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Therefore, its main functionality is to simulate the action of virtual laparoscopic surgical instruments for deforming and cutting tridimensional anatomical models. Throughout this paper, we present the general features of this simulator including the implementation of several biomechanical models and the integration of two force\u2010feedback devices in the simulation platform. More precisely, we describe three new important developments that improve the overall realism of our simulator. First, we have developed biomechanical models, based on linear elasticity and finite element theory, that include the notion of anisotropic deformation. Indeed, we have generalized the linear elastic behaviour of anatomical models to \u2018transversally isotropic\u2019 materials, i.e. materials having a different behaviour in a given direction. We have also added to the volumetric model an external elastic membrane representing the \u2018liver capsule\u2019, a rather stiff skin surrounding the liver, which creates a kind of \u2018surface anisotropy\u2019. Second, we have developed new contact models between surgical instruments and soft tissue models. For instance, after detecting a contact with an instrument, we define specific boundary constraints on deformable models to represent various forms of interactions with a surgical tool, such as sliding, gripping, cutting or burning. In addition, we compute the reaction forces that should be felt by the user manipulating the force\u2010feedback devices. The last improvement is related to the problem of haptic rendering. Currently, we are able to achieve a simulation frequency of 25\u2009Hz (visual real time) with anatomical models of complex geometry and behaviour. But to achieve a good haptic feedback requires a frequency update of applied forces typically above 300\u2009Hz (haptic real time). Thus, we propose a force extrapolation algorithm in order to reach haptic real time. Copyright \u00a9 2002 John Wiley &amp; Sons, Ltd.<\/jats:p>","DOI":"10.1002\/vis.257","type":"journal-article","created":{"date-parts":[[2002,10,9]],"date-time":"2002-10-09T05:14:53Z","timestamp":1034140493000},"page":"147-167","source":"Crossref","is-referenced-by-count":84,"title":["Improving realism of a surgery simulator: linear anisotropic elasticity, complex interactions and force extrapolation"],"prefix":"10.1002","volume":"13","author":[{"given":"Guillaume","family":"Picinbono","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean\u2010Christophe","family":"Lombardo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herv\u00e9","family":"Delingette","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Ayache","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2002,10]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.3109\/13645709809153093"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199811000-00001"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-1684(98)00143-1"},{"key":"e_1_2_1_5_2","doi-asserted-by":"crossref","unstructured":"SolerL DelingetteH MalandainG MontagnatJ AyacheN ClementJ\u2010M KoehlC DourtheO MutterD MarescauxJ.A fully automatic anatomical pathological and functionnal segmentation from CT\u2010scans for hepatic surgery. 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