Evaluation of game engines for simulated surgical training

The increasing complexity and costs of surgical training and the constant development of new surgical procedures has made virtual surgical training an essential tool in medical education. Unfortunately, commercial tools are very expensive and have a small support base. Game engines offer unique advantages for the creation of highly interactive and collaborative environments. This paper examines the suitability of currently available game engines for developing applications for medical education and simulated surgical training. We formally evaluate a list of available game engines for stability, availability, the possibility of custom content creation and the interaction of multiple users via a network. Based on these criteria, three of the highest ranked engines are used for further case studies. We found that in general it is possible to easily create scenarios with custom medical models that can be cooperatively viewed and interacted with. Limitations in physical simulation capabilities make some engines unsuitable for fully interactive applications, but they can be used in combination with predefined animations. We show that overall game engines represent a good foundation for low cost virtual surgery applications and we discuss technologies which can be used to further extend their physical simulation capabilities.