Purpose: A virtual reality (VR) system, where surgeons can practice procedures on virtual anatomies, is a scalable and cost-effective alternative to cadaveric training. The fully digitized virtual surgeries can also be used to assess the surgeon's skills using measurements that are otherwise hard to collect in reality. Thus, we present the Fully Immersive Virtual Reality System (FIVRS) for skull-base surgery, which combines surgical simulation software with a high-fidelity hardware setup. Methods: FIVRS allows surgeons to follow normal clinical workflows inside the VR environment. FIVRS uses advanced rendering designs and drilling algorithms for realistic bone ablation. A head-mounted display with ergonomics similar to that of surgical microscopes is used to improve immersiveness. Extensive multi-modal data is recorded for post-analysis, including eye gaze, motion, force, and video of the surgery. A user-friendly interface is also designed to ease the learning curve of using FIVRS. Results: We present results from a user study involving surgeons with various levels of expertise. The preliminary data recorded by FIVRS differentiates between participants with different levels of expertise, promising future research on automatic skill assessment. Furthermore, informal feedback from the study participants about the system's intuitiveness and immersiveness was positive. Conclusion: We present FIVRS, a fully immersive VR system for skull-base surgery. FIVRS features a realistic software simulation coupled with modern hardware for improved realism. The system is completely open-source and provides feature-rich data in an industry-standard format.

翻译：目的：提出一种虚拟现实（VR）系统，使外科医生能够在虚拟解剖结构上进行手术操作，作为尸体训练的可扩展且经济有效的替代方案。此外，完全数字化的虚拟手术可用于评估外科医生的技能，通过测量在现实中难以获取的指标。为此，我们介绍了适用于颅底手术的完全沉浸式虚拟现实系统（FIVRS），该系统将手术模拟软件与高保真硬件设备相结合。方法：FIVRS允许外科医生在VR环境中遵循常规临床工作流程。该系统采用先进的渲染设计和钻孔算法，实现逼真的骨骼磨除。使用人体工程学设计与手术显微镜相似的头戴式显示器，以增强沉浸感。系统记录多模态数据（包括眼动追踪、运动轨迹、作用力及手术视频）用于后续分析。此外，我们设计了用户友好型界面以降低FIVRS的使用门槛。结果：我们展示了涉及不同专业水平外科医生的用户研究结果。FIVRS记录的初步数据成功区分了不同专业水平的参与者，为未来自动化技能评估研究提供了前景。同时，参与者对系统直观性和沉浸感的非正式反馈均为正面。结论：我们提出了FIVRS——一套用于颅底手术的完全沉浸式VR系统。该系统通过逼真的软件模拟与现代硬件相结合，显著提升了真实感。FIVRS完全开源，并以行业标准格式提供功能丰富的数据记录。