Physical and virtual modelling of the head and neck for surgical simulation and training.

PURPOSE OF REVIEW: Investigation and surgical manipulation of the larynx, pharynx, and oesophagus suffer from inherent challenges with access to the sites of interest. To reduce trauma and external scarring, visualization and minimally invasive interventions by the transnasal or transoral routes have become more prevalent. This article discusses engineering methods used to understand and overcome the mechanical constraints inside the airway and upper gastrointestinal tract, and examines the role that robotics and engineering are beginning to play in modelling of surgical interventions in this region.

RECENT FINDINGS: Although robotic solutions to minimally invasive surgery of the airway and upper gastrointestinal tract already exist, there is still scope for increasing the breadth of their use. Physical and virtual models of these organs are used to investigate the capability and limitations of manual and robotic surgical interventions in this region. Understanding the tissue mechanics and tool capabilities is central to improving outcomes in the clinical setting. Both physical and virtual modelling modalities are used in training surgeons for both manual-assisted and robot-assisted surgeries.

SUMMARY: Minimally invasive surgical interventions via the transnasal and the transoral route are strong candidates for overcoming access issues to the airway. They are likely to become more robotically driven as the demand for higher dexterity and accuracy increases for fine manipulation. Physical and virtual organ models are required to enable surgical training for these procedures.