VR Surgery Simulator for Medical Training Experience

The surgeon simulator provides realistic surgical 3D simulations to practice working with instruments for performing percutaneous dilatational tracheostomy




  • C#
  • Unity
  • .Net


Our customer manufactures medical equipment and instruments for the treatment of patients with serious illnesses, injuries and oncology. The company specializes in the production of instruments for percutaneous dilatational tracheostomy. Their products are used in hospitals and clinics across 65 countries worldwide.


According to statistics, approximately 300,000 patients require percutaneous dilatation tracheostomy (PDT) each year. The procedure facilitates the flow of air and oxygen into the lungs by creating an opening in the trachea. PDT often becomes necessary in case of an accident or emergency situation. 

The success of the PDT procedure depends on several factors. Among them are the cause of the person’s inability to breathe, the patient's overall condition, and their position during the procedure. Additionally, quick response and professionalism of the doctor play a crucial role, especially in emergency cases. Each situation requires the use of appropriate tools tailored to the specific case. 

The instruments used in percutaneous tracheostomy include: 

  • needle
  • catheter
  • guidewire
  • tracheostomy tube

Each tracheostomy set is unique, so the manufacturer provides training to surgeons on the usage of PDT instruments. This preparation includes online courses, seminars and practice on training models. However, such training formats may not always provide a comprehensive understanding of the risks associated with tracheostomy or identify knowledge gaps that individual doctors may have. Training on actual patients without the necessary knowledge can pose potential dangers.

Our customer provides its services around the world, so they are trying to adapt training methods to consider the language and cultural nuances of specialists. Traditional learning approaches don’t address such a challenge well enough.


Rubius developed a special vr application, a step-by-step instructional tool for surgeons that provides visualizations of the percutaneous tracheostomy procedure and detailed descriptions of each instrument’s usage. Surgeon simulator provides an effective learning experience in VR.

Surgeon simulator setup

The web application can be accessed and run on any modern computer or laptop using a browser. 

To perform the procedure, the user is prompted to choose from a selection of instrument kits, each containing tracheostomy tubes of various sizes.

The basic PDT instrument kit include: needle, catheter, guidewire, tracheostomy tube

The instrument kit may include a bronchoscope. It helps to see the procedure from the inside on the monitor screen and make more precise surgical operations. 

PDT instrument kit may include a bronchoscope. It helps to see the procedure from the inside on the monitor screen and make more precise surgical operations

The application offers two simulation modes. In the “training” mode, users are guided through the procedure with the help of text, voice and visual prompts using 3D models. In the “practice” mode, users can perform the procedure on their own and, if needed, request hints. The simulation keeps track of the number of hints used, allowing users to assess their performance.

PDT procedure stages available for training using the simulator:

  • Patient and instruments preparation for the procedure.
  • Making a horizontal skin incision to access the trachea. Inserting the bronchoscope to provide internal monitoring of the procedure.
  • Feeding a guidewire through the catheter to create space for the tube.
  • Inserting a tracheostomy tube and connecting the patient to a ventilator.
  • Completion of the procedure.


The application introduces the surgeon to the percutaneous tracheostomy procedure on a model similar to a real person. The simulation uses a specific instrument kit that the doctor will use after training. This approach enables the surgeon to identify areas where skill development is needed. Ultimately, this will speed up the surgical training with minimal risks to the patient’s health.

The surgeon simulator provides an accessible and user-friendly learning process, thanks to its voice, text, and gesture prompts. To use the application, a medical specialist only needs a laptop or PC with internet access and basic proficiency in English.

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