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VR Simulator for Thyroid Surgery

A virtual reality thyroidectomy training simulator prototype built with Unity, enabling immersive exploration of CT-derived, deformable anatomical models in a photorealistic operating room environment.

Publication

This repository accompanies the following peer-reviewed publication:

Prototype of a Virtual Reality Simulator for Thyroidectomy: A Proof of Concept Cureus 17(9): e92724 (September 2025) DOI: 10.7759/cureus.92724

About

The simulator enables users to navigate a photogrammetry-based virtual operating room and interact with deformable anatomical models of the thyroid surgical field. It was designed to facilitate training in anatomical structure recognition for thyroid surgery, particularly the identification and preservation of the recurrent laryngeal nerve and parathyroid glands.

Features

  • Photorealistic OR environment based on photogrammetric reconstruction
  • CT-derived anatomical models (thyroid, trachea, muscles, vessels, parathyroid glands, recurrent laryngeal nerve)
  • Real-time soft-body tissue deformation
  • VR controller-based tissue manipulation with undo functionality
  • Surgical loupes simulation (2x-6x magnification)
  • Nerve stimulation monitoring feedback system

Asset Sources

  • OR environment: Photogrammetric reconstruction of an operating room at Charite - Universitatsmedizin Berlin (Queisner et al., 2022)
  • Anatomical models: Derived from anonymized, publicly available CT data, segmented using TotalSegmentator in 3D Slicer, with manual insertion of parathyroid glands and recurrent laryngeal nerve in Blender
  • Patient model: High-resolution photogrammetry of a surgical training mannequin, processed with Agisoft Metashape
  • Textures: AI-generated using FLUX 1.1 Pro Ultra via fal.ai

Requirements

  • Unity 6000.0.29f1
  • Obi Softbody (Version 7.0, Virtual Method Studio) -- paid Asset Store package, not included
  • Hardware: Meta Quest headset (tested with Quest 3, tethered via USB-C)
  • Recommended PC: NVIDIA RTX 3090 or equivalent, 64 GB RAM

Setup

  1. Clone this repository
  2. Open the project in Unity 6000.0.29f1
  3. Purchase and import Obi Softbody into Assets/Obi/
  4. Open one of the scenes in Assets/Scenes/
  5. Connect a Meta Quest headset and press Play

Project Structure

Assets/
├── Scripts/          Custom scripts (nerve monitor, surgical loupes, UV utilities)
├── Scenes/           Surgery simulation scenes
├── Materials/        Anatomical and OR materials
├── Textures/         Texture resources
├── Settings/         URP render pipeline configuration
├── Samples/          XR Hands & XR Interaction Toolkit samples
└── Segmentierte Datensaetze/   Segmented anatomical models (FBX)

Key Dependencies

Package Version
XR Interaction Toolkit 3.0.7
OpenXR 1.13.2
XR Hands 1.5.0
Universal Render Pipeline 17.0.3
Burst 1.8.18
Input System 1.11.2

License

This project is provided for academic and research purposes. The Obi Softbody asset is proprietary and must be purchased separately. See the linked publication for full details on methods and attributions.

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