Development and Validation of a Virtual Electrosurgical Skill Trainer (VEST)

虚拟电外科技能训练器 (VEST) 的开发和验证

• 批准号: 8370225
• 负责人: CAROLINE GL CAO
• 金额: $ 66.73万
• 依托单位: RENSSELAER POLYTECHNIC INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8370225
• 关键词: Advisory Committees; Am 80; American; Auditory; Blood Vessels; Board Certification; Cholelithiasis; Communities; Competence; Complex; Computational algorithm; Computer Simulation; Computers; Controlled Environment; Cues; Data; Development; Devices; Diagnosis; Dissection; Education; Educational Curriculum; Educational process of instructing; Electrocoagulation; Electrodes; Electrosurgery; Ensure; Environment; Feedback; Frequencies; Goals; Healed; Healthcare Systems; Hemorrhage; Hemostatic function; Image; Incidence; Individual; Injury; Interdisciplinary Study; Intestines; Laparoscopic Cholecystectomy; Laparoscopic Surgical Procedures; Learning; Length of Stay; Measures; Mentors; Metric; Minimally Invasive Surgical Procedures; Modeling; Morbidity - disease rate; Motor Skills; Movement; Operating Rooms; Operative Surgical Procedures; Organ; Outcome; Patients; Perforation; Performance; Physics; Physiological; Procedures; Process; Recording of previous events; Regimen; Reporting; Research; Research Project Grants; Risk; Societies; Surgeon; Surgical complication; Surgical sutures; System; Techniques; Technology; Time; Tissues; Touch sensation; Training; Translating; Treatment Cost; Validation; Visual; base; bile duct; design; experience; eye hand coordination; gastrointestinal; haptics; healing; improved; in vivo; instrument; minimally invasive; multidisciplinary; novel; pressure; programs; prototype; research study; seal; skills; skills training; soft tissue; tool; two-dimensional; vaporization; virtual; virtual reality

DESCRIPTION (provided by applicant): "Electrosurgery" is now becoming universally accepted as the technique of choice in most minimally invasive surgical (MIS) procedures for achieving a variety of tissue effects ranging from dissection to hemostasis (control of bleeding) using high frequency electrical energy. However, there exists no standardized curriculum or training regimen outside the operating room (OR), for the surgical community to safely and effectively use the complex electrosurgical instruments. It is anticipated that a virtual reality (VR)-based trainer, with visual and haptic (touch) feedback, will be invaluable for electrosurgical skill training, allowing the trainees to attain competence in a controlled environment that does not expose actual patients to the bare brunt of their "learning curves"; customization based on individual needs; and real time feedback, mentoring and objective assessment without the need for a proctor. While a few VR-based trainers exist for laparoscopic psychomotor skill training (i.e., training for hand-eye coordination and motor skills necessary for tasks such as tool movement, cutting, suturing, etc), none exists specifically for electrosurgical procedures as major technological hurdles must be overcome, including (1) realistic physics-based modeling of the complex bio- physics of tissue cutting, hemostasis and tissue joining; (2) physical in vivo experiments to determine tissue parameters and support modeling and validation; and (3) novel realistic VR interfaces. The goal of this project is to overcome these technological barriers and design, develop and evaluate the first Virtual Electrosurgical Skill Trainer (VEST). To accomplish the goals of the project, a multidisciplinary team has been assembled to achieve the following Specific Aims: (SA1) Develop physics-based computational technology for modeling, in real time, the interaction of electrosurgical devices with soft tissue: Specifically, we will develop physics-based computational models of electrosurgical tissue cutting, joining and hemostasis based on in vivo studies. Novel computational algorithms will be developed to allow real time performance. (SA2) Design and develop a realistic VEST platform: We will integrate the computational models and experimental data generated in SA1 and develop the prototype of the VEST with training scenarios for (1) tissue dissection; (2) arc fulguration and (3) coaptive vessel closure. VEST will include real time feedback identifying errors; visual, auditory and haptic cues to guide the trainee; display of physiological consequence of surgical complications; effects of alternate surgical procedures and devices as well as automatic real time assessment of surgical skill. (SA3) Establish the validity of the VEST as a training tool. We will conduct experiments at the Skills Lab at BIDMC to ensure that the tasks in VEST reflect the technical skills in electrosurgery, and the scores measured in VEST are the appropriate performance metrics in assessing training. (SA4) Evaluate the usefulness of the VEST as a training tool. By dividing subjects into practice and non-practice groups we will study whether training on the VEST transfers positively to the OR. PUBLIC HEALTH RELEVANCE: The goal of this research is to develop and validate a comprehensive computer-based technology that will allow surgical trainees to practice their surgical skills on computer-based models. Surgical procedures and techniques, learnt and perfected in this risk-free manner before application to patients, will translate to fewer operatin room errors, reduced patient morbidity and improved patient outcomes resulting in faster healing, shorter hospital stay and reduced post surgical complications and treatment costs.

描述（由申请人提供）：在大多数微创手术（MIS）程序中，“电外科”现在已被普遍接受为选择的技术，用于实现从剖腹产到止血到止血的各种组织效应（使用高频电能）。但是，在手术室外没有标准化的课程或培训方案，可以安全有效地使用复杂的电外科仪器。预计具有视觉和触觉（触摸）反馈的虚拟现实（VR）教练对于电外科手术是无价的 技能培训，使学员能够在受控环境中获得能力，而这些环境不会使实际患者首当其冲的“学习曲线”；根据个人需求进行定制；而无需监管者而无需实时反馈，指导和客观评估。 While a few VR-based trainers exist for laparoscopic psychomotor skill tr​​aining (i.e., training for hand-eye coordination and motor skills necessary for tasks such as tool movement, cutting, suturing, etc), none exists specifically for electrosurgical procedures as major technological hurdles must be overcome, including (1) realistic physics-based modeling of the complex bio- physics of tissue cutting, hemostasis and tissue joining; （2）体内实验确定组织参数并支持建模和验证； （3）新颖的现实VR接口。该项目的目的是克服这些技术障碍和设计，开发和评估第一个虚拟电外科技能教练（背心）。为了实现该项目的目标，已经组装了一个多学科团队，以实现以下特定目标：（SA1）开发基于物理的计算技术，用于实时建模，是电真外科设备与软组织的相互作用：具体而言，我们将开发基于电外科组织切割，连接，结合和血液基础的基于物理学的计算模型。将开发新颖的计算算法以允许实时性能。 （SA2）设计和开发一个逼真的背心平台：我们将整合SA1中生成的计算模型和实验数据，并使用（1）组织解剖的训练场景开发背心的原型； （2）弧形和（3）Coaptive容器闭合。背心将包括实时反馈确定错误；视觉，听觉和触觉提示指导学员；表现出手术并发症的生理后果；替代手术程序和设备的影响以及手术技能的自动实时评估。 （SA3）确定背心作为培训工具的有效性。我们将在BIDMC的技能实验室进行实验，以确保背心的任务反映了电外科手术的技术技能，并且在背心中测得的分数是评估培训的适当性能指标。 （SA4）评估背心作为培训工具的实用性。通过将受试者分为实践和非实践组，我们将研究对背心转移的培训是否积极地转移给OR。 公共卫生相关性：这项研究的目的是开发和验证一项全面的基于计算机的技术，该技术将使手术学员能够在基于计算机的模型上练习其外科手术技能。在适用于患者之前，以这种无风险方式学习和完善的手术程序和技术将转化为较少的操作室错误，降低患者的发病率并改善患者结局，从而更快地康复，较短的医院住院和降低手术后的并发症后并发症和治疗成本。