[Use of virtual reality in eating disorders]. / Utilisation de la réalité virtuelle dans les troubles des conduites alimentaires.

Virtual reality is a new technology that can be used to model an environment with which an individual can interact using all five senses. It is notably used in psychiatry for anxiety disorders and addictions, and its use in eating disorders has been growing in recent years. Indeed, virtual reality offers interesting advantages, such as its ability to personalize any environment, which is also more secure and controllable. Recent studies show promising results in the understanding, evaluation, and therapeutic management of eating disorders. The use of avatars in anorexia nervosa allows for a correct assessment of the perceptual (body image distortion) and cognitive-affective (body dissatisfaction) components of the body image disorder in a similar way to conventional methods, but also for a better understanding of them. Moreover, avatars allow the development of innovative therapeutic protocols and are thus used in the context of exposure therapy. The new body swapping protocol, based on a multisensory illusion, offers particularly promising results in the reduction of body image disorder. For bulimia nervosa and binge eating disorder, virtual reality has made it possible to better characterize the triggering mechanisms of binge eating episodes through studies that have observed different responses to food-related environments and stimuli. At the therapeutic level, virtual reality cue exposure therapy has the most empirical support. Its aim is to reduce or eliminate the anxiety and craving felt by a patient in response to exposure to food or other food-related cues by preventing the patient from consuming food, and results show clear reductions in anxiety, craving and binge eating episodes. While all these results seem to indicate a bright future for virtual reality in eating disorders, further studies are needed to validate the positive impact of its use, but also its limitations. Notably, cyber sickness could alter the smooth running of virtual reality therapy sessions by causing nausea and disorientation. Moreover, it is important to verify that a therapeutic protocol does not lose its effectiveness when it is transposed into virtual reality. However, virtual reality seems to be a therapeutic tool that is better accepted by patients, and even better by adolescents, which is very interesting for eating disorders since adolescents are the most affected. Virtual reality could therefore help motivate patients to pursue treatment and reduce the dropout rate while offering good therapeutic results. Thus, studies conducted in recent years have shown that virtual reality is a promising tool in the understanding, assessment and treatment of eating disorders, and future research should confirm this, particularly in the adolescent population.

[Feasibility study of therapeutic exposure in virtual reality for pathological gamblers]. / Étude de faisabilité d'une exposition thérapeutique en réalité virtuelle pour joueurs pathologiques.

The experiment presented is the result of a partnership between the Paris-Nanterre University (CLIPSYD laboratory, EA 4430) and the CSAPA Imagine (Simone Veil Hospital, GH Eaubonne-Montmorency). Virtual reality immersion exposure for pathological gamblers is beneficial in the context of cognitive and behavioral interventions. It can be used to evoke the desire to play and to have access to automatic thoughts and mistaken beliefs of the players when they find themselves in a gambling context. Exposure is used until the urge to play diminishes and disappears which is the process of desensitization or extinction. OBJECTIVE: The objective of the study was to investigate the possibilities implemented by virtual reality in the case of an exhibition for pathological gamers to create a desire to play and work with the patient in an environment identical to the ecological one. Two hypotheses were proposed. On the one hand, the virtual reality exhibition will help to change the desire to play in relation to the game. On the other hand, virtual exhibition sessions associated with cognitive restructuring will have a greater impact on the perception of reality. METHOD: After a diagnosis was made, participation in the study was offered to patients (n=10) in routine care and able to participate (exclusion criteria). It consisted of four virtual reality exposure sessions integrated with traditional care. Exposure did not exceed 20minutes. To carry out this study we used the virtual reality headset "Oculus Rift CV1" and the headphones measuring EEG waves, "Emotiv Epoc". A battery of questionnaires were proposed to evaluate gambling-related behaviors (ICJP, GRCS, UPPS), to analyze the interest of the virtual reality exhibition (SIS, CGI, TEI, EVA), and to glimpse the immersion abilities (QEP and QPI). RESULTS: Ten participants aged 25 to 60 agreed to participate in the study. The results of this study demonstrated the viability of RV gamers' exposure as a tool that can help reduce pathological gambling symptoms and the severity perceived by therapists (CPI: t=1.6, P=0.001; CGI: t=4.87, P=0.001) between the beginning of the care and the end of the care and at D+1. We were also able to observe significant results (P<0.05) concerning a decrease in cognitive distortions (GRCS tot, Illusion of control, Power of prediction, Favorable interpretation). CONCLUSION: The feasibility study shows that the desire to play is very present during the virtual reality exhibition in accordance with literature studies. The results also demonstrate the utility of virtual reality to allow the patient to elaborate on the cognitive distortions associated with the practice of pathological gambling. From a therapeutic point of view, the results suggest that virtual reality can increase the effectiveness of cognitive restructuring and increase understanding of the urge to play related to stimuli in the environment of play.

[Virtual reality exposure therapy for post-traumatic stress disorders, obsessive-compulsive disorders and anxiety disorders: Indications, added value and limitations]. / La thérapie par exposition en réalité virtuelle pour les états de stress post-traumatiques, les troubles obsessionnels compulsifs et les troubles anxieux : indications, plus-value et limites.

The exposure in cognitive behavioral therapy (CBT) is a well-known intervention, widely investigated in scientific research. Several studies have shown the benefits of this intervention in the treatment of anxiety disorders, obsessive-compulsive disorders (OCD) and post-traumatic stress disorders (PTSD). The different exposure techniques are mainly based on the emotional processing of fear theory and use an emotional stimulation of fear, following by its habituation. However, new approaches have emerged and are based on the inhibitory learning theory. The virtual reality technology allows emotional involvement from patients and represents a complementary approach to the classical modalities of exposure therapy (e.g., mental or in vivo expositions). This modern approach presents specific features that need to be taken into account by the therapist. Firstly, the presence feeling, which is defined as the "be there" feeling. This feeling is dependent on immersive technical features and personality factors. Secondly, virtual reality sickness, similar to motion sickness, represents a limitation that might prejudice a virtual therapy. The main scientific investigations of Virtual Reality Exposure Therapy (VRET) for treating social phobia, specific phobia, PTSD, and panic disorders are encouraging and demonstrate a similar effectiveness between both in vivo and in virtuo exposures. The scarce investigations on generalized anxiety disorders and OCD also suggeste a similar effectiveness between these exposures. However, further scientific investigations are needed to support these preliminary findings. The attrition rates and deteriorating states are similar to classical CBT approaches. Nevertheless, scientific literature presents several limits: 1) much of the research on this topic has interest conflicts (e.g., developers are also authors of a large number of studies); 2) there is a high heterogeneity of materials and virtual environments used; 3) important measures are not always taken into account in scientific research (e.g., the presence feeling); and 4) a massive use of waiting lists as a control measure. Despite these limitations, the VRET have strong silver linings: 1) the easy access to exposure (less limited than standard exposure techniques) and a cost reduction; 2) highly guaranteed security; 3) the anonymization of exposures (i.e., the patients do not risk meeting someone they know during the exposure therapy); 4) the therapist has a greater control of exposures; 5) a standardization of the exposures; 6) a greater involvement in therapy for technophile patients. Virtual exposure also seems to be generally more accepted by patients.

[Methodology to develop a virtual reality training for good practices in the preparation of anti-cancer drugs]. / Méthodologie pour développer une formation aux bonnes pratiques de préparation des anticancéreux en réalité virtuelle à 360°.

OBJECTIVE: Describe the process for designing and creating SimUPAC 360°, a virtual reality training in anti-cancer drug production units. METHODS: A multi-centre (a University Hospital, a General Hospital and a Cancer Control Centre), inter-professional (pharmacists, hospital pharmacy technicians and health executives) working group has been set up. It was based on videoconferencing and online document sharing. The work was divided into six phases: choice of target audience and training objectives, definition of the business model, development of the scenario, shooting and editing, creation of the training tool and finally tests, adjustments and validation of the tool. RESULTS: After brainstorming, 77 errors were proposed. Three areas have been defined: covering area, storage and production area, and isolator. They contained 15 errors among the 77 proposed and 20 points of interest. The shooting was carried out over 2 days, in 2 hospitals. Assembly was carried out by a service provider specialist in real virtuality. Before to go online, the tool was tested and validated by experts. DISCUSSION: The establishment of a multi-centric and interdisciplinary working group, the choice of target audience, pedagogical objectives and business model ensure the economic viability and scientific and technical robustness of the tool. The scenario development requires to define: activity areas and then, number, difficulty and typology of errors. CONCLUSION: Creation of a virtual reality training requires a consistent and structured methodology. This methodology will make it possible to develop other training scenarios.

[When virtual reality invites itself into the operating room]. / Quand la réalité virtuelle s'invite au bloc opératoire.

New technologies can effectively support care teams, for the well-being of the patient and to take into account his anxieties in particular. Thus virtual reality can be a good solution to reduce the ever-increasing doses of anxiolytics, their side effects and thus reduce hospitalization costs due to increased monitoring.

[Virtual reality and palliative care, a complement in the care provision]. / Réalité virtuelle et soins palliatifs, un complément dans la prise en charge.

Commonplace in the world of gaming or the cinema, virtual reality headsets have made their appearance in the hospital over recent years. A nursing team in Lyon shares its feedback regarding the benefit of these tools as a complement to the care provided to patients in a palliative care unit.

[Computer-assisted therapy and video games in psychosocial rehabilitation for schizophrenia patients]. / L'utilisation des thérapies assistées par ordinateur et des jeux vidéo à visée thérapeutique dans les soins de réhabilitation psychosociale chez les sujets souffrant de schizophrénie, revue de la littérature.

OBJECTIVES: Video games and virtual reality have recently become used by clinicians for training or information media or as therapeutic tools. The purpose is to review the use of these technologies for therapy destined for schizophrenia patients. METHODS: We conducted a review in October 2016 using Pubmed, Scopus and PsychInfo using the following Medical Subject Headings (MESH): "video games", "virtual reality" and "therapy, computer-assisted/methods", each associated with "schizophrenia". Papers were included in the review if: (a) they were published in an English, Spanish or French-language peer-reviewed journal, (b) the study enrolled patients with schizophrenia or schizo-affective disorder, (c) the patients used a therapeutic video game or therapeutic virtual reality device. RESULTS: Eighteen publications were included. The devices studied are mainly therapeutic software developed specifically for therapeutic care. They can be classified according to their therapeutic objectives. These targets corresponded to objectives of psychosocial rehabilitation: improvement of residual symptomatology, cognitive remediation, remediation of cognition and social skills, improvement of everyday life activities, support for occupational integration. Very different devices were proposed. Some researchers analysed programs developed specifically for patients with schizophrenia, while others were interested in the impact of commercial games. Most of the studies were recent, preliminary and European. The impact of these devices was globally positive, particularly concerning cognitive functions. CONCLUSIONS: Computer-assisted therapy, video games and virtual reality cannot replace usual care but could be used as adjunctive therapy. However, recommending their use seems premature because of the recent and preliminary character of most studies. Moreover, a link is still lacking between this field of research in psychiatry and other fields of research, particularly game studies. Finally, it might be interesting to analyse more precisely the neuropsychological impact of existing commercial games which could potentially be useful for psychosocial rehabilitation.

[What do virtual reality tools bring to child and adolescent psychiatry?] / Qu'apportent les outils de réalité virtuelle en psychiatrie de l'enfant et l'adolescent ?

Virtual reality is a relatively new technology that enables individuals to immerse themselves in a virtual world. It offers several advantages including a more realistic, lifelike environment that may allow subjects to "forget" they are being assessed, allow a better participation and an increased generalization of learning. Moreover, the virtual reality system can provide multimodal stimuli, such as visual and auditory stimuli, and can also be used to evaluate the patient's multimodal integration and to aid rehabilitation of cognitive abilities. The use of virtual reality to treat various psychiatric disorders in adults (phobic anxiety disorders, post-traumatic stress disorder, eating disorders, addictions…) and its efficacy is supported by numerous studies. Similar research for children and adolescents is lagging behind. This may be particularly beneficial to children who often show great interest and considerable success on computer, console or videogame tasks. This article will expose the main studies that have used virtual reality with children and adolescents suffering from psychiatric disorders. The use of virtual reality to treat anxiety disorders in adults is gaining popularity and its efficacy is supported by various studies. Most of the studies attest to the significant efficacy of the virtual reality exposure therapy (or in virtuo exposure). In children, studies have covered arachnophobia social anxiety and school refusal phobia. Despite the limited number of studies, results are very encouraging for treatment in anxiety disorders. Several studies have reported the clinical use of virtual reality technology for children and adolescents with autistic spectrum disorders (ASD). Extensive research has proven the efficiency of technologies as support tools for therapy. Researches are found to be focused on communication and on learning and social imitation skills. Virtual reality is also well accepted by subjects with ASD. The virtual environment offers the opportunity to administer controlled tasks such as the typical neuropsychological tools, but in an environment much more like a standard classroom. The virtual reality classroom offers several advantages compared to classical tools such as more realistic and lifelike environment but also records various measures in standardized conditions. Most of the studies using a virtual classroom have found that children with Attention Deficit/Hyperactivity Disorder make significantly fewer correct hits and more commission errors compared with controls. The virtual classroom has proven to be a good clinical tool for evaluation of attention in ADHD. For eating disorders, cognitive behavioural therapy (CBT) program enhanced by a body image specific component using virtual reality techniques was shown to be more efficient than cognitive behavioural therapy alone. The body image-specific component using virtual reality techniques boots efficiency and accelerates the CBT change process for eating disorders. Virtual reality is a relatively new technology and its application in child and adolescent psychiatry is recent. However, this technique is still in its infancy and much work is needed including controlled trials before it can be introduced in routine clinical use. Virtual reality interventions should also investigate how newly acquired skills are transferred to the real world. At present virtual reality can be considered a useful tool in evaluation and treatment for child and adolescent disorders.

[Self-regulation and virtual reality in forensic psychiatry: An emphasis on theoretical underpinnings]. / Applications de la réalité virtuelle en psychiatrie légale : la perspective de l'autorégulation comme cadre théorique.

INTRODUCTION: Forensic psychiatry is the field whose expertise is the assessment and treatment of offending behaviours, in particular when offenses are related to mental illness. An underlying question for all etiological models concerns the manner in which an individual's behaviours are organized. Specifically, it becomes crucial to understand how certain individuals come to display maladaptive behaviours in a given environment, especially when considering issues such as offenders' responsibility and their ability to change their behaviours. VIRTUAL REALITY: Thanks to its ability to generate specific environments, associated with a high experimental control on generated simulations, virtual reality is gaining recognition in forensic psychiatry. Virtual reality has generated promising research data and may turn out to be a remarkable clinical tool in the near future. While research has increased, a conceptual work about its theoretical underpinnings is still lacking. However, no important benefit should be expected from the introduction of a new tool (as innovative as virtual reality) without an explicit and heuristic theoretical framework capable of clarifying its benefits in forensic psychiatry. OBJECTIVES: Our paper introduces self-regulation perspective as the most suitable theoretical framework for virtual reality in forensic psychiatry. It will be argued that virtual reality does not solely help to increase ecological validity. However, it does allow one to grant access to an improved understanding of violent offending behaviours by probing into the underlying mechanisms involved in the self-regulation of behaviours in a dynamical environment. Illustrations are given as well as a discussion regarding perspectives in the use of virtual reality in forensic psychiatry.

[The effects of hypnosis by virtual reality on tolerance to flexible bronchoscopy]. / Effets de l'hypnose par réalité virtuelle sur la tolérance de la bronchoscopie flexible.

INTRODUCTION: Patients often perceive flexible bronchoscopy as an unpleasant procedure. The aim of this study was to investigate the effect of virtual reality (VR) hypnosis on tolerance to flexible bronchoscopy. MATERIALS AND METHODS: We conducted a prospective, randomized, controlled, monocentric study comparing flexible bronchoscopy with VR-induced hypnosis to the usual procedure. Patient tolerance was evaluated using a visual analogue scale (VAS), the state-trait anxiety inventory (STAI) before and after the procedure and, finally, willingness to repeat the examination under the same conditions (WTR). RESULTS: Among the 70 patients included, 34 were randomized to the VR hypnosis group and 36 to the control group. There was no difference between the 2 groups in terms of modification of the pre-/post-bronchoscopy VAS for anxiety, pain, cough, choking, nausea and overall discomfort, or modification of the STAI score and WTR. Subgroup analysis among patients who were more anxious before the procedure revealed a trend toward reduced anxiety in the VR hypnosis group. CONCLUSION: This study did not observe any effect of VR hypnosis on the tolerance of patients during routine flexible bronchoscopy. However, VR hypnosis may be beneficial in patients with higher anxiety score before bronchoscopy, a hypothesis that needs to be confirmed by further studies with a larger number of subjects.

[Virtual reality and care for caregivers]. / Réalité virtuelle et soin aux soignants.

After having used virtual reality with patients, the hospital of Valenciennes (59) made the bet that its use, associated with a hypnotic speech combining cardiac coherence, selected images and special filming techniques, would be likely to cause a significant reduction of stress and a release of emotions in health professionals. A use which would allow, during the same session, to re-energize them so that they can resume their activity.

["Bull'therapy", a decompression chamber for carers]. / La "Bull'thérapie", un sas de décompression pour les soignants.

As part of a global approach to supporting carers in times of health crisis, the Elbeuf-Louviers-Val de Reuil hospital (76) has launched an experiment in "Bull'therapy". By providing a connected hypnosis mask, caregivers can benefit from a time of break time away from the stressful situations they face during their work.

Impact of virtual reality headset use on eye blinking and lipid layer thickness.

PURPOSE: Blinking plays an important role in protecting the eyes, and the use of computers has been associated with a reduction in the blink rate. The goal of this study was to evaluate the effect of a virtual reality headset on blinking and lipid layer thickness and to compare these data to those associated with a conventional desktop monitor. METHODS: Two experiments were performed to compare the effect of 20minutes of use of a virtual reality headset (FOVE) and 20minutes of use of a desktop monitor on the frequency and length of blinks (experiment 1, 15 participants) and on the thickness of the lipid layer as measured by Lipiview (experiment 2, 12 participants). RESULTS: In the first experiment, the blink rate [F(1.83)=4.3, P=0.04, ß=0.36] and duration [F(1.83)=13, P=0.001, ß=0.35] increased with time under both conditions, but no statistical difference was found between the two conditions (headset vs. desktop monitor) either for blink rate [rmANOVA F(1.11)=0.01, P=0.92; headset: 15.1 blinks, 95% CI: 12.6 to 17.6 blinks; desktop: 14.6 blinks, 95% CI: 13.6 to 15.7 blinks] or for blink duration [rmANOVA F(1.11)=4.534, P=0.06; headset: 205.75ms, 95% CI: 200.9 to 210.6ms; desktop: 202.82ms, 95% CI: 198.2 to 207.5ms]. However, strong individual variations were observed. Evaluation of simulator sickness and visual fatigue by questionnaire showed no significant differences between the two conditions (SSQ simulator sickness questionnaire: V=46, P=0.62; VFQ visual fatigue questionnaire: V=15.5, P=0.13). In the second experiment, the lipid layer thickness increased significantly after use of the VR headset [F(1.18)=11.03, P=0.004, headset: 76.2nm, desktop: 58.8nm]. CONCLUSION: In terms of recommendations, the effect of virtual reality headsets on blink duration and frequency during a moderate exposure (20minutes) is comparable to that of a conventional desktop monitor. However, the strong individual variations observed, the lack of reliable tests to evaluate this individual sensitivity, and the significant increase in lipid layer thickness in experiment 2 suggest the value of a more detailed investigation, in particular with consideration of a longer exposure time and other tear film parameters.

Video game-based therapy for the non-dominant hand improves manual skills and grip strength.

The study was designed to investigate the effect of virtual reality-supported training on manual skills and grip strength in the non-dominant hand in healthy participants. Thirty participants were randomized into two groups: ErgoActive group (n=15) and control group (n=15). The ErgoActive study group received 8 weeks of training with leap motion controller-based virtual reality games. The training was done 1 day per week for 30min. The participants' hand function was evaluated using the Jebsen Taylor Hand Function Test (JTHFT), while grip strength was evaluated with a Jamar Hand Dynamometer and Pinchmeter. After 8 weeks, the ErgoActive and control groups had significantly different JTHFT, Jamar and Pinchmeter results (P<0.05). When leap motion controller-based virtual reality applications are used, healthy subjects have increased manual skills and grip strength in their non-dominant hand. These virtual reality games are an effective and fun way of improving patients' hand functions.

Applying an immersive tutorial in virtual reality to learning a new technique.

OBJECTIVE: The medical world is continuously evolving, with techniques being created or improved almost daily. Immersive virtual reality (VR) is a technology that could be harnessed to develop tools that meet the educational challenges of this changing environment. We previously described the immersive tutorial, a 3D video (filmed from the first-person point of view), displayed on a VR application. This tool offers access to supplementary educational data in addition to the video. Here we attempt to assess improvement in learning a technique using this new educational format. MATERIAL AND METHODS: We selected a single neurosurgical technique for the study: external ventricular drainage. We wrote a technical note describing this procedure and produced the corresponding immersive tutorial. We conducted a prospective randomized comparative study with students. All participants read the technical note, and one group used the immersive tutorial as a teaching supplement. The students completed a multiple-choice questionnaire immediately after the training and again at six months. RESULTS: One hundred seventy-six fourth-year medical students participated in the study; 173 were included in assessing the immediate learning outcomes and 72 were included at the six-month follow-up. The VR group demonstrated significantly better short-term results than the control group (P=0.01). The same trend was seen at six months. CONCLUSION: To our knowledge, this study presents one of the largest cohorts for VR. The use of the immersive tutorial could enable a large number of healthcare professionals to be trained without the need for expensive equipment.

[Virtual reality, a safety tool for nursing care in transfusion practice]. / La réalité virtuelle, un outil de sécurité pour les soins infirmiers en transfusion.

Virtual reality is an innovative solution in simulation when it is used to reinforce caregivers' skills. A health facility has set up a continuing professional development programme using this technique. It has enabled caregivers to reinforce their skills in the area of blood transfusion safety.

Tele-analysis: the use of media technology in psychotherapy and its impact on the therapeutic relationship.

A growing number of approaches in psychotherapy make use of internet- and other media-based interactions. This paper discusses the impact on the therapist-client relationship of using media technology and gives an overview of the current state of the debate. It is suggested that the technical conditions of internet-based interactions produce new forms of social relationships that differ significantly from face-to-face-interactions and that unconscious, nonverbal cues get lost. Research on the therapeutic interaction making use of 'discourse linguistic' methods is presented. The loss of nonverbal cues has implications for psychotherapy in general and especially for the treatment of patients who have difficulties relying on a secure therapeutic relationship. Emotional security in interactional relationships is transmitted to a much greater extent by nonverbal cues than by verbal content; psychoanalytic methods are specialized to refer to this level of interaction. Two alternative scenarios are discussed based on the psychoanalytic theories of Winnicott and Lacan: the risk of an illusionary, idealized image of the other and the possibility that cyberspace can be used for psychological development as a transitional space.

[Interest of complex tasks on laparoscopic virtual reality simulator]. / Intérêt des tâches complexes sur simulateur de réalité virtuelle laparoscopique.

OBJECTIVES: The purpose of this study was to assess the contribution of complex tasks on virtual reality simulator (VRS) for novice surgeons in laparoscopy learning. MATERIALS AND METHODS: Fifty-five medical students were prospectively randomized in two groups (A: basic skills, n=28 and B: basic and complex skills, n=27) and then trained during two sessions on VRS. Evaluations took place before and after each training. These evaluations consisted of the achievement of an intracorporeal suture, recorded on video, with the left then with the right hand. Two independent experts evaluated those gestures blindly. RESULTS: A significant progression in terms of times and technical scores was observed in both groups between the first and the last evaluations (P between 0.001 and 0.04). Students in group B improved slower and longer than those in group A. However, left and right hands results confused did not highlight significant differences between the two groups. At the third session, the first hand to train is significantly faster in group B than in group A (P=0.04). CONCLUSION: This study found only a late and minimal impact of complex skills to reduce the execution time of intracorporeal suture. It also showed an slower and longer overall progression for those who use them compared to subjects using basic skills only.

[3D modeling of the female pelvis by Computer-Assisted Anatomical Dissection: Applications and perspectives]. / Modélisation anatomique 3D du pelvis féminin par dissection anatomique assistée par ordinateur : applications et perspectives.

OBJECTIVES: To achieve a 3D vectorial model of a female pelvis by Computer-Assisted Anatomical Dissection and to assess educationnal and surgical applications. MATERIALS AND METHOD: From the database of "visible female" of Visible Human Project(®) (VHP) of the "national library of medicine" NLM (United States), we used 739 transverse anatomical slices of 0.33mm thickness going from L4 to the trochanters. The manual segmentation of each anatomical structures was done with Winsurf(®) software version 4.3. Each anatomical element was built as a separate vectorial object. The whole colored-rendered vectorial model with realistic textures was exported in 3Dpdf format to allow a real time interactive manipulation with Acrobat(®) pro version 11 software. RESULTS: Each element can be handled separately at any transparency, which allows an anatomical learning by systems: skeleton, pelvic organs, urogenital system, arterial and venous vascularization. This 3D anatomical model can be used as data bank to teach of the fundamental anatomy. CONCLUSION: This 3D vectorial model, realistic and interactive constitutes an efficient educational tool for the teaching of the anatomy of the pelvis. 3D printing of the pelvis is possible with the new printers.