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

I-Corps：用于评估和训练基于力量的腹腔镜技能的新型手术模拟器

• 批准号: 1247508
• 负责人: Timothy Burg
• 金额: $ 5万
• 依托单位: Clemson University
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-01 至 2012-12-31
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=1247508&HistoricalAwards=false
• 关键词: Corps; Novel; Surgical; Simulator; Evaluating

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.

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长的工具，并通过监视器上转播的摄像机图像进行手术。由于它对患者具有可取的优势，医学生(住院医生)学习这种外科技术的需求很大。然而，获得熟练的腹腔镜术所需的技能是极其具有挑战性的，因为外科医生离手术地点很远。正因为如此，腹腔镜手术中的大多数手术错误都是由于对组织施加过大的力造成的。本项目的重点是一种新的方法，通过一种新型的手术模拟器来训练外科住院医师应用受控力量，以获得基于力(或触觉)的腹腔镜技能。根据先前研究的知觉任务分解，确定了三种手术任务，在这些任务中，施加精确和可控的力量对手术结果至关重要：抓取组织、探测组织和清扫组织。三个原型模拟器最初是作为概念验证而开发的，后来被集成到一个单独的“核心触觉技能”模拟器中。对有经验的外科医生和新手进行的初步研究表明，该模拟器在评估和训练用户的触觉技能方面是有效的。根据最近的一份报告，每年约有10万人死于医疗差错。其他研究表明，大多数手术错误是由于误用武力造成的。这里介绍的技术可以显著降低由于外科医生技能不足而导致的患者发病率和死亡率。手术模拟器还通过让新手具备一定的技能能力，有效地为手术室准备新手外科医生。结果，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。