Abstract—One of the essential requirements of a realistic surgical simulator is to reproduce haptic sensations due to the interactions in the virtual environment. However, the interaction need to be performed in real-time, since a delay between the user action and the system reaction reduces the immersion sensation. In this paper, a prototype of a coronary stent implant simulator is present; this system allows real-time interactions with an artery by means of a specific haptic device. To improve the realism of the simulation, the building of the virtual environment is based on real patients’ images and a Web Portal is used to search in the geographically remote medical centres a virtual environment with specific features in terms of pathology or anatomy. The functional architecture of the system defines several Medical Centres in which virtual environments built from the real patients’ images and related metadata with specific features in terms of pathology or anatomy are stored. The searched data are downloaded from the Medical Centre to the Training Centre provided with a specific haptic device and with the software necessary both to manage the interaction in the virtual environment. After the integration of the virtual environment in the simulation system it is possible to perform training on the specific surgical procedure. Keywords—Medical Simulation, Web Portal, Virtual Reality. I. INTRODUCTION IRTUAL reality technology brings numerous advantages to the medical community including improved surgical training. With the continuously increasing speed of computers, surgical simulators are now being offered to hospitals as a mean of improving training and reducing the costs of education. Computer based simulators will increasingly become more eligible as a training aid, especially due to their extensive range of educational features. By means of this kind of simulator it is possible to model unusual and rare cases and to practise new procedures avoiding risk for real patients; in addition it is possible to have objective measures of surgical skill. Many minimally invasive procedures need to be learned by repetition; using a real cadaver, in case of a mistake, a Giovanni Aloisio is with the Department of Innovation Engineering - University of Lecce & SPACI Consortium (Southern Partnership for Advanced Computational Infrastructure), 73100 Lecce, Italy. Lucio T. De Paolis is with the Department of Innovation Engineering - University of Lecce & SPACI Consortium (Southern Partnership for Advanced Computational Infrastructure), 73100 Lecce, Italy. Alessandro De Mauro is with the Department of Innovation Engineering - University of Lecce, 73100 Lecce, Italy. Antonio Mongelli is with the Department of Innovation Engineering - University of Lecce, 73100 Lecce, Italy. given procedure cannot be repeated because the body organs are altered. Realism and real-time interactions are the essential features for surgery simulators in order to be used as training systems. The realism of the simulation strictly depends on the accuracy of the human tissue modelling and on the use of force feedback devices. Therefore, the most critical issues in designing surgical simulators are accuracy - the simulator should generate visual and haptic sensations very close to the reality - and efficiency - deformations must be rendered in real-time on the graphic display. Accuracy and efficiency are two opposite requirements; in fact, increased accuracy implies higher computational time and vice versa. So, it is necessary to find a trade-off according to the application. For surgery training, real-time visual and haptic feedbacks are more important than deformation accuracy. However, substantial differences between the real and the virtual deformations may lead to a wrong learning of the procedure. This work takes into account some results of the HERMES (HEmatology Research virtual MEdical System) Project managed by Consorzio CETMA, Brindisi, Italy; the aim of this project is to build the first prototype of a training system to simulate the coronary stent implant procedure [10]. In the HERMES simulator we have mainly focused on the real-time constraint and on the accuracy of the interactions in the virtual environment rather than on the visual accuracy. The virtual artery model is constructed using anatomical model described in the medical literature and, for this reason, it is not enough realistic. It is very important that a Training Centre can carry out the same surgical procedure on a variety of different case studies, studies which differ in terms of the pathology, the anatomical structure and the patient’s age, so that they correspond to several virtual patients, each of them exhibiting a particular difficulty. For this reason, afterwards we decided to build the virtual environment based on real patients’ images. Many virtual environments can be stored in geographically remote medical centres and, using a Web Portal, it is possible to search a virtual environment with specific features in terms of pathology or anatomy. II. RELATED WORKS Several simulators have been developed for training on a specific procedure. An Angioplasty Intervention Simulator with a Specific Virtual Environment G. Aloisio, L. T. De Paolis, A. De Mauro, and A. Mongelli V World Academy of Science, Engineering and Technology International Journal of Medical and Health Sciences Vol:2, No:10, 2008 353 International Scholarly and Scientific Research & Innovation 2(10) 2008 scholar.waset.org/1307-6892/5600 International Science Index, Medical and Health Sciences Vol:2, No:10, 2008 waset.org/Publication/5600