RESUMEN
OBJECTIVE: To test whether basic skills acquired on a virtual endoscopic surgery simulator are transferable from virtual reality to physical reality in a comparable training setting. SUMMARY BACKGROUND DATA: For surgical training in laparoscopic surgery, new training methods have to be developed that allow surgeons to first practice in a simulated setting before operating on real patients. A virtual endoscopic surgery trainer (VEST) has been developed within the framework of a joint project. Because of principal limitations of simulation techniques, it is essential to know whether training with this simulator is comparable to conventional training. METHODS: Devices used were the VEST system and a conventional video trainer (CVT). Two basic training tasks were constructed identically (a) as virtual tasks and (b) as mechanical models for the CVT. Test persons were divided into 2 groups each consisting of 12 novices and 4 experts. Each group carried out a defined training program over the course of 4 consecutive days on the VEST or the CVT, respectively. To test the transfer of skills, the groups switched devices on the 5th day. The main parameter was task completion time. RESULTS: The novices in both groups showed similar learning curves. The mean task completion times decreased significantly over the 4 training days of the study. The task completion times for the control task on Day 5 were significantly lower than on Days 1 and 2. The experts' task completion times were much lower than those of the novices. CONCLUSIONS: This study showed that training with a computer simulator, just as with the CVT, resulted in a reproducible training effect. The control task showed that skills learned in virtual reality are transferable to the physical reality of a CVT. The fact that the experts showed little improvement demonstrates that the simulation trains surgeons in basic laparoscopic skills learned in years of practice.
Asunto(s)
Competencia Clínica , Laparoscopía , Procedimientos Quirúrgicos Mínimamente Invasivos/educación , Interfaz Usuario-Computador , Simulación por Computador , Educación de Pregrado en Medicina , Cirugía General/educación , Humanos , Desempeño Psicomotor , Programas Informáticos , Grabación en VideoRESUMEN
Force feedback increases the effectiveness of virtual-reality surgery training systems. An overview of the fundamentals of applying force feedback is presented. An impedance control technique and data processing methods for stability preservation are illustrated. A flexible interface for general force-feedback applications has been developed. This interface is capable of controlling several different force-feedback hardware systems, including the SensAble PHANTOM, the Laparoscopic Impulse Engines from Immersion, and the VS-One virtual endoscopic surgery trainer. The findings are evaluated using the main simulation system, KISMET, and the modeling tools KISMO and VESUV. Within the scope of a cooperative project called HapticIO (funded by the German Ministry of Education and Research [BMBF]), new haptic devices have been designed for virtual neuroendoscopy and laparoscopy. The concept and implementations presented in this paper have been found to be flexible, stable and suitable for universal use. The impedance method, combined with the open-loop feed-forward control technique, is well suited and appropriate for the task.
Asunto(s)
Simulación por Computador , Endoscopía/métodos , Retroalimentación , Procedimientos Neuroquirúrgicos/métodos , Interfaz Usuario-Computador , Tecnología Educacional , Diseño de Equipo , HumanosRESUMEN
To improve training facilities for surgeons, a surgical training system based on virtual reality techniques has been developed. The goal of the developed system is to improve education of surgeons by making the knowledge of expert surgeons directly available to trainees. The system realizes two different approaches: the library and the driving school paradigm. In its current form, the system consists of two modules. The main module combines the virtual reality kernel KISMET, a visual and haptic display, and a database of different operations and/or techniques. The master station is a copy of the input and output facilities of the main module. Both modules communicate by a TCP/ IP-based connection. Initial tests demonstrated the feasibility of the chosen framework. Further developments include the gathering of data not only from virtual reality but also from real operations. Robotic-assisted surgery provides an attractive way of accomplishing this.