Safety Instruction and Competency Assessment for Laparoscopy

腹腔镜安全指导和能力评估

• 批准号: 9032997
• 负责人: JORG PETERS
• 金额: $ 20万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-03-10 至 2018-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9032997
• 关键词: Address; Advertising; Algorithms; Anatomy; Appendectomy; Awareness; Blinded; Cholecystectomy; Clinical; Code; Collection; Communication; Computer software; Computers; Congresses; Consensus; Critiques; Databases; Development; Devices; E-learning; Education; Educational Curriculum; Environment; Feedback; Funding; Gastric Bypass; Goals; Head; Hour; Institution; Instruction; Internet; Laparoscopic Surgical Procedures; Laparoscopy; Lead; Licensing; Litigation; Location; Measurement; Measures; Medical; Medical Education; Medical center; Modeling; Modification; Online Systems; Operative Surgical Procedures; Output; Pathology; Peer Review; Performance; Physics; Procedures; Published Comment; Publishing; Questionnaires; Randomized; Residencies; Safety; Specialist; Specificity; Speed; Stomach; Structure; Surgeon; Techniques; Technology; Testing; Time; Tissues; Training; Training Activity; Validation; Variant; Work; base; biliary tract; cohort; cost; dexterity; empowered; experience; high risk; improved; innovation; insight; portability; scaffold; simulation; spelling; symposium; technology/technique; tool; virtual reality

DESCRIPTION (provided by applicant): Significance Omission of steps, wrong sequencing and excessive force in laparoscopic surgery lead to unnecessary suffering and costly litigation. Due to rapidly advancing techniques, technology and work hour restrictions, only a fraction of the full spectrum of lap procedures and safety concerns can be addressed by current basic dexterity training or by 'see-one-do-one' in the OR. Computer-based training with force-feedback promises to help fill the gap. But commercial products focus on standard cases and do not allow surgeon-educators themselves to select and fine-tune anatomy, pathology and technique. Innovation The proposed authoring environment will broaden the range, deepen the specificity and speed up innovation in computer-based training by enabling surgeon-educators (a) to define their focus and scope via a structured list of surgical steps from which module components are automatically initialized; (b) to fine-tune crucial details that convey surgical expertise, techniqe and insight. This enables growing a rich collection of sharable training modules across a variety of surgical procedures. No similar approach currently exists. - Building on state-of-the-art solutions of tissue physics, GPU-computing and graphics challenges of interactive 3D surgery simulation with force-feedback, this proposal additionally breaks new ground for simulation technology by (a) automatically instantiating modules (instruction pages, VR-scenario, measurement) and (b) enabling surgeons to fine-tune scenarios. Approach (1) For each anatomic/pathological variant of appendectomy, cholecystectomy and gastric bypass, a lead surgeon will draft, and at least three surgeons will critique, a web-based step-by-step list of task and safety issues. In the rare case when no consensus is reached, competing lists and cases are generated. Heads of residency, chief surgeons and a dean for Simulation and Medical Education have signed up to lead the efforts at five institutions. (2) The output, a highly structured list of task and safety issues, enables software to automatically initialize a training module's instructional pages and VR-scenario. This raw module is fine-tuned by the lead author who also sets acceptable performance ranges by executing the VR-simulation. The resulting modules undergo a peer-review cycle. VR-simulation leverages a simulation engine and an extensive database of anatomy and surgical tools developed under R21 funding, published and demonstrated at conferences [35, 37, 34, 14, 57, 58, 79, 56, 44, 36, 76]. (3) The impact of each released module on safety awareness in the OR is measured by a separate small randomized, blinded study at two of the five participating medical centers. (4) The authoring environment and its results will be advertised at major medical conferences (AAMC, ACS CC, ACGME) and its structured code base will be disseminated on the web under the GNU LGP License to encourage broad sharing and enable modification and continued distributed development supported by the stakeholders.

描述（由申请人提供）：腹腔镜手术中的步骤，错误测序和过度的力量的显着性遗漏导致不必要的痛苦和昂贵的诉讼。由于迅速发展的技术，技术和工作时间限制，只能通过当前的基本灵活性培训或OR中的“ see-One-one-do-One”来解决全部膝盖程序和安全问题的一小部分。基于计算机的训练有望有助于填补空白。但是，商业产品专注于标准案例，不允许外科医生自己选择和微调解剖学，病理学和技术。 创新拟议的创作环境将扩大范围，加深特殊性和 通过使外科医生教育者（a）定义他们的重点，加快基于计算机培训的创新 并通过自动初始化模块组件的手术步骤的结构化列表； （b）微调至关重要的细节，以传达手术专业知识，技术和洞察力。这使得在各种外科手术过程中增加了丰富的可共享培训模块。目前没有类似的方法。 - 基于组织物理学的最新解决方案，通过力量反向进行互动3D手术模拟的互动3D手术模拟的挑战，该建议还通过（a）自动实例化模拟模块（教学页，VR-SCCENARIO，测量，测量）和（b）启动Scaune Sceelars sceachors sceacles broke broke new new基础。 阑尾切除术，胆囊切除术和胃的每种解剖/病理变体的方法（1） 旁路，主要外科医生将起草，至少三名外科医生将批评，这是一个基于网络的逐步列表 任务和安全问题。在罕见的情况下，当未达成共识时，会产生竞争的清单和案件。居住者，首席外科医生和一名用于模拟和医学教育的院长已签约，以领导五个机构的努力。 （2）输出，高度 任务和安全问题的结构化列表，使软件能够自动初始化培训模块的教学页面和VR-Scenario。该RAW模块由主要作者进行了微调，他还通过执行VR-Simulation来设置可接受的性能范围。结果模块经历了同行评审周期。 VR-Simulation利用了在R21资金下开发的解剖学和外科手术工具的大量模拟引擎，并在会议上发布和演示[35，34，34，14，57，57，58，79，79，79，56，44，44，36，76]。 （3）在五个参与医疗中心中的两个中，每个释放的模块对OR中的安全意识的影响是由单独的随机，盲目的研究来衡量的。 （4）将在主要医疗会议（AAMC，ACS CC，ACGME）及其结构化代码基础上进行广告宣传，并将根据GNU LGP许可在网络上传播，以鼓励广泛的共享和启用修改，并继续由利益相关者支持。