7 research outputs found
Design and Validation of a Bimanual Haptic Epidural Needle Insertion Simulator
The case experience of anesthesiologists is one of the leading causes of
accidental dural puncture and failed epidural - the most common complications
of epidural analgesia. We designed a bimanual haptic simulator to train
anesthesiologists and optimize epidural analgesia skill acquisition, and
present a validation study conducted with 15 anesthesiologists of different
competency levels from several hospitals in Israel. Our simulator emulates the
forces applied on the epidural (Touhy) needle, held by one hand, and those
applied on the Loss of Resistance (LOR) syringe, held by the second hand. The
resistance is calculated based on a model of the Epidural region layers that is
parameterized by the weight of the patient. We measured the movements of both
haptic devices, and quantified the rate of results (success, failed epidurals
and dural punctures), insertion strategies, and answers of participants to
questionnaires about their perception of the realism of the simulation. We
demonstrated good construct validity by showing that the simulator can
distinguish between real-life novices and experts. Good face and content
validity were shown in experienced users' perception of the simulator as
realistic and well-targeted. We found differences in strategies between
different level anesthesiologists, and suggest trainee-based instruction in
advanced training stages.Comment: 12 pages, 11 figure
Haptic feedback from human tissues of various stiffness and homogeneity
This work presents methods for haptic modelling of soft and hard tissue with varying stiffness. The model provides visualization of deformation and calculates force feedback during simulated epidural needle insertion. A spring-mass-damper (SMD) network is configured from magnetic resonance image (MRI) slices of patientâs lumbar region to represent varying stiffness throughout tissue structure. Reaction force is calculated from the SMD network and a haptic device is configured to produce a needle insertion simulation. The user can feel the changing forces as the needle is inserted through tissue layers and ligaments. Methods for calculating the force feedback at various depths of needle insertion are presented. Voxelization is used to fill ligament surface meshes with spring mass damper assemblies for simulated needle insertion into soft and hard tissues. Modelled vertebrae cannot be pierced by the needle. Graphs were produced during simulated needle insertions to compare the applied force to haptic reaction force. Preliminary saline pressure measurements during Tuohy epidural needle insertion are also used as a basis for forces generated in the simulation
A Review of Pneumatic Actuators Used for the Design of Medical Simulators and Medical Tools
International audienc