NOViSE: a virtual natural orifice transluminal endoscopic surgery simulator

Purpose: Natural Orifice Transluminal Endoscopic Surgery (NOTES) is a novel technique in minimally invasive surgery whereby a flexible endoscope is inserted via a natural orifice to gain access to the abdominal cavity, leaving no external scars. This innovative use of flexible endoscopy creates many new challenges and is associated with a steep learning curve for clinicians. Methods: We developed NOViSE - the first force-feedback enabled virtual reality simulator for NOTES training supporting a flexible endoscope. The haptic device is custom built and the behaviour of the virtual flexible endoscope is based on an established theoretical framework – the Cosserat Theory of Elastic Rods. Results: We present the application of NOViSE to the simulation of a hybrid trans-gastric cholecystectomy procedure. Preliminary results of face, content and construct validation have previously shown that NOViSE delivers the required level of realism for training of endoscopic manipulation skills specific to NOTES Conclusions: VR simulation of NOTES procedures can contribute to surgical training and improve the educational experience without putting patients at risk, raising ethical issues or requiring expensive animal or cadaver facilities. In the context of an experimental technique, NOViSE could potentially facilitate NOTES development and contribute to its wider use by keeping practitioners up to date with this novel surgical technique. NOViSE is a first prototype and the initial results indicate that it provides promising foundations for further development

Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

Training and assessment paradigms for laparoscopic surgical skills are evolving from traditional mentor–trainee tutorship towards structured, more objective and safer programs. Accreditation of surgeons requires reaching a consensus on metrics and tasks used to assess surgeons’ psychomotor skills. Ongoing development of tracking systems and software solutions has allowed for the expansion of novel training and assessment means in laparoscopy. The current challenge is to adapt and include these systems within training programs, and to exploit their possibilities for evaluation purposes. This paper describes the state of the art in research on measuring and assessing psychomotor laparoscopic skills. It gives an overview on tracking systems as well as on metrics and advanced statistical and machine learning techniques employed for evaluation purposes. The later ones have a potential to be used as an aid in deciding on the surgical competence level, which is an important aspect when accreditation of the surgeons in particular, and patient safety in general, are considered. The prospective of these methods and tools make them complementary means for surgical assessment of motor skills, especially in the early stages of training. Successful examples such as the Fundamentals of Laparoscopic Surgery should help drive a paradigm change to structured curricula based on objective parameters. These may improve the accreditation of new surgeons, as well as optimize their already overloaded training schedules

3D sound for simulation of arthroscopic surgery

Arthroscopic surgery offers many advantages compared to traditional surgery. Nevertheless, the required skills to practice this kind of surgery need specific training. Surgery simulators are used to train surgeon apprentices to practice specific gestures. In this paper, we present a study showing the contribution of 3D sound in assisting the triangulation gesture in arthroscopic surgery simulation. This ability refers to the capacity of the subject to manipulate the instruments while having a modified and limited view provided by the video camera of the simulator. Our approach, based on the use of 3D sound metaphors, provides interaction cues to the subjects about the real position of the instrument. The paper reports a performance evaluation study based on the perception of 3D sound integrated in the process of training of surgical task. Despite the fact that 3D sound cueing was not shown useful to all subjects in terms of execution time, the results of the study revealed that the majority of subjects who participated to the experiment confirmed the added value of 3D sound in terms of ease of use

A Compact Driving Simulator to Support Research and Training Needs - Hardware, Software, and Assessment

In 2009, there were 10.8 million automotive crashes in the United States. When reviewing these incidents, young drivers were the over-represented group who were involved in these vehicular crashes. One reason that these young drivers have such high crash rates is that they often do not possess extensive driving knowledge and typically lack driving experience. Over the past three decades, researchers have investigated the driver training process which includes the classroom and behind the wheel to help address teaching the deficiencies in the driver education program. To complement the current driver education process, automotive simulators can be utilized to teach skills and strategies. Driving simulators offer multiple advantages as student drivers are accustomed to playing video games, it is entirely safe to practice driving in a virtual environment, and many different types of driving tracks and custom scenarios can be implemented. In this thesis, an innovative automotive simulator will be created and tested to evaluate its effectiveness for teaching novice drivers fundamental motor vehicle skills. The personal computer-based portable Clemson Automotive Training System (CATS) was developed to teach young drivers the necessary driving knowledge and then allow them to practice driving a vehicle on a virtual track. The students became familiarized with typical road situations and simultaneously enhanced their driving abilities when facing unexpected scenarios. In CATS, a track and four different scenarios (e.g., \u27Control Sign\u27, \u27Lane Selection\u27, \u27Braking\u27, and \u27Obstacle Avoidance\u27) were created to test different driving aspects. The driving rating and feedback was displayed on the computer screen immediately after the student completed the driving test. As part of the experimental study, 50 participants were invited to complete the virtual driving training process. The driving test contained three parts: a pre-test questionnaire, four driving scenarios, and a post-test questionnaire. The laboratory results show that the novice drivers demonstrated a significantly higher potential in acquiring basic driving knowledge and improving their driving skills after practicing on a CATS simulator than more experienced drivers. There was an overall driving improvement of 28% after the students finished the CATS. The simulator has successfully demonstrated its ability to enhance both driving knowledge and driving skills through the training of novice drivers. Further development of CATS is necessary to refine and improve its ability to educate and train novice drivers. A more realistic track should be constructed with high-resolution objects such as a school zone and buildings along the roadway, and more scenarios designed to expore more advanced driving skills. In addition, an additional force feedback function should be added to enhance the driving realism. Finally, vehicular traffic should be added to the simulator environment that will interact with each student\u27s vehicle to offer a more realistic scenario

PC-based aviation training devices (PCATDs): research, development and certification

This paper examines the development of two PCATD’s (one helicopter, one fixed-wing) and their eventual certification by CAA. Certification has demonstrated the potential these devices have for aviation training in New Zealand. Traditionally FTD‘s and PCATD’s have been sourced from foreign companies, and they represent a considerable financial investment for large flying training organisations. The procurement of these simulator types is generally beyond the financial resources of most small to medium sized flying schools. Aviation training in NZ is facing significant financial constraints as well as an increasing demand to simulate complex glass cockpit systems that are now installed in most new General Aviation (GA) aircraft. The development, utilisation and certification of this type of PCATD technology could solve these difficult challenges

Biopsym : a learning environment for transrectal ultrasound guided prostate biopsies

This paper describes a learning environment for image-guided prostate biopsies in cancer diagnosis; it is based on an ultrasound probe simulator virtually exploring real datasets obtained from patients. The aim is to make the training of young physicians easier and faster with a tool that combines lectures, biopsy simulations and recommended exercises to master this medical gesture. It will particularly help acquiring the three-dimensional representation of the prostate needed for practicing biopsy sequences. The simulator uses a haptic feedback to compute the position of the virtual probe from three-dimensional (3D) ultrasound recorded data. This paper presents the current version of this learning environment