R01EB025247: Development and Validation of a Virtual Laparoscopic Hiatal Hernia Simulator (VLaHHS)

R01EB025247：虚拟腹腔镜食管裂孔疝模拟器 (VLaHHS) 的开发和验证

基本信息

批准号：
10438480
负责人：
Ganesh Sankaranarayanan
金额：
$ 51.96万
依托单位：
UT SOUTHWESTERN MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-07-01 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10438480
关键词：
Abdomen Abdominal Cavity Academic Medical Centers Address Affect Algorithms Anatomy Animals Barrett Esophagus Cadaver Chest Custom Decision Making Defect Development Devices Effectiveness Elements Environment Esophageal Adenocarcinoma Esophagitis Esophagus Evaluation Face Fellowship Fundoplication Gastroesophageal reflux disease Graph Hernia Hiatal Hernia Human Inferior esophageal sphincter structure Intestinal Volvulus Ischemia Lead Learning Left Length Ligaments Link Malignant neoplasm of esophagus Mediastinum Methods Modeling Operative Surgical Procedures Organ Paraesophageal Patients Performance Population Positioning Attribute Procedures Process Property Psychological Transfer Public Health Quality of life Recurrence Reflux Research Resected Respiratory Diaphragm Rest Risk Slide Standardization Stomach Structure Surgeon Surgical Error Surgical incisions Techniques Texas Time Tissues Training Universities Validation base biomechanical model cognitive skill cognitive task design experimental study force feedback haptic interface haptics human subject improved in vivo minimally invasive models and simulation novel operation patient safety simulation software development task analysis tool validation studies virtual virtual reality simulator virtual surgery

项目摘要

Project Summary Gastroesophageal reflux disease (GERD) is prevalent in USA and affects about 20% of the population and leads to decreased quality of life. If untreated, GERD can lead to complications such as esophagitis, Barrett’s esophagus and esophageal adenocarcinoma. Hiatal hernia is a condition in which the contents of the abdominal cavity, mainly the stomach, herniate through the hole meant for esophagus in the diaphragm and into the chest cavity. A strong link has been established between the presence of hiatal hernias and GERD. Moreover, presence of hiatal hernia doubles the risk of esophageal cancer. 85% of the hiatal hernia cases are of Type I and 5- 15% of the cases are of paraesophageal Type II-IV hernias, which when left untreated, apart from inducing GERD, can also result in ischemia or volvulus of the herniated contents. Laparoscopic hiatal hernia surgery is a minimally invasive procedure performed with specialized tools through five small incisions on the abdomen. It is an advanced general surgery procedure that has a learning curve of about 50 cases to achieve a low recurrent rate. Currently training for this procedure is through limited fellowships and there exists no animal, cadaver or virtual reality simulator to train in this specific procedure. Virtual reality simulators provide a standardized training environment where, a procedure can be practiced repeatedly to gain proficiency. They can also automatically assess the performance without any subjective influence. To address the gap in training for laparascopic hiatal hernia surgery, we propose to develop the Virtual Laparoscopic Hiatal Hernia Simulator (VLaHHS) with realistic modeling techniques, capabilities to simulate types III hiatal hernia, custom bimanual force feedback (haptic) interface. The VLaHHS developed in this project will also be useful to train surgeons in anti-reflux surgeries to treat GERD. We propose three specific aims to achieve and prove the effectiveness of our simulator. In aim1 we will develop the simulator that uses tissue properties and real-time deformation to simulate the procedure. We will develop custom haptic device to provide force feedback. In aim 2, we will develop, simulation scenario and metrics, and integrate into VLaHHS. In aim 3, we will conduct validation studies to prove that training on VLaHHS will lead to improved performance. The research will eventually lead to fewer surgical errors and improvement to patient safety.

项目概要胃食管反流病 (GERD) 在美国很流行，影响约 20% 的人如果不治疗，胃食管反流病可能会导致并发症。例如食管炎、巴雷特食管和食管裂孔疝。腹腔内容物（主要是胃）通过腹腔疝出的情况横膈膜上的食道和胸腔之间有一个强有力的联系。确定存在食管裂孔疝和胃食管反流病。食管疝使食管癌的风险增加一倍，85% 的食管裂孔疝病例属于 I 型和 5- 型。 15% 的病例属于食管旁 II-IV 型疝气，如果不及时治疗，除了诱发胃食管反流病，还可导致腹腔镜下疝内容物缺血或扭转。食管裂孔疝手术是一种微创手术，使用专门的工具通过这是一种先进的普通外科手术，在腹部有五个小切口。大约50个案例的学习曲线，以实现低复发率目前正在为此进行培训。程序是通过有限的奖学金进行的，不存在任何动物、尸体或虚拟现实模拟器为这个特定的训练程序提供了一个标准化的虚拟现实模拟器。可以反复练习某个程序以达到熟练程度的培训环境。还可以自动评估性能，不受任何主观影响。由于腹腔镜食管裂孔疝手术培训存在差距，我们建议开发虚拟腹腔镜食管裂孔疝模拟器 (VLaHHS) 具有逼真的建模技术和功能模拟 III 型食管裂孔疝，定制双手力反馈（触觉）界面。该项目中开发的 VLaHHS 也将有助于培训外科医生进行抗反流手术我们提出了三个具体目标来实现并证明我们的有效性。在模拟器中，我们将开发使用组织特性和实时性的模拟器。我们将开发定制触觉设备来提供力。在目标 2 中，我们将开发模拟场景和指标，并将其集成到 VLaHHS 中。在目标 3 中，我们将进行验证研究，以证明 VLaHHS 培训将带来改进该研究最终将减少手术失误并改善手术效果。患者安全。