Background: Ventricular puncture is a common procedure in neurosurgery and the first that resident must learn. Ongoing education is critical to improving patient outcomes. However, training at the expense of potential risk to patients warrants new and safer training methods for residents.Methods: An augmented reality (AR) simulator for the practice of ventricular punctures was designed. It consists of a navigation system with a virtual 3D projection of the anatomy over a 3D‐printed patient model. Forty‐eight participants from neurosurgery staff performed two free‐hand ventricular punctures before and after a training session.Results: Participants achieved enhanced accuracy in reaching the target at the Monro foramen after practicing with the system. Additional metrics revealed significantly better trajectories after the training.Conclusion: The study confirms the feasibility of AR as a training tool. This motivates future work towards standardising new educative methodologies in neurosurgery.

Recreating cerebral tissue using a tissue-mimicking phantom is valuable because it provides a tool for studying physiological and biological processes related to tissues without the necessity of performing the study directly in the tissue or even in a patient. The reproduction of the optical properties allows investigation in areas such as imaging, optics, and ultrasound, among others. This paper presents a methodology for manufacturing agarose-based phantoms that mimic the optical characteristics of brain tissue using scattering and absorbing agents and proposes combinations of these agents to recreate the healthy brain tissue optical coefficients within the wavelength range of 350 to 500 nm. The results of the characterization of the manufactured phantoms propose ideal combinations of the used materials for their use in controlled environment experiments in the UV range, following a cost-effective methodology.

Background: During minimally invasive surgeries, the Kambin Triangle infiltration procedure is primarily used as a safe anatomical access route to critical spine structures. Inadequate location of final infiltrations can be critical for inexperienced residents. Methods: A mixed reality (MR) navigator simulator for spine infiltration was developed. It combines virtual fluoroscopy simulation (FS) and augmented reality views with 3D‐printed lumbar spine patient models. Ten residents of orthopaedics tested the system. Results: Residents showed more infiltration success under MR than FS but with higher risky contacts at the nerve roots. Residents reported an improved understanding of the anatomy and clinical case during MRI guidance and greater ease in locating target points in this condition. Conclusion: The results demonstrate the advantages of combining MR with FS for training minimally invasive spinal procedures to progressively train in a scenario close to reality once the anatomical and safety aspects of the approach have been understood.

We present the experimental characterization of a laser speckle contrast imaging system for blood flow monitoring under variable imaging conditions. A tissue phantom setup was used to evaluate system performance across multiple parameters, including laser power, exposure time, vessel depth, and flow velocity. Additionally, two optical configurations were tested to assess their robustness to the variation of these parameters: the conventional arrangement, where the camera is positioned perpendicular to the sample, and an alternative geometry, where the laser is perpendicular to the sample and the camera is placed at an angular offset. The latter was designed to facilitate future integration into multispectral or stereoscopic imaging setups. The analysis includes speckle contrast maps and a discriminability index to quantify the detectability of flow. Results obtained with the alternative configuration indicate that the system reliably detects blood flow across a range of conditions, although acquisition parameters significantly influence performance. A suitable range of laser power and exposure time was identified that enhances the flow detection through experimental selection of discriminability index values. Angular variation in the alternative configuration had a measurable effect; however, both configurations enabled reliable flow detection, opening the possibility of extending this approach to research toward scalable multi-camera imaging platforms.

Purpose Minimally invasive interventions of the spine (MISP) involve high-risk procedures. Lack of accuracy in infiltrations or poor screw placement can lead to severe neurological, vascular, and visceral injuries. This requires better training methods for residents, including surgical simulation, to reduce patient risk and lead to more efficient surgeries with lower error rates and improved clinical outcomes. Methods A mixed-reality simulator for training in MISP procedures was evaluated. The simulator combines two navigation modalities: (1) virtual reality fluoroscopy simulation and (2) mixed reality with augmented and virtual reality scenes. Two interventions were selected for simulation: pure facet infiltration and transpedicular screw placement. A pilot training program was designed and implemented, comparing the two navigation modalities: fluoroscopy simulation vs. mixed-reality navigation. Ten orthopedic residents participated in the study. Their performance was evaluated by using simulator metrics. Their perceived experience was assessed through a specifically designed questionnaire. Results Residents improved overall execution times during mixed reality navigation. In particular, greater success in screw placements with shorter execution times during mixed reality navigation compared to fluoroscopy simulation. Similarly, they also achieved greater accuracy in the infiltration procedure. The questionnaire reveals that residents have a positive evaluation of the simulator and find it valuable for training purposes. Conclusion Compared to fluoroscopy simulation, residents found it easier to perform tasks with the mixed reality guide in perceiving and understanding anatomy, safe pathways, and correct target locations. Overall, the simulator was deemed valuable for training. This motivates further research on stratified programs and their benefits, possibly starting with mixed reality, followed by fluoroscopy simulation. Also provides useful information for improving the simulation, including better visual feedback and patient-specific cases.