We present algorithms for simulating and visualizing the insertion and steering of needles through
deformable tissues for surgical training and planning. Needle insertion is an essential component of
many clinical procedures such as biopsies, injections, neurosurgery, and brachytherapy cancer treatment.
The success of these procedures depends on accurate guidance of the needle tip to a clinical
target while avoiding vital tissues. Needle insertion deforms body tissues, making accurate placement
difficult. Our interactive needle insertion simulator models the coupling between a flexible
needle and deformable tissue. We introduce (1) a novel algorithm for local remeshing that quickly
enforces the conformity of a tetrahedral mesh to a curvilinear needle path, enabling accurate computation
of contact forces, (2) an efficient method for coupling a 3D finite element simulation with a
1D inextensible rod with stick-slip friction, and (3) optimizations that reduce the computation time
for physically based simulations. We can realistically and interactively simulate needle insertion
into a prostate mesh of 13,375 tetrahedra and 2,763 vertices at a 25 Hz frame rate on an 8-core 3.0
GHz Intel Xeon PC. The simulation models prostate brachytherapy with needles of varying stiffness,
steering needles around obstacles, and supports motion planning for robotic needle insertion.
We evaluate the accuracy of the simulation by comparing against real-world experiments in which
flexible, steerable needles were inserted into gel tissue phantoms.