I-Corps: A Novel Surgical Simulator for Evaluating and Training Force-based Laparoscopic Skills

腹腔镜手术是一种微创手术技术，外科医生通过腹部的小切口插入长工具，并通过监视器上的摄像机图像进行手术。由于其对患者有利，医学生（住院医师）学习该手术技术的需求很大。然而，掌握熟练腹腔镜检查所需的技能是极具挑战性的，因为外科医生离手术部位“遥远”。因此，腹腔镜手术过程中的大多数手术错误是由于对组织施加过大的力引起的。这个项目的重点是一种新的方法，通过一种新的手术模拟器来训练外科住院医生应用基于力（或触觉）的腹腔镜技能。基于先前研究的感知任务分解，确定了三个手术任务，其中应用精确和可控的力对成功的手术结果至关重要：抓取组织，探查组织和清扫组织。三个原型模拟器最初是作为概念验证而开发的，后来集成到一个单一的“核心触觉技能”模拟器中。与经验丰富的外科医生和新手的初步研究已经证明了模拟器在评估和训练用户的触觉技能方面的有效性。根据最近的一份报告，每年大约有10万人死于医疗事故。其他研究表明，大多数手术错误是由于用力不当造成的。该技术可以显著降低因外科医生技术不足而导致的患者发病率和死亡率。手术模拟器也有效地为新手外科医生准备手术室，装备他们一定水平的技能能力。因此，昂贵的手术室培训时间被最小化，培训成本显著降低。如果可以减少手术室的训练时间，那么在第一阶段训练中使用的动物数量也会减少。除培训外，手术模拟器还可用于客观技能评估和认证。

Laparoscopic surgery is a minimally invasive surgical technique wherein surgeons insert long tools through small incisions made in the abdomen and perform surgery via camera images relayed on a monitor. Due to its desirable advantages to patients, there is an enormous demand for medical students (residents) to learn this surgical technique. However, acquiring the skills needed for proficient laparoscopy is extremely challenging because of the surgeon's "remoteness" to the surgical site. Due to this, most surgical errors during laparoscopic procedures are caused by the application of excessive forces on tissues. This project focuses on a new method to train surgery residents to apply controlled forces via a novel surgical simulator for force-based (or haptic) laparoscopic skills. Based on perceptual task decomposition from previous studies, three surgical tasks were identified where applying precise and controlled forces was crucial for successful surgical outcomes: grasping tissue, probing tissue, and sweeping tissue. Three prototypical simulators were initially developed as a proof-of-concept and were later integrated into a single "Core Haptic Skills" simulator. Initial studies with experienced surgeons and novices have demonstrated the efficacy of the simulator in both evaluating and training haptic skills of users. According to a recent report, approximately 100,000 people die every year as a result of medical errors. Other studies show that a majority of surgical errors are caused due to misapplication of force. The technology presented here could significantly reduce patient morbidity and mortality caused due deficiencies in surgeons' skill. Surgical simulators also efficiently prepare novice surgeons for the operating room by equipping them with a certain level of skill competence. As a result, expensive operating room training time is minimized and training costs are significantly reduced. If training time in the operating room can be reduced, then the number of animals used in the first phases of training is also reduced. Beyond training, surgical simulators could be used for objective skill assessment and certification.