# Development of an Augmented Reality Surgical Trainer for Minimally Invasive Pancreatic Surgery
## 1 Introduction  
Minimally invasive surgery (MIS) offers several advantages over open surgery, including smaller incisions, reduced recovery times, and improved patient outcomes. The adoption of robotic systems has proven enhanced precision and stability, but at the cost of substantial training due to indirect manipulation, limited tactile feedback, and high hand-eye coordination requirements. Conventional training on animal models or cadavers raises ethical and financial concerns, prompting the rise in virtual surgical simulators as safer, more reproducible environments for skill development [1]. Early commercial robotic surgical simulators such as the da Vinci(r) Skills Simulator (dVSS) [2,3] and the Robotic Surgical Simulator (RoSS) [4] provided immersive tasks with real-time performance metrics. However, their high costs stimulated research into customizable, cost-effective platforms like CRESSim [5] or the simulator proposed by [PERSON] al. [6]. These alternatives offer greater flexibility in creating specialized training scenarios while maintaining lower financial barriers. Even though this field has achieved a lot of progress, there are still certain areas that might use development. Of particular importance are those related to force feedback, which is still a challenge in producing realistic and immersive surgical simulations. To address this issue, many researchers have focused on developing solutions to overcome this limitation. Recent advances in surgical simulation have focused on various individual components that enhance realism and training efficacy. For instance, ref. [7] investigated the simulation of force feedback by modeling tissue interactions in spinal surgery simulators, demonstrating the challenges associated with accurately replicating tissue behavior. Similarly, ref. [8] developed a haptic feedback system integrated into a virtual reality framework for surgical planning, with an emphasis on interface design and tactile response. These studies highlight the importance of realistic force feedback, yet they are limited by their reliance on physical sensors, which are not only costly but also sensitive to environmental variations. In the domain of augmented reality, research such as [9] has shown that AR can significantly enhance visual immersion and spatial awareness during surgical training. Commercial platforms like the da Vinci Skills Simulator and the Robotic Surgical Simulator also incorporate AR and haptic feedback elements. However, these systems typically employ traditional physical sensors for force measurement and are not specifically optimized for minimally invasive pancreatic surgery. Despite these advancements, no existing work has yet integrated these individual technologies into a single, unified system that specifically addresses the challenges of replicating precise force interactions in pancreatic surgery. To address these gaps, this research presents an innovative augmented reality-based simulator that not only determines the force exerted by an instrument on an organ but also visualizes it within the simulation and renders it as haptic feedback for the user. The paper presents the simulator of a parallel robot developed especially for minimally invasive pancreatic surgery. The robot offers precision and stability, making it suitable for the requirements of this surgery and enhancing the simulator's ability to replicate surgical scenarios. The simulator features the following key innovations:  
* An innovative parallel robot particularly designed for minimally invasive pancreatic surgery;
* A real-time augmented reality environment for enhanced visualization and spatial guidance;
* An AI-driven force prediction model that replaces traditional physical sensors, thus reducing costs and improving adaptability to variable conditions;
* A high-fidelity haptic feedback algorithm to ensure realistic interactions.