Surgical model-view-controller simulation software framework for local and collaborative applications



Surgical simulations require haptic interactions and collaboration in a shared virtual environment. A software framework for decoupled surgical simulation based on a multi-controller and multi-viewer model-view-controller (MVC) pattern was developed and tested.


A software framework for multimodal virtual environments was designed, supporting both visual interactions and haptic feedback while providing developers with an integration tool for heterogeneous architectures maintaining high performance, simplicity of implementation, and straightforward extension. The framework uses decoupled simulation with updates of over 1,000 Hz for haptics and accommodates networked simulation with delays of over 1,000 ms without performance penalty.


The simulation software framework was implemented and was used to support the design of virtual reality-based surgery simulation systems. The framework supports the high level of complexity of such applications and the fast response required for interaction with haptics. The efficacy of the framework was tested by implementation of a minimally invasive surgery simulator.


A decoupled simulation approach can be implemented as a framework to handle simultaneous processes of the system at the various frame rates each process requires. The framework was successfully used to develop collaborative virtual environments (VEs) involving geographically distributed users connected through a network, with the results comparable to VEs for local users.

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  1. 1

    Adl-Tabatabai A-R, Gross T, Lueh G-Y (1996) Code reuse in an optimizing compiler. OOPSLA ‘96. In: Proceedings of the 11th ACM SIGPLAN conference on Object-oriented programming, systems, languages, and applications, ACM, pp 51–68

  2. 2

    Allard J, Cotin S, Faure F, Bensoussan P-J, Poyer F, Duriez C, Delingette H, Grisoni L (2007) SOFA an open source framework for medical simulation. Medicine meets virtual reality (MMVR’15)

  3. 3

    Ayache N, Delingette H (2003) Surgery simulation and soft tissue modeling, international symposium, IS4TM 2003, Juan-Les-Pins, France, June 12–13, Springer

  4. 4

    Basdogan C, De S, Kim J, Muniyandi M, Kim H, Srinivasan MA (2004) Haptics in minimally invasive surgical simulation and training. IEEE Comput Graph Appl 24(2): 56–64

  5. 5

    Boeing A, Bräunl T (2007) Evaluation of real-time physics simulation systems. ‘GRAPHITE ‘07. In: Proceedings of the 5th international conference on computer graphics and interactive techniques in Australia and Southeast Asia’, ACM, New York, NY, USA, pp 281–288

  6. 6

    Buttolo P, Oboe R, Hannaford B (2000) Architectures for shared haptic virtual environments. Compt Graph 21(4): 478–483

  7. 7

    De S, Lim Y-J, Muniyandi M, Srinivasan MA (2006) Physically realistic virtual surgery using the point-associated finite field (PAFF) approach. Presence, 2006, 15, 294–308. Presence: teleoperators and virtual environments, 1997, 6, 147–159

  8. 8

    Deo D, De S, A physics-driven neural networks-based surgery simulation system (PhyNNeSS) for multimodal interactive virtual environments involving nonlinear deformation objects. Submitted to Presence

  9. 9

    El-Far NR, Nourian S, Jilin Zhou, Hamam A, Xiaojun Shen, Georganas ND (2005) A cataract tele-surgery training application in a hapto-visual collaborative environment running over the CANARIE photonic network, Haptic audio visual environments and their applications. IEEE Int Workshop, 4:1–2

  10. 10

    Gamma E, Helm R, Johnson R, Vlissides J (1995) Design patterns: elements of reusable object-oriented software. Addison-Wesley Professional, Massachusetts

  11. 11

    Gottschalk S, Lin MC, Manocha D (1996) OBBTree: a hierarchical structure for rapid interference detection. SIGGRAPH ‘96. In: Proceedings of the 23rd annual conference on computer graphics and interactive techniques, ACM Press, pp 171–180

  12. 12

    Gunn C, Hutchins M, Adcock M, Hawkins R (2004) Surgical training using haptics over long internet distances. Stud health technol inform 98. Published by IOS Press, pp 121–123

  13. 13

    Hermann E, Raffin B, Faure F (2009) Interactive Physical Simulation on Multicore Architectures. In: Eurographics workshop on parallel and graphics and visualization, EGPGV’09. Munich, Germany, March 2009

  14. 14

    Jeffrey H, Gerald MF, Lee LS, Nathaniel JS, Lelan FS, Bruce S, Kaaren H The SAGES FLS Committee: (2004) Development and validation of a comprehensive program of education and assessment of the basic fundamentals of laparoscopic surgery. Surgery 135(1): 21–27

  15. 15

    Lin MC, Manocha D (2000) Fast proximity queries with swept sphere volume. In: Proceedings of international conference on robotics and automation, pp 3719–3726, April 2000

  16. 16

    Liu A, Tendick F, Cleary K, Kaufmann C (2003) A survey of surgical simulation: applications, technology, and education. Presence 12(6): 599–614

  17. 17

    Teschner M, Kimmerle S, Heidelberger B, Zachmann G, Raghupathi L, Fuhrmann A, Cani M-P, Faure F, Magnenat-Thalmann N, Strasser W, Volino P (2005) Collision detection for deformable objects. Comput Graph Forum 24(1): 61–81

  18. 18

    Maciel A, Halic T, Lu Z, Nedel LP, De S (2009) Using the PhysX engine for physics-based virtual surgery with force feedback. Int J Med Robot 5: 341–353

  19. 19

    Maciel A, De S (2008) An efficient dynamic point algorithm for line-based collision detection in real time virtual environments involving haptics. Comput Animat Virtual Worlds 19(2): 151–163

  20. 20

    Maciel A, Liu Y, Ahn W, Singh TP, Dunnican W, De S (2008) Development of the VBLaST TM: a virtual basic laparoscopic skill trainer. Int J Med Robot 4(2): 131–138

  21. 21

    Maciel A, Boulic R, Thalmann D (2007) Efficient collision detection within deforming spherical sliding contact. IEEE transactions on visualization and computer graphics. IEEE Comput Soci 13: 518–529

  22. 22

    Marks S, Windsor J, Wünsche B (2007) Evaluation of game engines for simulated surgical training, GRAPHITE ‘07: In: Proceedings of the 5th international conference on computer graphics and interactive techniques in Australia and Southeast Asia, ACM, New York, pp 273–280

  23. 23

    Ponder M, Papagiannakis G, Molet T, Magnenat-Thalmann N, Thalmann D (2003) VHD++ development framework: towards extendible, component based VR/AR simulation engine featuring advanced virtual character technologies. In: Proceedings computer graphics international. IEEE Computer Society, 2003

  24. 24

    Pree W (1994) Meta patterns—A means for capturing the essentials of reusable object-oriented design, ECOOP ‘94. In: Proceedings of the 8th European conference on object-oriented programming, Springer, pp 150–162. (frozen spots/hot spots)

  25. 25

    Rihele D (2000) Framework design: a role modeling approach. ETH Zürich, Zürich

  26. 26

    Ruffaldi E, Frisoli A, Bergamasco M, Gottlieb C, Tecchia F (2006) A haptic toolkit for the development of immersive and web-enabled games. In: VRST ‘06: Proceedings of the ACM symposium on virtual reality software and technology. pp 320–323. ACM, New York

  27. 27

    Saupin G, Duriez C, Cotin S (2008) Contact model for haptic medical simulations. ISBMS, Switzerland, pp 157–165

  28. 28

    Schroeder W, Martin K, Lorensen B (1997) The visualization toolkit: an object-oriented approach to 3-D graphics. Prentice Hall, New Jersey

  29. 29

    Seugling A, Rölin M (2006) Evaluation of physics engines and implementation of a physics module in a 3d-authoring tool. Umea University, Sweden

  30. 30

    Shaw C, Green M, Liang J, Sun Y (1993) Decoupled simulation in virtual reality with the MR toolkit. ACM transactions information system vol 11, no. 3. ACM, New York, pp 287–317

  31. 31

    Vlissides JM, Linton MA (1990) Unidraw: a framework for building domain-specific graphical editors. ACM Trans Inf Syst 8: 237–268

  32. 32

    Yeongho K, Jeong-Ho C, Jongki L, Myeng KK, Nam KK, Jin SY, Yong OK (2001) Collaborative surgical simulation over the internet. Int Comput IEEE 5(3): 65–73

  33. 33

    Zhou J, Shen X, Georganas ND (2004) Haptic tele-surgery simulation, haptic, audio and visual environments and their applications. HAVE, 2004. In: Proceedings the 3rd IEEE international workshop on, pp 99–104, 2–3, October 2004

  34. 34

    Zhou J, Shen X, Saddik AE, Georganas ND (2007) Design and implementation of haptic tele-mentoring over the internet. In: Proceedings of the 11th IEEE international symposium on distributed simulation and real-time applications (October 22–26, 2007)

  35. 35

    Zhu B, Gu L, Peng X, Zhou Z (2010) A point-based simulation framework for minimally invasive surgery. In: Székely et al. (ed), Biomedical simulation. 5th international symposium, ISBMS 2010. Springer, LNCS

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Correspondence to Anderson Maciel.

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Maciel, A., Sankaranarayanan, G., Halic, T. et al. Surgical model-view-controller simulation software framework for local and collaborative applications. Int J CARS 6, 457–471 (2011).

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  • Surgical simulation
  • Virtual environments
  • Physics-based simulation
  • User interfaces—Haptic I/O
  • Software framework