GPU-based efficient realistic techniques for bleeding and smoke generation in surgical simulators

Tansel Halic, Ganesh Sankaranarayanan, Suvranu De

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background In actual surgery, smoke and bleeding due to cauterization processes provide important visual cues to the surgeon, which have been proposed as factors in surgical skill assessment. While several virtual reality (VR)-based surgical simulators have incorporated the effects of bleeding and smoke generation, they are not realistic due to the requirement of real-time performance. To be interactive, visual update must be performed at at least 30 Hz and haptic (touch) information must be refreshed at 1 kHz. Simulation of smoke and bleeding is, therefore, either ignored or simulated using highly simplified techniques, since other computationally intensive processes compete for the available Central Processing Unit (CPU) resources. Methods In this study we developed a novel low-cost method to generate realistic bleeding and smoke in VR-based surgical simulators, which outsources the computations to the graphical processing unit (GPU), thus freeing up the CPU for other time-critical tasks. This method is independent of the complexity of the organ models in the virtual environment. User studies were performed using 20 subjects to determine the visual quality of the simulations compared to real surgical videos. Results The smoke and bleeding simulation were implemented as part of a laparoscopic adjustable gastric banding (LAGB) simulator. For the bleeding simulation, the original implementation using the shader did not incur noticeable overhead. However, for smoke generation, an input/output (I/O) bottleneck was observed and two different methods were developed to overcome this limitation. Based on our benchmark results, a buffered approach performed better than a pipelined approach and could support up to 15 video streams in real time. Human subject studies showed that the visual realism of the simulations were as good as in real surgery (median rating of 4 on a 5-point Likert scale). Conclusions Based on the performance results and subject study, both bleeding and smoke simulations were concluded to be efficient, highly realistic and well suited to VR-based surgical simulators.

Original languageEnglish (US)
Pages (from-to)431-443
Number of pages13
JournalInternational Journal of Medical Robotics and Computer Assisted Surgery
Issue number4
StatePublished - Dec 2010
Externally publishedYes


  • bleeding and smoke simulation
  • computer graphics
  • haptics
  • minimally invasive surgery
  • physics-based simulation
  • rendering
  • surgical simulation
  • virtual reality

ASJC Scopus subject areas

  • Surgery
  • Biophysics
  • Computer Science Applications


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