Development and validation of a Virtual Colorectal Surgical Trainer (VCoST)

虚拟结直肠手术训练器 (VCoST) 的开发和验证

基本信息

批准号：
10470083
负责人：
Suvranu De
金额：
$ 66.44万
依托单位：
RENSSELAER POLYTECHNIC INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-07-25 至 2024-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10470083
关键词：
3-Dimensional American Anastomosis - action Anatomy Anus Certification Clinical Cognitive Colon and Rectal Surgeon Colonoscopy Colorectal Colorectal Surgery Computer Models Computers Control Groups Credentialing Decision Making Detection Development Devices Endoscopy Enrollment Environment Evaluation Excision Face Feedback Goals Hand Healthcare Systems Hemorrhage Human Ileal Reservoirs Immersion Interdisciplinary Study Laparoscopic Surgical Procedures Learning Length of Stay Manuals Measures Modeling Morbidity - disease rate Operating Rooms Operative Surgical Procedures Oral Oral Examination Patient-Focused Outcomes Patients Pelvis Performance Physics Procedures Process Psychological Transfer Recording of previous events Rectal Prolapse Research Research Project Grants Resolution Risk Sigmoid colon Societies Standardization Structure Surgeon System Tactile Technical Expertise Technology Testing Time Touch sensation Training Translating Treatment Cost Validation Visual apprenticeship base computer generated design experimental study force feedback haptic feedback haptic interface haptics head mounted display healing human old age (65+)human tissue improved in vivo mortality novel operation response simulation skills skills training success three-dimensional visualization tool transfer learning virtual virtual reality virtual reality environment virtual reality simulation virtual reality simulator

项目摘要

Development and validation of a Virtual Colorectal Surgical Trainer (VCoST) Abstract For the first time in the history of surgery, a hands-on surgical technical skills examination – the Colorectal Objective Structured Assessment of Technical Skills (COSATS), developed by the American Society of Colon and Rectal Surgeons (ASCRS) – has been introduced in the American Board of Colon and Rectal Surgeons (ABCRS) examination, starting in 2014. The COSATS requires an elaborate setup with eight different stations through which residents must circulate to perform five open surgical tasks (rectal prolapse, pelvic bleeding, ileal pouch anal anastomosis, coloanal anastomosis, handsewn anastomosis), two laparoscopic and a colonoscopic task. It is anticipated that a computer generated virtual reality (VR)-based simulator with both visual and haptic (touch) feedback could provide an integrated training and evaluation environment for colorectal residents to climb their "learning curves" without risk to actual patients, standardize the process of skill training and credentialing and allow objective quantification of performance, without the need for human proctors. While VR simulation technology is being developed for colonoscopy and laparoscopic surgical procedures, three major technical hurdles have thwarted the development of VR-based simulation of open surgical procedures, such as the ones in COSATS: (1) fully immersive 3D visualization to allow surgeons to interact with the patient’s anatomy directly using their hands as well as manipulate untethered surgical tools; (2) high fidelity stable computations for contact detection, response and physical simulations; and (3) full-hand bi-manual haptic interactions with the virtual anatomy and untethered surgical tools. Our aim, in this present proposal, is to overcome these challenges and design, develop, and evaluate, for the first time, a Virtual Colorectal Surgical Trainer (VCoST) for the five open surgical tasks in the COSATS. To achieve our goal, a multidisciplinary research team has been assembled to achieve the following specific aims: (SA1) Develop a VCoST platform. Specifically, we will develop: (1) highly realistic simulation of the five open COSATS tasks within an immersive 3D high definition (HD) head mounted display (HMD) system; (2) physics-based simulations based on in vivo experimental studies; (3) novel haptic interface devices (with both tactile and force feedback) that allow realistic full-hand interactions with the virtual anatomy and untethered surgical tools; and (4) real time assessment and feedback. (SA2) Establish the validity of the VCoST as a training tool. We will conduct experiments on voluntarily enrolled subjects to establish face and construct validity of the VCoST. We hypothesize that the VCoST tasks, like the COSATS tasks, will be capable of distinguishing the skill levels of graduating general surgery and colorectal surgery residents.(SA3) Evaluate the usefulness of the VCoST as a training tool. We will perform learning, retention, and transfer-of-learning studies on the VCoST. We hypothesize that residents who trained with VCoST will demonstrate learning and transfer in the clinical environment, and will perform better than a control group.

虚拟结直肠手术培训师（VCOST）的开发和验证抽象的这是手术历史上的第一次，手术技术技能检查 - 结直肠由美国协会开发的技术技能的客观结构化评估（COSAT）结肠和直肠外科医生（ASCR） - 已在美国结肠和直肠董事会中引入外科医生（ABCR）检查，从2014年开始。Cosats需要精心设计，八个居民必须循环以执行五项开放手术任务的不同站点（直肠脱垂，骨盆出血，回肠袋肛门吻合术，演出吻合，手吻合），两个腹腔镜和结肠镜检查。预计计算机生成的虚拟现实（VR）基于具有视觉和触觉（触摸）反馈的模拟器可以提供集成的培训和评估结直肠居民攀登其“学习曲线”的环境，没有对实际患者的风险，标准化技能培训和证书的过程，并允许对绩效进行客观量化，而没有需要人类代理。而VR模拟技术正在开发用于结肠镜检查和腹腔镜手术程序，三个主要的技术障碍挫败了基于VR的发展模拟开放手术程序，例如Cosats中的手术程序：（1）完全沉浸式3D可视化允许外科医生使用手直接与患者的解剖结构进行互动以及操纵不束缚的手术工具；（2）高保真稳定的计算，用于接触检测，响应和物理模拟；（3）与虚拟解剖结构和不固定外科手术的全手手动触觉相互作用工具。在本提案中，我们的目标是克服这些挑战和设计，发展，并首次评估五个开放手术任务的虚拟大肠外科教练（VCOST）在cosats中。为了实现我们的目标，已经组建了一个多学科研究团队以实现以下特定目的：（SA1）开发一个VCOST平台。具体来说，我们将发展：（1）高度现实在沉浸式3D高清（HD）头安装显示内的五个开放式COSATS任务的模拟（HMD）系统；（2）基于体内实验研究的基于物理的模拟；（3）新颖的触觉界面设备（既有触觉反馈和力反馈），可与虚拟解剖结构进行全手相互作用和不束缚的手术工具；（4）实时评估和反馈。（SA2）确定 VCOST作为培训工具。我们将对自愿招募的受试者进行实验，以建立面部和构建Vcost的有效性。我们假设VCOST任务（例如Cosats）将有能力区分毕业的一般手术和有色手术居民的技能水平。（SA3）评估 VCOST作为培训工具的有用性。我们将执行学习，保留和学习的转移关于VCOST的研究。我们假设接受VCOST培训的居民将展示学习和在临床环境中转移，并且表现要比对照组更好。

项目成果

期刊论文数量（7）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Objective metrics for hand-sewn bowel anastomoses can differentiate novice from expert surgeons.

手工缝制肠吻合术的客观指标可以区分新手和专家外科医生。

DOI：
10.1007/s00464-022-09584-1
发表时间：
2023
期刊：
Surgical endoscopy
影响因子：
0
作者：
Sankaranarayanan,Ganesh;Parker,LisaM;Khan,Aimal;Dials,James;Demirel,Doga;Halic,Tansel;Crawford,Alyson;Kruger,Uwe;De,Suvranu;Fleshman,JamesW
通讯作者：
Fleshman,JamesW

Waveform-Dependent Electrosurgical Effects on Soft Hydrated Tissues.

对软水合组织的波形依赖性电外科效应。

DOI：
10.1115/1.4042898
发表时间：
2019
期刊：
Journal of biomechanical engineering
影响因子：
0
作者：
Karaki,Wafaa;Lopez,CarlosA;Rahul;Borca-Tasciuc,Diana-Andra;De,Suvranu
通讯作者：
De,Suvranu

Training on a virtual reality cricothyroidotomy simulator improves skills and transfers to a simulated procedure.

DOI：
10.1136/tsaco-2021-000826
发表时间：
2022
期刊：
Trauma surgery & acute care open
影响因子：
2
作者：
Sankaranarayanan G;Odlozil CA;Hasan SS;Shabbir R;Qi D;Turkseven M;De S;Funk G;Weddle RJ
通讯作者：
Weddle RJ

Development and Validation of Task-Specific Metrics for the Assessment of Linear Stapler-Based Small Bowel Anastomosis.