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

虚拟腹腔镜食管裂孔疝模拟器 (VLaHHS) 的开发和验证

• 批准号: 10020977
• 负责人: Ganesh Sankaranarayanan
• 金额: $ 60.62万
• 依托单位: BAYLOR RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10020977
• 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

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.

项目摘要 胃食管反道疾病（GERD）在美国普遍存在，影响约20％ 人口并导致生活质量改善。如果未经治疗，GERD会导致并发症 例如食管炎，巴雷特的食管和食管腺癌。裂孔疝是一个 腹腔内容物（主要是摊位）的条件通过 孔可用于隔膜中的食道并进入胸腔。有一个牢固的联系 在裂孔疝和Gerd的存在之间建立。而且，裂隙的存在 疝气增加了食管癌的风险。 85％的裂孔性疝病为I型和5-- 15％的病例是par虫II型疝气，当未经治疗时，除了 诱导GERD，也可能导致椎间盘突出症的缺血或沃尔图斯。腹腔镜 裂孔性疝手术是一种通过专业工具执行的微创手术 腹部五个小切口。这是一种先进的常规手术程序，具有 学习曲线的大约50例，以达到较低的复发率。目前为此训练 程序是通过有限的研究金，没有动物，尸体或虚拟现实 模拟器在此特定过程中进行训练。虚拟现实模拟器提供标准化 训练环境，可以反复练习一种程序以提高熟练程度。他们 也可以在没有任何主观影响的情况下自动评估性能。解决 在腹腔主管裂口疝手术的培训中，我们建议开发虚拟 具有逼真的建模技术，能力 为了模拟III类型裂孔疝类型，定制的双人力反馈（触觉）界面。这 该项目中开发的Vlahhs也将对培训抗反应手术的外科医生有用 治疗gerd。我们提出了三个特定的目标，以实现和证明我们的有效性 模拟器。在AIM1中，我们将开发使用组织特性和实时的模拟器 变形以模拟过程。我们将开发自定义触觉设备以提供力 反馈。在AIM 2中，我们将开发，模拟场景和指标，并集成到Vlahhs中。 在AIM 3中，我们将进行验证研究，以证明对Vlahhs的培训将导致改进 表现。这项研究最终将导致较少的手术错误和改善 患者安全。