A Novel Haptic Simulator for Evaluating and Training Salient Force-Based Skills for Laparoscopic Surgery

Laparoscopic surgery has evolved from an \u27alternative\u27 surgical technique to currently being considered as a mainstream surgical technique. However, learning this complex technique holds unique challenges to novice surgeons due to their \u27distance\u27 from the surgical site. One of the main challenges in acquiring laparoscopic skills is the acquisition of force-based or haptic skills. The neglect of popular training methods (e.g., the Fundamentals of Laparoscopic Surgery, i.e. FLS, curriculum) in addressing this aspect of skills training has led many medical skills professionals to research new, efficient methods for haptic skills training. The overarching goal of this research was to demonstrate that a set of simple, simulator-based haptic exercises can be developed and used to train users for skilled application of forces with surgical tools. A set of salient or core haptic skills that underlie proficient laparoscopic surgery were identified, based on published time-motion studies. Low-cost, computer-based haptic training simulators were prototyped to simulate each of the identified salient haptic skills. All simulators were tested for construct validity by comparing surgeons\u27 performance on the simulators with the performance of novices with no previous laparoscopic experience. An integrated, \u27core haptic skills\u27 simulator capable of rendering the three validated haptic skills was built. To examine the efficacy of this novel salient haptic skills training simulator, novice participants were tested for training improvements in a detailed study. Results from the study demonstrated that simulator training enabled users to significantly improve force application for all three haptic tasks. Research outcomes from this project could greatly influence surgical skills simulator design, resulting in more efficient training

Research on real-time physics-based deformation for haptic-enabled medical simulation

This study developed a multiple effective visuo-haptic surgical engine to handle a variety of surgical manipulations in real-time. Soft tissue models are based on biomechanical experiment and continuum mechanics for greater accuracy. Such models will increase the realism of future training systems and the VR/AR/MR implementations for the operating room

Tangible auditory interfaces : combining auditory displays and tangible interfaces

Bovermann T. Tangible auditory interfaces : combining auditory displays and tangible interfaces. Bielefeld (Germany): Bielefeld University; 2009.Tangible Auditory Interfaces (TAIs) investigates into the capabilities of the interconnection of Tangible User Interfaces and Auditory Displays. TAIs utilise artificial physical objects as well as soundscapes to represent digital information. The interconnection of the two fields establishes a tight coupling between information and operation that is based on the human's familiarity with the incorporated interrelations. This work gives a formal introduction to TAIs and shows their key features at hand of seven proof of concept applications

Development and Validation of a Hybrid Virtual/Physical Nuss Procedure Surgical Trainer

With continuous advancements and adoption of minimally invasive surgery, proficiency with nontrivial surgical skills involved is becoming a greater concern. Consequently, the use of surgical simulation has been increasingly embraced by many for training and skill transfer purposes. Some systems utilize haptic feedback within a high-fidelity anatomically-correct virtual environment whereas others use manikins, synthetic components, or box trainers to mimic primary components of a corresponding procedure. Surgical simulation development for some minimally invasive procedures is still, however, suboptimal or otherwise embryonic. This is true for the Nuss procedure, which is a minimally invasive surgery for correcting pectus excavatum (PE) – a congenital chest wall deformity. This work aims to address this gap by exploring the challenges of developing both a purely virtual and a purely physical simulation platform of the Nuss procedure and their implications in a training context. This work then describes the development of a hybrid mixed-reality system that integrates virtual and physical constituents as well as an augmentation of the haptic interface, to carry out a reproduction of the primary steps of the Nuss procedure and satisfy clinically relevant prerequisites for its training platform. Furthermore, this work carries out a user study to investigate the system’s face, content, and construct validity to establish its faithfulness as a training platform

Microscope Embedded Neurosurgical Training and Intraoperative System

In the recent years, neurosurgery has been strongly influenced by new technologies. Computer Aided Surgery (CAS) offers several benefits for patients\u27 safety but fine techniques targeted to obtain minimally invasive and traumatic treatments are required, since intra-operative false movements can be devastating, resulting in patients deaths. The precision of the surgical gesture is related both to accuracy of the available technological instruments and surgeon\u27s experience. In this frame, medical training is particularly important. From a technological point of view, the use of Virtual Reality (VR) for surgeon training and Augmented Reality (AR) for intra-operative treatments offer the best results. In addition, traditional techniques for training in surgery include the use of animals, phantoms and cadavers. The main limitation of these approaches is that live tissue has different properties from dead tissue and that animal anatomy is significantly different from the human. From the medical point of view, Low-Grade Gliomas (LGGs) are intrinsic brain tumours that typically occur in younger adults. The objective of related treatment is to remove as much of the tumour as possible while minimizing damage to the healthy brain. Pathological tissue may closely resemble normal brain parenchyma when looked at through the neurosurgical microscope. The tactile appreciation of the different consistency of the tumour compared to normal brain requires considerable experience on the part of the neurosurgeon and it is a vital point. The first part of this PhD thesis presents a system for realistic simulation (visual and haptic) of the spatula palpation of the LGG. This is the first prototype of a training system using VR, haptics and a real microscope for neurosurgery. This architecture can be also adapted for intra-operative purposes. In this instance, a surgeon needs the basic setup for the Image Guided Therapy (IGT) interventions: microscope, monitors and navigated surgical instruments. The same virtual environment can be AR rendered onto the microscope optics. The objective is to enhance the surgeon\u27s ability for a better intra-operative orientation by giving him a three-dimensional view and other information necessary for a safe navigation inside the patient. The last considerations have served as motivation for the second part of this work which has been devoted to improving a prototype of an AR stereoscopic microscope for neurosurgical interventions, developed in our institute in a previous work. A completely new software has been developed in order to reuse the microscope hardware, enhancing both rendering performances and usability. Since both AR and VR share the same platform, the system can be referred to as Mixed Reality System for neurosurgery. All the components are open source or at least based on a GPL license

Visuohaptic Simulation of a Borescope for Aircraft Engine Inspection

Consisting of a long, fiber optic probe containing a small CCD camera controlled by hand-held articulation interface, a video borescope is used for remote visual inspection of hard to reach components in an aircraft. The knowledge and psychomotor skills, specifically the hand-eye coordination, required for effective inspection are hard to acquire through limited exposure to the borescope in aviation maintenance schools. Inexperienced aircraft maintenance technicians gain proficiency through repeated hands-on learning in the workplace along a steep learning curve while transitioning from the classroom to the workforce. Using an iterative process combined with focused user evaluations, this dissertation details the design, implementation and evaluation of a novel visuohaptic simulator for training novice aircraft maintenance technicians in the task of engine inspection using a borescope. First, we describe the development of the visual components of the simulator, along with the acquisition and modeling of a representative model of a {PT-6} aircraft engine. Subjective assessments with both expert and novice aircraft maintenance engineers evaluated the visual realism and the control interfaces of the simulator. In addition to visual feedback, probe contact feedback is provided through a specially designed custom haptic interface that simulates tip contact forces as the virtual probe intersects with the {3D} model surfaces of the engine. Compared to other haptic interfaces, the custom design is unique in that it is inexpensive and uses a real borescope probe to simulate camera insertion and withdrawal. User evaluation of this simulator with probe tip feedback suggested a trend of improved performance with haptic feedback. Next, we describe the development of a physically-based camera model for improved behavioral realism of the simulator. Unlike a point-based camera, the enhanced camera model simulates the interaction of the borescope probe, including multiple points of contact along the length of the probe. We present visual comparisons of a real probe\u27s motion with the simulated probe model and develop a simple algorithm for computing the resultant contact forces. User evaluation comparing our custom haptic device with two commonly available haptic devices, the Phantom Omni and the Novint Falcon, suggests that the improved camera model as well as probe contact feedback with the 3D engine model plays a significant role in the overall engine inspection process. Finally, we present results from a skill transfer study comparing classroom-only instruction with both simulator and hands-on training. Students trained using the simulator and the video borescope completed engine inspection using the real video borescope significantly faster than students who received classroom-only training. The speed improvements can be attributed to reduced borescope probe maneuvering time within the engine and improved psychomotor skills due to training. Given the usual constraints of limited time and resources, simulator training may provide beneficial skills needed by novice aircraft maintenance technicians to augment classroom instruction, resulting in a faster transition into the aviation maintenance workforce

The evaluation of a novel haptic machining VR-based process planning system using an original process planning usability method

This thesis provides an original piece of work and contribution to knowledge by creating a new process planning system; Haptic Aided Process Planning (HAPP). This system is based on the combination of haptics and virtual reality (VR). HAPP creates a simulative machining environment where Process plans are automatically generated from the real time logging of a user’s interaction. Further, through the application of a novel usability test methodology, a deeper study of how this approach compares to conventional process planning was undertaken. An abductive research approach was selected and an iterative and incremental development methodology chosen. Three development cycles were undertaken with evaluation studies carried out at the end of each. Each study, the pre-pilot, pilot and industrial, identified progressive refinements to both the usability of HAPP and the usability evaluation method itself. HAPP provided process planners with an environment similar to which they are already familiar. Visual images were used to represent tools and material whilst a haptic interface enabled their movement and positioning by an operator in a manner comparable to their native setting. In this way an intuitive interface was developed that allowed users to plan the machining of parts consisting of features that can be machined on a pillar drill, 21/2D axis milling machine or centre lathe. The planning activities included single or multiple set ups, fixturing and sequencing of cutting operations. The logged information was parsed and output to a process plan including route sheets, operation sheets, tool lists and costing information, in a human readable format. The system evaluation revealed that HAPP, from an expert planners perspective is perceived to be 70% more satisfying to use, 66% more efficient in completing process plans, primarily due to the reduced cognitive load, is more effective producing a higher quality output of information and is 20% more learnable than a traditional process planning approach