Developing Physics-Based Virtual Simulation Technology for Natural Orifice Transl

开发基于物理的自然孔口传输虚拟仿真技术

基本信息

批准号：
8665320
负责人：
CAROLINE GL CAO
金额：
$ 64.77万
依托单位：
RENSSELAER POLYTECHNIC INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-05-06 至 2016-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8665320
关键词：
Abdomen Adhesions Air Anatomic Models Animal Model Animals Anus Appendectomy Biomechanics Body Surface Body cavities Carbon Dioxide Cicatrix Clinical Colon Computer Simulation Computers Cosmetics Data Data Set Dental Development Devices Effectiveness Endoscopes Engineering Ensure Environment Esophagus Excision Extravasation Family suidae Feedback Funding Gases Gastroenterology Gastrointestinal Endoscopy Gastrointestinal tract structure Goals Greater sac of peritoneum Gynecologic Surgical Procedures Healed Hemoperitoneum Hernia Hour Human Image Infection Infection prevention Information Sciences Information Technology Insufflation Intestines Intra-abdominal Laparoscopic Surgical Procedures Lead Length of Stay Medical Mentors Modeling Morbidity - disease rate National Institute of Biomedical Imaging and Bioengineering Operating Rooms Operative Surgical Procedures Oral cavity Organ Organ Model Outcome Pain Patients Physics Physiological Pneumoperitoneum Postoperative Pain Postoperative Period Procedures Process Pump Puncture procedure Recovery Rectum Regimen Research Research Activity Research Project Grants Resolution Resources Risk Simulate Site Space Perception Stomach Stress Surgeon Surgical complication Surgical incisions System Techniques Technology Testing Time Tissues Touch sensation Training Translating Treatment Cost United States United States National Institutes of Health Vagina Validation Viscera Visible Human Project Visual Work Wound Infection base body cavity clinical practice experience flexibility gastrointestinal gastrotomy haptics healing improved instrumentation minimally invasive multidisciplinary new technology novel operation pressure prototype research study simulation soft tissue tool virtual virtual reality

项目摘要

DESCRIPTION (provided by applicant): Developing Physics-Based Virtual Simulation Technology for Natural Orifice Translumenal Endoscopic Surgery (NOTES) NOTES is an emerging revolutionary surgical paradigm, being viewed as a natural successor of laparoscopic surgery, where internal organs are accessed by perforating the viscera (stomach, colon or vagina) using a flexible endoscope inserted through natural orifices such as the mouth, anus or vagina; without making any incisions on the surface of the body. Such "scarless" procedures would not only lead to better cosmetic results but also enhance the prospects of decreased wound infections and incisional hernia, as well as operative stress, postoperative immobility and pain. However, animal studies have shown serious interoperative difficulties as well as post operative complications. Hence, the current enthusiasm regarding NOTES should not overtake a cautioned approach to the implementation of this new technique. Before NOTES can be safely introduced to humans in the United States several fundamental barriers to its development must be overcome including (1) discovering optimal techniques for accessing the intra-abdominal organs; (2) ensuring that the pressure inside the abdomen does not rise to dangerous levels or there is no leakage into the GI tract when gas (air or CO2) is pumped into the body cavity (this is known as pneumoperitoneum and is achieved through a process known as insufflation) through the endoscope to increase work volume; (3) maintaining spatial orientation inside the body cavity; (4) achieving near perfect closure of the puncture site in the gastric wall (gastrotomy closure); (5) prevention of infection; (6) control of intra-peritoneal hemorrhage; (7) developing novel instrumentation and (8) novel training regimens. The current paradigm is based on testing porcine models which is time consuming, resource intensive and severely delimits the number of possible alternatives that can be tested. To vastly accelerate the development of NOTES procedures and devices, we propose to develop the first virtual reality (VR)-based NOTES simulator with both visual and haptic (touch) feedback. While VR-based simulators exist for both laparoscopic surgery and gastrointestinal endoscopy, none exists for NOTES. Existing technology is inadequate for NOTES simulation and major technological hurdles - not encountered in GI endoscopy or laparoscopic surgery - must be overcome. The most significant of these hurdles include (1) realistic modeling of multilayered hollow organs (e.g., esophagus, stomach, intestines, rectum and vagina) based on physical experiments; (2) simulation of the interaction of flexible surgical tools with soft tissues; (3) physics-based techniques of ensuring the effectiveness of pneumoperitoneum and the integrity of gastrotomy closure and (4) developing realistic interfaces. The aim of the present proposal is to overcome these preliminary challenges and develop the first VR-NOTES simulator which is firmly based on physical experiments and surgical experience and is responsive to physiological consequence of surgical complications. The simulator must undergo extensive validation before it can be used in a clinical setting. A multidisciplinary team with collective expertise in physics-based medical simulation, biomechanical organ modeling, human factors engineering, interventional gastroenterology, laparoscopic and gynecologic surgery has been assembled to achieve the following specific aims in a 4-year R01 research project: SA1) To combine the latest 3D anatomical models with physics-based tissue deformation models to simulate the interaction of flexible surgical tools with detailed deformable organ models that occur in NOTES procedures; SA2) To integrate the computational models and experimental data generated in SA1 and develop the prototype of a virtual NOTES appendectomy (appendix removal) simulator which incorporates physiological consequence of surgical complications and allows comparison of alternate surgical procedures and devices; and SA3) To establish the validity of the computational models and the VR-NOTES simulator developed in SA2.

描述（由申请人提供）：开发基于物理的虚拟模拟技术，用于自然孔易感内窥镜手术（注释）注释是一种新兴的革命性手术范式，被视为腹腔镜手术的自然继任者，在该手术中，内部器官可以通过锻炼（胃，colon或colon）的嘴巴（胃，colon或阴道）的范围来访问内部器官，从而获得内部器官的内部器官。阴道不在身体表面上任何切口。这种“无疤痕”程序不仅会带来更好的美容结果，而且还可以增强伤口感染和切开的疝气以及手术压力，术后不动和疼痛的前景。然而，动物研究表明了严重的互操作困难以及手术后并发症。因此，目前对笔记的热情不应超越实施这项新技术的谨慎方法。在美国可以安全地将笔记介绍给人类之前，必须克服其发展的几个基本障碍，包括（1）发现进入腹内器官的最佳技术；（2）确保腹部内部的压力不会升高到危险水平，或者当气体（空气或二氧化碳）被泵入体腔中时，胃道没有泄漏到胃道（这被称为肺炎的肺炎，并且通过被称为不足的过程）通过内窥镜增加工作量来增加工作量；（3）在体腔内保持空间方向；（4）在胃壁（胃切开术）中实现几乎完美的穿刺部位的完美闭合；（5）预防感染；（6）控制腹膜内出血；（7）开发新颖的仪器和（8）新型训练方案。当前的范式基于测试猪模型，该模型耗时，资源密集并且严重划定了可以测试的可能替代方案的数量。为了极大地加速音符程序和设备的开发，我们建议使用视觉和触觉（触摸）反馈来开发第一个基于虚拟现实（VR）的笔记模拟器。虽然基于VR的模拟器存在用于腹腔镜手术和胃肠道内窥镜检查，但没有任何音符。必须克服现有技术的仿真模拟和重大技术障碍 - 必须克服GI内窥镜或腹腔镜手术的重大技术障碍。这些障碍中最重要的障碍包括（1）基于物理实验的多层空心器官（例如食管，胃，肠，直肠和阴道）的现实建模；（2）模拟柔性手术工具与软组织的相互作用；（3）基于物理学的技术，可确保气动性的有效性以及胃切开术的完整性和（4）开发逼真的界面。本提案的目的是克服这些初步挑战，并开发出第一个VR音符模拟器，该模拟器牢固地基于物理实验和手术经验，并且对手术并发症的生理后果有反应。模拟器必须进行广泛的验证，然后才能在临床环境中使用。一支具有基于物理的医学模拟，生物力学器官建模，人力因素工程，介入性胃肠道，腹腔镜和妇科手术方面具有集体专业知识的多学科团队，以在4年R01研究项目中实现以下特定目标，以结合最新的3D Anatom Modelition与Thratibilation Interation Tearmination Interation Chomptoriation Interiagence Interization Temberiation Tembiential In在注释程序中发生的详细可变形器官模型； SA2）整合了SA1中生成的计算模型和实验数据，并开发了虚拟音符的阑尾切除术（阑尾去除）模拟器的原型，该模拟器结合了手术并发症的生理后果，并允许比较替代手术程序和设备的替代手术过程和设备；和SA3）建立计算模型的有效性和在SA2中开发的VR音符模拟器。

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）

Monte carlo based simulation for evaluating optode fiber placement in prefrontal cortex imaging of motor skills during surgical training.

基于蒙特卡罗的模拟，用于评估手术训练期间运动技能前额皮质成像中的光极纤维放置。

DOI：
发表时间：
2014
期刊：
Studies in health technology and informatics
影响因子：
0
作者：
Nemani,Arun;Intes,Xavier;De,Suvranu
通讯作者：
De,Suvranu

Natural orifice translumenal endoscopic surgery (NOTES): emerging trends and specifications for a virtual simulator.

自然孔腔内窥镜手术（NOTES）：虚拟模拟器的新兴趋势和规范。

DOI：
10.1007/s00464-015-4182-1
发表时间：
2016
期刊：
Surgical endoscopy
影响因子：
0
作者：
Schwaitzberg,StevenD;Dorozhkin,Denis;Sankaranarayanan,Ganesh;Matthes,Kai;Jones,DanielB;De,Suvranu
通讯作者：
De,Suvranu

Development of a Virtual Reality Simulator for Natural Orifice Translumenal Endoscopic Surgery (NOTES) Cholecystectomy Procedure.

开发用于自然孔腔内窥镜手术 (NOTES) 胆囊切除术的虚拟现实模拟器。

DOI：
发表时间：
2014
期刊：
Studies in health technology and informatics
影响因子：
0
作者：
Ahn,Woojin;Dargar,Saurabh;Halic,Tansel;Lee,Jason;Li,Baichun;Pan,Junjun;Sankaranarayanan,Ganesh;Roberts,Kurt;De,Suvranu
通讯作者：
De,Suvranu

A prospective, randomized trial of esophageal submucosal tunnel closure with a stent versus no closure to secure a transesophageal natural orifice transluminal endoscopic surgery access site.

一项前瞻性、随机试验，比较用支架封闭食管粘膜下隧道与不封闭食管，以确保经食管自然孔道经腔内窥镜手术进入部位。

DOI：
10.1016/j.gie.2010.11.025
发表时间：
2011
期刊：
Gastrointestinal endoscopy
影响因子：
7.7
作者：
Turner,BrianG;Kim,Min-Chan;Gee,DeniseW;Dursun,Abdulmetin;Mino-Kenudson,Mari;Huang,EdwardS;Sylla,Patricia;Rattner,DavidW;Brugge,WilliamR
通讯作者：
Brugge,WilliamR

Haptic Communication in Collaborative Virtual Environments.

协作虚拟环境中的触觉通信。