CAPTAiN system helps novice surgeons achieve expert-level results in virtual simulations
A groundbreaking new virtual reality tool called CAPTAiN, developed by researchers at Johns Hopkins University, could revolutionize how novice surgeons learn to operate on the human spine, making training safer, smarter, and more personalized.
Each year, hundreds of thousands of spinal laminectomy procedures are performed in the U.S. These high-risk surgeries involve removing part of the vertebra to relieve pressure on the spinal cord. But learning to perform them safely is a challenge: residents have limited practice opportunities, and mistakes can carry serious consequences, including tears to the protective membrane surrounding the spinal cord, which occur in up to 11% of cases. Traditional training methods struggle to provide enough practice opportunities while teaching the precise anatomical awareness that the procedures demand.
Now, a federally-funded team at JHU has created Critical Anatomy-Preserving and Terrain-Augmenting Navigation (CAPTAiN), a novel virtual reality simulator that gives trainees not only more practice, but also better practice. Their results appear in IEEE Transactions on Medical Robotics and Bionics.
“The CAPTAiN system brings the simplicity of coloring within the lines to the complexity of spinal surgery,” said Adnan Munawar, assistant research scientist at the Whiting School of Engineering’s Laboratory for Computational Sensing and Robotics. “It translates detailed patient-specific anatomy into easy-to-understand visual guides, showing what to drill and what not to drill, in real time.”
Unlike current training methods that rely on expensive, single-use models or cadavers, the CAPTAiN virtual reality system provides a reusable, immersive training environment. It offers tactile or haptic feedback to mimic the feel of drilling through bone, and uses color-coded, 3D visual cues to help users understand which areas are safe to drill and which should be avoided.
Trainees can begin with visual guidance and gradually remove it as their skill improves. After each session, the system provides objective feedback on performance, allowing users to track their progress and focus on areas for improvement.
In a study involving 110 simulated laminectomies performed by orthopedic residents and medical students, CAPTAiN significantly boosted surgical accuracy: trainees using the system achieved an 88% success rate in virtual spine surgeries, compared to 74% without the guidance technology. Novices performed nearly as well as more experienced trainees, suggesting that the system can help close the experience gap, the researchers say.
Another key advantage: CAPTAiN can use real patient CT scans, allowing surgeons to rehearse complex cases on personalized anatomy before ever entering the operating room.
“Our work highlights how innovations in simulation can support safer, more effective surgery — not just for the spine, but potentially for a wide range of procedures in neurosurgery, otolaryngology, and beyond,” Munawar said.