A mixed-reality surgical trainer with comprehensive sensing for fetal laser minimally invasive surgery.
A mixed-reality surgical trainer with comprehensive sensing for fetal laser minimally invasive surgery.
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DOI：
10.1007/s11548-018-1822-7
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发表时间：
2018-12
影响因子：
3
通讯作者：
Vander Poorten E
中科院分区：
文献类型：
--
作者：
Javaux A;Bouget D;Gruijthuijsen C;Stoyanov D;Vercauteren T;Ourselin S;Deprest J;Denis K;Vander Poorten E
较小的切口和减少的手术创伤使得微创手术（MIS）越来越受欢迎，尽管需要长时间的培训来掌握器械操作限制。虽然过去已经开发了许多培训系统，但其中很少涉及胎儿手术，更具体地说是双胞胎输血综合征（TTTS）的治疗。为了解决这种缺乏培训资源的问题，本文提出了一种新型的混合现实手术训练器，配备了全面的TTTS程序传感。拟议的教练机结合了框教练机技术和虚拟现实系统的好处。介绍了人脸和内容验证研究，并通过一个用例强调了嵌入式传感器的好处。通过要求来自胎儿MIS领域的外科医生在训练器上完成特定任务来评估开发的设置的面和内容有效性。一个小的用例调查了训练传感器是否能够区分简单和困难的场景。教练被认为是足够现实的，其提出的任务与练习所需的运动技能有关。用例证明，训练器的运动和力感知能力能够分析手术技能。胎儿激光手术的培训师是由一个专门的中心在胎儿医学的外科医生验证。在其他中心进行进一步的类似调查是有意义的，以及质量改进，这将增加培训师的难度。综合感知似乎能够客观地评估技能。
Smaller incisions and reduced surgical trauma made minimally invasive surgery (MIS) grow in popularity even though long training is required to master the instrument manipulation constraints. While numerous training systems have been developed in the past, very few of them tackled fetal surgery and more specifically the treatment of twin-twin transfusion syndrome (TTTS). To address this lack of training resources, this paper presents a novel mixed-reality surgical trainer equipped with comprehensive sensing for TTTS procedures. The proposed trainer combines the benefits of box trainer technology and virtual reality systems. Face and content validation studies are presented and a use-case highlights the benefits of having embedded sensors. Face and content validity of the developed setup was assessed by asking surgeons from the field of fetal MIS to accomplish specific tasks on the trainer. A small use-case investigates whether the trainer sensors are able to distinguish between an easy and difficult scenario. The trainer was deemed sufficiently realistic and its proposed tasks relevant for practicing the required motor skills. The use-case demonstrated that the motion and force sensing capabilities of the trainer were able to analyze surgical skill. The developed trainer for fetal laser surgery was validated by surgeons from a specialized center in fetal medicine. Further similar investigations in other centers are of interest, as well as quality improvements which will allow to increase the difficulty of the trainer. The comprehensive sensing appeared to be capable of objectively assessing skill.
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