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Research Papers

Design and Evaluation of a Portable Laparoscopic Training System Using Virtual Reality

[+] Author and Article Information
Mohsen Zahiri

Department of Mechanical and Materials
Engineering,
University of Nebraska-Lincoln,
W342 Nebraska Hall,
Lincoln, NE 68588-0526
e-mail: mzahiri@huskers.unl.edu

Ryan Booton

College of Public Health,
University of Nebraska Medical Center,
984310 Nebraska Medical Center,
Omaha, NE 68198-4310
e-mail: rbooton@unmc.edu

Ka-Chun Siu

Division of Physical Therapy Education,
College of Allied Health Professions,
University of Nebraska Medical Center,
984420 Nebraska Medical Center,
Omaha, NE 68198-4420
e-mail: kcsiu@unmc.edu

Carl A. Nelson

Mem. ASME
Department of Mechanical
and Materials Engineering,
University of Nebraska-Lincoln,
W342 Nebraska Hall,
Lincoln, NE 68588-0526
e-mail: cnelson5@unl.edu

1Corresponding author.

Manuscript received January 4, 2016; final manuscript received August 30, 2016; published online December 21, 2016. Assoc. Editor: Chris Rylander.

J. Med. Devices 11(1), 011002 (Dec 21, 2016) (6 pages) Paper No: MED-16-1002; doi: 10.1115/1.4034881 History: Received January 04, 2016; Revised August 30, 2016

The ubiquitous nature of laparoscopic surgery and the decreased training time available for surgeons are driving an increased need for effective training systems to help surgeons learn different procedures. A cost-effective and user-friendly simulator has been designed to imitate specific training tasks for laparoscopic surgery in virtual environments via image processing and computer vision. The capability of using various actual surgical instruments suited for these specific procedures gives heightened fidelity to the simulator. Image processing via matlab software provides real-time mapping of the graspers in the workspace to the virtual reality (VR) environment (vizard software). Two different tasks (peg transfer and needle passing) were designed to evaluate trainees and compare their performance with characteristics of expert surgeons. Pilot testing of the system was carried out with 11 subjects to validate the similarity of this device with an existing surgical box trainer. Task completion time and muscle activity have been used as metrics for evaluation. The decrease in completion time for all subjects suggests similarity of skills transfer for both simulators. In addition, the p-value of muscle activity showed no significant differences for most muscles in the peg transfer task when using either the VR or physical analog environment and no significant differences for about half of the muscles in the needle passing task. Based on the results, the new proposed VR simulator appears to be a viable alternative to help trainees gain laparoscopic skills.

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References

Stiff, G. , Rhodes, M. , Kelly, A. , Telford, K. , Armstrong, C. P. , and Rees, B. I. , 1994, “ Long-Term Pain: Less Common After Laparoscopic Than Open Cholecystectomy,” Br. J. Surg., 81(9), pp. 1368–1370. [CrossRef] [PubMed]
Velanovich, V. , 2000, “ Laparoscopic vs Open Surgery: A Preliminary Comparison of Quality-of-Life Outcomes,” Surg. Endoscopy, 14(1), pp. 16–21. [CrossRef]
Laguna, M. P. , de Reijke, T. M. , and de la Rosette, J. J. , 2009, “ How Far Will Simulators be Involved Into Training?,” Curr. Urol. Rep., 10(2), pp. 97–105. [CrossRef] [PubMed]
Fried, G. M. , 2008, “ FLS Assessment of Competency Using Simulated Laparoscopic Tasks,” J. Gastrointest. Surg., 12(2), pp. 210–212. [CrossRef] [PubMed]
Rattner, D. W. , Apelgren, K. N. , and Eubanks, W. S. , 2001, “ The Need for Training Opportunities in Advanced Laparoscopic Surgery,” Surg. Endoscopy, 15(10), pp. 1066–1070. [CrossRef]
Morrison, J. E. , and Hammon, C. , 2000, “ On Measuring the Effectiveness of Large-Scale Training Simulations,” Institute for Defense Analyses, DTIC No. ADA394491, IDA Paper No. P-3570. http://www.dtic.mil/cgi-bin/GetTRDoc?AD=ADA394491
Varas, J. , Mejia, R. , Riquelme, A. , Maluenda, F. , Buckel, E. , Salinas, J. , Martinez, J. , Aggarwal, R. , Jarufe, N. , and Boza, C. , 2012, “ Significant Transfer of Surgical Skills Obtained With an Advanced Laparoscopic Training Program to a Laparoscopic Jejunojejunostomy in a Live Porcine Model: Feasibility of Learning Advanced Laparoscopy in a General Surgery Residency,” Surg. Endoscopy, 26(12), pp. 3486–3494. [CrossRef]
Emken, J. L. , McDougall, E. M. , and Clayman, R. V. , 2004, “ Training and Assessment of Laparoscopic Skills,” JSLS J. Soc. Laparoend., 8(2), pp. 195–199. http://escholarship.org/uc/item/7tw419t2#page-1
Kumar, U. , and Gill, I. S. , 2006, “ Learning Curve in Human Laparoscopic Surgery,” Curr. Urol. Rep., 7(2), pp. 120–124. [CrossRef] [PubMed]
Poulakis, V. , Witzsch, U. , De Vries, R. , Dillenburg, W. , Moeckel, M. , and Becht, E. , 2006, “ Intensive Laparoscopic Training: The Impact of a Simplified Pelvic-Trainer Model for the Urethrovesical Anastomosis,” World J. Urol., 24(3), pp. 331–337. [CrossRef] [PubMed]
Fried, G. M. , Derossis, A. M. , Bothwell, J. , and Sigman, H. H. , 1999, “ Comparison of Laparoscopic Performance In Vivo With Performance Measured in a Laparoscopic Simulator,” Surg. Endoscopy, 13(11), pp. 1077–1081. [CrossRef]
Hyltander, A. , Liljegren, E. , Rhodin, P. H. , and Lonroth, H. , 2002, “ The Transfer of Basic Skills Learned in a Laparoscopic Simulator to the Operating Room,” Surg. Endoscopy, 16(9), pp. 1324–1328. [CrossRef]
Avodeji, I. D. , Schijven, M. , Jakimowicz, J. , and Greve, J. W. , 2007, “ Face Validation of the Simbionix LAP Mentor Virtual Reality Training Module and Its Applicability in the Surgical Curriculum,” Surg. Endoscopy, 21(9), pp. 1641–1649. [CrossRef]
Scott, D. J. , Young, W. N. , Tesfay, S. T. , Frawlwy, W. H. , Rege, R. V. , and Jones, D. B. , 2001, “ Laparoscopic Skills Training,” Am. J. Surg., 182(2), pp. 137–142. [CrossRef] [PubMed]
Derossis, A. M. , Bothwell, J. , Sigman, H. H. , and Fried, G. M. , 1998, “ The Effect of Practice on Performance in an Laparoscopic Simulator,” Surg. Endoscopy, 12(9), pp. 1117–1120. [CrossRef]
Fraser, S. A. , Feldman, L. S. , Stanbridge, D. , and Fried, G. M. , 2005, “ Characterizing the Learning Curve for a Basic Laparoscopic Drill,” Surg. Endoscopy, 19(12), pp. 1572–1578. [CrossRef]
Hartenberg, R. S. , and Denavit, J. , 1995, Kinematic Synthesis of Linkages, McGraw-Hill, New York.
Yang, Y. , Cao, Q. , Lo, C. , and Zhang, Z. , 2009, “ Pose Estimation Based on Four Coplanar Point Correspondences,” Sixth International Conference on Fuzzy Systems and Knowledge Discovery, (FSKD), Tianjin, China, Aug. 14–16, pp. 410–414.
Hartley, R. , and Zisserman, A. , 2004, Multiple View Geometry in Computer Vision, 2nd ed., Cambridge University Press, Cambridge, UK.
Kowalczuk, J. E. , Psota, E. T. , and Pérez, L. C. , 2013, “ Scale-Accurate 3D Vehicle Point Cloud Extraction From Single-Camera Traffic Video,” International Conference on Image Processing, Computer Vision, and Pattern Recognition (IPCV), Las Vegas, July 22–25, pp. 626–632. http://weblidi.info.unlp.edu.ar/WorldComp2013-Mirror/p2013/IPC4042.pdf
Fried, G. M. , Feldman, L. S. , Vassiliou, M. C. , Fraser, S. A. , Stanbridge, D. , Ghitulescu, G. , and Andrew, C. G. , 2004, “ Proving the Value of Simulation in Laparoscopic Surgery,” Ann. Surg., 240(3), pp. 518–525. [CrossRef] [PubMed]

Figures

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Fig. 1

PortCAS simulator with actual laparoscopic graspers

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Fig. 2

Markers mounted on the surgical instruments

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Fig. 3

Decomposition of the projection process for camera pose refinement [20]

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Fig. 4

Three-dimensional position of the object

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Fig. 5

Coordinate frames attached to gimbal joint

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Fig. 6

Virtual task: (a) peg transfer task and (b) needle passing

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