meshing with a tetrahedron by a program based on anatomical properties (P102 in FIG. 1).
Next, for the volume data, geometric information is used as input information, the thickness is determined based on the anatomical properties, and a membrane model is generated around the designated organ (P103 in FIG. 1). The film is not recognizable from the medical image, but is formed of a plurality of layers around a predetermined organ. This membrane is appropriately arranged such that the predetermined organ and the membrane and the distance between each membrane have a constant distance or a portion having a different interval (P103a, P103b in FIG. 1).
As shown in FIG. 6, virtual lines 603a, 603b, 603c,... Are extended from the respective nodes 602a, 602b, 602c,. Are formed at the intersections of the simulated films 604a, 604b, 604c,... 603c, and the simulated films 604a, 604b, 604c,. The surface nodes 602a, 602b, 602c..., The membrane surface nodes 605a, 605b, 605c... And the virtual membrane springs 606a, 606b, 606c. The film surface nodes 605a, 605b, 605 for the surfaces 604b, 604c,. ... 607a surface direction spring to mesh form between, 607b, placing 607c ... (P104 in Fig. 1). The inter-virtual membrane springs 606a, 606b, 606c,... And the surface direction springs 607a, 607b, 607c,.
At this time, the virtual membrane springs 606a, 606b, 606c,... Connected between the nodes have different spring constants k (k = k1, k2,...), And surface springs 607a, 607b,. 607c... May have different spring constants K (K = K1, K2...) (P104a, P104b in FIG. 1).
The virtual intermembrane springs 606a, 606b, 606c... And the surface springs 607a, 607b, 607c... Connected between the nodes can be provided with physical constants that are cut by a predetermined tension or elongation (FIG. 1). P104c).
These surgical simulation model data are recorded and stored in the surgical simulation model data section 505.

Next, a method for generating a surgical simulation model intended to be able to simulate a large deformation of a predetermined organ with high accuracy will be described with reference to FIG.
In FIG. 2, the contents of steps P201 and P202 are the same as steps 101 and P102 in FIG.
Next, in the process P203, for the finite element model of the predetermined organ meshed with the tetrahedron, the nodes connected by meshing are formed by virtual springs 701a, 701b, 701c,... (FIG. 7). The virtual springs 701a, 701b, 701c,... Can be formed by a spring model, and can also be configured so as to include those having different spring constants in the organs as in the first embodiment. Further, the virtual springs 701a, 701b, 701c,... Connected between the nodes can be provided with physical constants that are cut by a predetermined tension or elongation. At this time, the force and elongation characteristics applied by the virtual springs 701a, 701b, 701c,... Are not linear, and one spring is, for example, a non-linear one convex upward as shown in FIG. It shall be.
These surgical simulation model data are recorded and stored in the surgical simulation model data section 505.

Next, a description will be given of a simulation using the surgical simulation model data configured in the first embodiment and an apparatus for carrying out the simulation. The apparatus described in FIG. 5 is used as the embodiment apparatus.
Surgery simulation model data that has multiple layers of simulated membrane tissue that covers the organ to be operated on and cannot be recognized from medical images, and sets the mechanical properties of the organ and the living tissue of the simulated membrane The data is read from the data unit 505, an image including the organ is generated by the image generation device 503, and displayed on the image display device 504.
The surgeon operates the simulated forceps 510 that is one of the surgical operation tools 508 to contact the simulated membrane that is the simulated living body, and pulls the simulated membrane with the holding surface of the simulated forceps 510. A reaction force corresponding to the position of the simulated forceps 510 and the contact position of the simulated membrane is generated by the force sense device 506 and fed back to the simulated forceps 510 via the force sense device 506. (P301)
The reaction force applied to the simulated forceps 510 is determined by the simulated motion calculation device 507 based on the spring constants of the virtual intermembrane springs 606a, 606b, 606c..., The surface springs 607a, 607b, 607c. Calculation is performed to generate a pulling force in the force sense device 506 and simulate it. At this time, the grip force of the simulated forceps varies depending on the position of the holding surface of the simulated forceps 510 that sandwiches the simulated membrane, and this grip force is calculated by the simulated motion calculation device 507. When the extension or tension of the simulated membrane when the simulated forceps 510 pulls the membrane reaches a predetermined value or more, the virtual intermembrane springs 606a, 606b, 606c..., The surface springs 607a, 607b, 607c. Can be simulated. (P302)
During the surgical simulation, the image generation device 503 is configured to display the simulated living body including the simulated membrane as imaged from the simulated endoscope according to the position based on the moving motion of the simulated forceps 510 and the simulated membrane calculated by the simulated motion calculation device 507. A motion simulation image of the surgical operation tool 508 including simulated forceps is generated. (P303)
The simulated image is displayed on the image display device 504, and the surgeon performs a surgical simulation while viewing the image. (P304)

これを、剛性マトリクス＜Ｋ＞が変位＜Ｕ＞の関数である＜Ｋ（＜Ｕ＞）＞とした次の非線形モデルとする。

（区分的に線形化すること）
今、物体（臓器等）に鉗子等の模擬術具（手術操作具）により力を加えたとする。すると、物体が変形して応力を発生しこの表面力と、模擬術具による力が釣り合った状態で変形が止まり、平衡状態に達する。ここで、更に力を加えると、次の釣り合う表面力を発生するまで変形し、次の平衡状態で安定する。実時間の処理では、これを、高速に繰り返している。
このような動的な計算を想定した場合、１フレーム前の剛性マトリクス（応力発生の元となる情報）と現在の剛性マトリクスの差は少ないと考えられる（即ち、区分的には線形化される）。特に、手術シミュレータでは操作が比較的緩やかである。従って、１フレーム前の位置（＜Ｕ＞^ｋ−１）に対応する剛性マトリクス＜Ｋ＞_ｉ、とΔ＜ｕ＞^ｋ _ｉを用いて、

から得られる。
従って、処理は、

処理（１）から処理（７）全体を式（４）とする。
但し、添え字ｋは計算時刻、α_ｉはｉ番目の要素の加速度、ｆ_ｉは同外力、ｖ_ｉは同速度、ｕ_ｉは同変位、Ｋ_ｆｉは剛性力である。図９に＜Ｋ_ｆ＞，＜Ｋ（＜Ｕ＞）＞，＜Ｕ＞の関係を示す。また、＜Ｕ^ｋ＞は、各要素に対応したｕ_ｉ ^ｋを積み重ねて、

ｕ^ｋ＝（ｕ_１ ^ｋ，ｕ_２ ^ｋ，…ｕ_Ｎ ^ｋ） （５）

としたものである。但し、Ｎは有限要素数である。
処理（６）におけるＫ_ｉ ^ｋをｕ_ｉ ^ｋを用いて計算することは、以下の式を用いる。
Ｋ_ｉはＫ_ｅと表示して、

ここで、＜Ｂ（＜ｘ＞）＞は歪みテンソルと変位（節点１から節点ｎの変位）とを（歪みテンソル）＝（形状マトリクス）・（変位）として関係付ける形状マトリクス、＜Ｄ＞は応力テンソルと歪みテンソルとを（応力テンソル）＝（物性マトリクス）・（歪みテンソル）として関係付ける物性マトリクスである。
上記式（４）の処理により、形状に応じた剛性マトリクス＜Ｋ＞の再構成と、模擬運動演算装置５０７上での更新を、実時間で実施する。（Ｐ４０３）
手術シミュレーションの間、画像生成装置５０３は、模擬運動演算装置５０７が計算する模擬鉗子５１０と模擬臓器との移動運動に基づく位置により、模擬内視鏡から撮像したように模擬臓器を含む模擬生体と模擬鉗子を含む手術操作具５０８の運動模擬画像を生成する。（Ｐ４０３）
この模擬画像は、画像表示装置５０４に表示され、手術者はこの画像を見ながら、手術シミュレーションを行う。（Ｐ４０４） Next, a description will be given of a simulation using the surgical simulation model data configured in the second embodiment and an apparatus for carrying out the simulation. The apparatus described in FIG. 5 is used as the embodiment apparatus.
Read out from the surgical simulation model data section 505 the surgical simulation model data in which each node connected to the organ to be operated by meshing is formed and arranged with a virtual spring, and the image generating device 503 generates an image including the organ, The image is displayed on the image display device 504.
The surgeon operates the simulated forceps 510 that is one of the surgical operation tools 508 to contact an organ that is a simulated living body, and pushes or pulls the simulated organ with the holding surface of the simulated forceps 510. A reaction force corresponding to the position of the simulated forceps 510 and the contact position of the simulated organ is generated by the force sense device 506. (P401)
The reaction force applied to the simulated forceps 510 is calculated by the simulated motion calculation device 507 based on the spring constants of the virtual springs 701a, 701b, 701c,. The device 506 is simulated by generating a compressive force or a pulling force. At this time, the grip force of the simulated forceps differs depending on the position of the holding surface of the simulated forceps that sandwiches the simulated membrane that cannot be recognized from the medical image , and this grip force is calculated by the simulated motion calculation device 507.
In order to simulate the deformation of a living body with high accuracy, a nonlinear FEM (finite element method) is used for a deformation model of a main organ.
Nonlinear processing is performed in real time by piecewise linearizing the nonlinear processing. The conventional linear calculation model is based on the assumption that the displacement is small. The displacement vector is <U>, the mass matrix is <M>, the viscous resistance matrix is <C>, the stiffness matrix is <K>, and the external force is <f>. It is indicated by the following absolute display. (In this specification, <a> represents a vector and matrix of a, and is used with bold characters.)

This is the following nonlinear model in which the stiffness matrix <K> is <K (<U>)>, which is a function of the displacement <U>.

(Linearized piecewise)
Assume that force is applied to an object (organ etc.) with a simulated surgical instrument (surgical operation tool) such as forceps. Then, the object is deformed to generate stress, and the deformation stops in a state where the surface force and the force by the simulated surgical tool are balanced, and an equilibrium state is reached. Here, when a further force is applied, it is deformed until the next balanced surface force is generated, and is stabilized in the next equilibrium state. In real-time processing, this is repeated at high speed.
When such a dynamic calculation is assumed, it is considered that there is little difference between the stiffness matrix one frame before (information on which stress is generated) and the current stiffness matrix (that is, linearized piecewise). ). In particular, the operation is relatively gentle in the operation simulator. Therefore, using the stiffness matrix <K> _i and Δ <u> ^k _i corresponding to the position (<U> ^k−1 ) one frame before,

Obtained from.
Therefore, the process is

Process (1) to process (7) as a whole is represented by equation (4).
However, the subscript k is calculated time, the alpha _i i-th element of the acceleration, _{f i} is Dogairyoku, _{v i} is the velocity, _{u i} is the _{displacement, K fi} is rigidity. FIG. 9 shows the relationship between <K _f >, <K (<U>)>, and <U>. Also, <U ^k > is a stack of u _i ^k corresponding to each element,

u ^k = (u ₁ ^k , u ₂ ^k ,... u _N ^k ) (5)

It is what. However, N is the number of finite elements.
The following formula is used to calculate K _i ^k in process (6) using u _i ^k .
K _i is displayed as K _e

Here, <B (<x>)> is a shape matrix that relates a strain tensor and displacement (displacement from node 1 to node n) as (distortion tensor) = (shape matrix) · (displacement), and <D> is This is a physical property matrix that relates a stress tensor and a strain tensor as (stress tensor) = (physical property matrix) · (strain tensor).
Through the processing of the above formula (4), the reconstruction of the stiffness matrix <K> corresponding to the shape and the update on the simulated motion calculation device 507 are performed in real time. (P403)
During the surgical simulation, the image generation device 503 is configured to display the simulated living body including the simulated organ as captured from the simulated endoscope according to the position based on the movement of the simulated forceps 510 and the simulated organ calculated by the simulated motion calculation device 507. A motion simulation image of the surgical operation tool 508 including simulated forceps is generated. (P403)
The simulated image is displayed on the image display device 504, and the surgeon performs a surgical simulation while viewing the image. (P404)

501: medical image data storage unit, 502: volume data construction unit,
503: Image generation device, 504: Image display device,
505: Model data part for surgery simulation, 506: Force sense device,
507: Simulated motion calculation device, 508: Surgical operation tool, 509: Simulated endoscope,
510: Simulated forceps, 601: predetermined organ, 602a, 602b, 602c ...: each node on the surface,
603a, 603b, 603c ...: Virtual line,
604a, 604b, 604c ...: Simulated membrane,
605a, 605b, 605c ...: Membrane surface nodes,
606a, 606b, 606c ...: Virtual intermembrane spring,
607a, 607b, 607c...: Plane direction spring.

Claims (7)

In the volume data construction unit, geometric information is obtained from the original data of the medical image of the surgical subject stored in the medical image data storage unit, and necessary organs included in the original data of the medical image are two-dimensionally extracted A first step of arranging the sliced images according to the determined connection relationship of each organ and further stacking these sliced images to construct the required three-dimensional volume data of the organ;
After the first step, a second step of meshing the generated three-dimensional volume data organ in the volume data construction unit;
In the volume data construction unit, a third process of forming a plurality of layers of simulated films that cover the meshed organ and cannot be recognized from a medical image;
In a volume data construction unit, a fourth process of forming and arranging a virtual spring that generates a force corresponding to a simulated surgical tool, in which a spring constant is set nonlinearly between nodes connected by meshing of the meshed organ, A method for generating a surgical simulation model, comprising: A force sense simulation process in which the force sense device generates a reaction force according to the position of the surgical operation tool operated by the operator and the contact position with the simulated living body;
The simulated motion calculation device is an operation target, and the volume data construction unit acquires geometric information from the original data of the medical image of the operation target person stored in the medical image data storage unit, and the original data of the medical image Necessary contained organs are extracted two-dimensionally, arranged according to the determined connection relationship of each organ, and these sliced images are stacked to construct three-dimensional volume data and meshed organs and meshing A spring constant is set nonlinearly between nodes connected by meshing to multiple layers of simulated membranes that cover the organs that cannot be recognized from medical images. Model data for surgical simulation is obtained, and the reaction force due to the movement of the surgical operation tool by the force simulation process and the contact between the surgical operation tool and the simulated living body is measured. A simulated exercise calculation process of calculating the motion of the reaction of the simulated bio-together given to the force sense simulated process and,
An image generation process in which an image generation device generates a simulated image of a simulated living body imaged from a simulated endoscope;
An operation simulation method, wherein the image display device includes an image display process for displaying an image generated by the image generation process.   3. The simulated motion calculation process, wherein a positional deformation, which is a reaction of a simulated living body due to an applied force, is reflected in a change in a physical property value of the living body, and a reaction force is calculated based on the reflected physical property value. Surgical simulation method.

The volume data construction unit obtains geometric information from the original data of the medical image of the surgical subject stored in the medical image data storage unit, and acquires necessary organs included in the original data of the medical image. Two-dimensionally extracted, arranged according to the determined connection relationship of each organ, and further laminated these sliced images to construct three-dimensional volume data to cover the meshed organ and the meshed organ. Model data for surgical simulation in which spring constants are set non-linearly between the nodes connected by meshing to multiple layers of simulated membranes that cannot be recognized from medical images, and are formed and arranged with virtual springs that generate forces according to the simulated surgical tools Obtaining and storing a model data part for surgical simulation,
A force sense device that generates a reaction force according to the position of the surgical operation tool operated by the surgeon and the position of contact with the simulated living body;
Obtaining the surgical simulation model data from the surgical simulation model data section, calculating the reaction force due to the movement of the surgical operation tool by the force sense device and the contact between the surgical operation tool and the simulated living body, and giving it to the force sense device A simulated motion calculation device that calculates the motion of the simulated biological reaction and motion;
An image generating device that generates a simulated image of a simulated living body calculated by the simulated motion calculation device and imaged from a simulated endoscope;
An operation simulator comprising an image display device for displaying an image generated by the image generation device.   6. The simulated motion calculation device reflects a positional deformation, which is a reaction of a simulated living body due to an applied force, in a change in a physical property value of the living body, and calculates a reaction force based on the reflected physical property value. Surgery simulator.

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