E-MIS validity applied to TELMA enhanced learning environment

Enhanced learning environments are arising with great success within the field of cognitive skills training in minimally invasive surgery (MIS) because they provides multiple benefits since they avoid time, spatial and cost constraints. TELMA [1,2] is a new technology enhanced learning platform that promotes collaborative and ubiquitous training of surgeons. This platform is based on four main modules: an authoring tool, a learning content and knowledge management system, an evaluation module and a professional network. TELMA has been designed and developed focused on the user; therefore it is necessary to carry out a user validation as final stage of the development. For this purpose, e-MIS validity [3] has been defined. This validation includes usability, contents and functionality validities both for the development and production stages of any e-Learning web platform. Using e-MIS validity, the e-Learning is fully validated since it includes subjective and objective metrics. The purpose of this study is to specify and apply a set of objective and subjective metrics using e-MIS validity to test usability, contents and functionality of TELMA environment within the development stage

Procedimiento automático para el calibrado de cámaras: Estudio comparativo de la distorsión en diferentes combinaciones de cámaras y ópticas laparoscópicas

En este trabajo se propone un método de calibración automático para el cálculo y corrección de la distorsión en imágenes producida por las lentes de los sistemas de captura. Este procedimiento ha sido empleado como herramienta para analizar la distorsión provocada por diversos sistemas de cámara y óptica laparoscópica, de modo que podamos determinar el sistema que proporciona una imagen más fiable al cirujano

Adaptación de la usabilidad del entorno de formación TELMA a las necesidades de los cirujanos expertos

Uno de los principales inconvenientes manifestados por los cirujanos a la hora de llevar a cabo su formación continuada es la elevada carga asistencial que les limita la posibilidad de asistir a cursos y estancias presenciales. Por tanto, los cirujanos necesitan otros métodos formativos distintos a la formación in situ y para ello son de gran utilidad las tecnologías web, como es el caso de la plataforma de e-Learning TELMA, que ofrezcan contenidos didácticos adaptados a cada usuario para que puedan complementar su formación con contenidos multimedia online. Estudios previos de validación de TELMA detectaron diferentes problemas respecto a su diseño y usabilidad, propiciando mayores dificultades de accesibilidad para los cirujanos expertos en relación a los cirujanos noveles. Para corregirlos, en este trabajo se han analizado las deficiencias encontradas y se han propuesto una serie de medidas fundamentadas en un conjunto de directivas de diseño web que se deberían adoptar en futuras versiones de la plataforma TELMA para tratar de solventar estas desigualdades, ofreciendo a todos los usuarios tanto expertos como noveles, las mismas facilidades de accesibilidad

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

Technical evaluation of a third generation optical pose tracker for motion analysis and image-guided surgery

Laparoscopic instrument tracking systems are an essential component in image-guided interventions and offer new possibilities to improve and automate objective assessment methods of surgical skills. In this study we present our system design to apply a third generation optical pose tracker (Micron- Tracker®) to laparoscopic practice. A technical evaluation of this design is performed in order to analyze its accuracy in computing the laparoscopic instrument tip position. Results show a stable fluctuation error over the entire analyzed workspace. The relative position errors are 1.776±1.675 mm, 1.817±1.762 mm, 1.854±1.740 mm, 2.455±2.164 mm, 2.545±2.496 mm, 2.764±2.342 mm, 2.512±2.493 mm for distances of 50, 100, 150, 200, 250, 300, and 350 mm, respectively. The accumulated distance error increases with the measured distance. The instrument inclination covered by the system is high, from 90 to 7.5 degrees. The system reports a low positional accuracy for the instrument tip

Evaluación objetiva de destrezas laparoscópicas básicas a partir de métricas obtenidas con el simulador virtual SINERGIA

Las técnicas laparoscópicas se han convertido en patrón oro en muchos procedimientos quirúrgicos, pero implican un proceso de adquisición de destrezas más complejo que en el caso de la cirugía abierta. En esta fase formativa, los simuladores virtuales tienen un papel muy importante puesto que permiten evaluar de forma objetiva la ejecución de una tarea quirúrgica mediante la extracción automática de métricas. Este trabajo de investigación presenta un análisis de las métricas calculadas por el simulador virtual SINERGIA con el fin de poder llevar a cabo una evaluación objetiva de las destrezas laparoscópicas básicas

Sistema de seguimiento del instrumental laparoscópico basado en marcas artificiales: pruebas iniciales

Sistema de seguimiento del instrumental laparoscópico basado en marcas artificiales: pruebas iniciale

Controlling virtual scenarios for minimally invasive surgery training using the EVA Tracking System

Software-based solutions such as virtual reality simulators and serious games can be useful assets for training minimally invasive surgery technical skills. However, their high cost and lack of realism/fidelity can sometimes be a drawback for their incorporation in training facilities. In this sense, the hardware interface plays an important role as the physical connection between the learner and the virtual world. This article presents the first efforts in integrating the EVA Tracking System, based on computer vision, to control a virtual serious game with real laparoscopic instruments. Integration between the game engine and the tracking system is achieved using ZeroC Ice and Apache Thrift frameworks. Control of the game is viable in this manner, though there are several functional limitations (grasping, rotation), as well as a need to compromise between robustness and lag. Validation with real users will be the next step towards establishing the acceptance and viability of this new solution

Development of a pancreatic ex vivo model for registration between preoperative imaging and laparoscopic ultrasound

Pancreatic adenocarcinoma has one of the highest mortaly rates of all cancers

Serious game - Evaluation of the needs and its possible role in the laparoscopic teaching

Laparoscopy rapidly gained popularity in the surgical practice, but as a matter of fact, the educational possibilities of laparoscopy are still not effective. Before developing the Kheiron Training System ? a serious game for the development of laparoscopic psychomotor skills supported by the Lifelong Learning Programme of the European Commission