Development and validation of a hybrid surgical simulator for ultrasound guided laparoscopic common bile duct exploration

This thesis investigates using 3D printing for developing a low-cost, quick, and simple fabrication method for the surgical simulation of the basic skills needed in a laparoscopic common bile duct exploration using ultrasound. This is achieved through a human-centred design methodology where each step of the development is guided by interactions or evaluations with the end users. The specifications are defined by using interviews to understand the needs of surgeons in a simulation practice and to characterise the experience of performing surgery, including the embodied knowledge of surgeons when they manipulate soft tissues. Using an action research methodology combining qualitative and quantitative evaluations in an iterative process, commonly used materials in simulation are thoroughly investigated to identify the most suitable synthetic materials for each type of soft tissue. The synthetic materials identified are silicones because of their tactile properties; moreover, two augmented reality techniques are implemented in addition to the physical model. The first one is style transfer, which aims to improve the appearance of the physical simulator when it is viewed through the laparoscopic camera. The style transfer algorithm used during this research can successfully modify the appearance of the simulator to replicate the diversity of real life. The second technique is marker tracking, which is used to simulate the laparoscopic ultrasound step by overlaying pre-recorded ultrasound images onto the physical model. This technique allows surgeons to practice reading laparoscopic ultrasound images and identifying key anatomical features during the surgery. Through consultations with the surgeons, the outcomes of this research are evaluated using face, content, and construct validations. Throughout this thesis, the research methods and results are explained and discussed to provide a basis for further research. These findings can be used as a framework for future development of surgical simulators