Surgical Simulator for Improving Skill Proficiency and Resilience

摘要 不断发展的微创技术提高了 成功和安全的外科手术的要求。在这方面， 在过去的二十年里，开发了用于培训外科医生的医疗模拟器。然而，大部分 工作集中在医学生和外科住院医生谁是目前正式 培训项目。有一个公认的需要，以确保执业外科医生保持他们的水平 通过不断评估，同时学习更新的程序， 手术室里的设备本提案的目的是开发、评估 并验证模拟技术，以训练，再训练和提高性能， 执业外科医生的弹性。我们计划开发开源软件模板， 创建高保真模拟，包括罕见和不良手术事件， 执业外科医生保持并提高他们的外科技能。 在这个项目中，我们提出了扩展交互式医疗模拟工具包（iMSTK）-一个 开源医疗模拟平台，已被用于原型虚拟教练， 腹腔镜手术、正颌手术等临床应用。我们将开发 用于罕见和不良事件模拟的软件模板，包括出血（由于血管 穿刺和意外切割）、热损伤、解剖变异和生理 建模在大多数情况下，生理模型是单独开发的，没有协调 交互式手术模拟限制了他们的能力。在这个项目中，我们将整合 Kitware的开源脉冲生理引擎与iMSTK构建闭环生理 处理局部生理变化和全局、系统生理反应的模型。 该项目是Kitware Inc.以及布法罗大学 医学和生物医学科学（UB）与最终用户咨询小组（EAG）， 儿童国家医学中心（CNMC）和贝勒大学医学中心（BUMC）。的 各研究所在模拟技术开发项目方面有着长期的合作记录。我们 将通过构建虚拟手术模拟器来演示新的软件模板， 胆囊切除术与胆管损伤和其他并发症，可发生在这种类型的 手术最终用户咨询小组将定期与技术小组举行会议， 提供技术发展的反馈。我们将进行面子、内容、建设 有效性测试和学习评估，以验证模拟器。

Abstract Minimally invasive techniques that are constantly evolving have increased the skill requirements for successful and safe surgical procedures. There has been an extensive effort in the last two decades to develop medical simulators for training surgeons. However, much of the work has focused on medical students and surgical residents who are currently in formal training programs. There is a recognized need to ensure practicing surgeons maintain their level of skills through continuous evaluation while simultaneously learning newer procedures or equipment that get adopted into the OR. The objective of this proposal is to develop, evaluate and validate simulation technologies to train, retrain and advance the performance and resiliency of practicing surgeons. We plan to develop open source software templates for rapid creation of high-fidelity simulations that include rare and adverse surgical events to enable practicing surgeons maintain and enhance their surgical skill. In this project, we propose extending Interactive Medical Simulation Toolkit (iMSTK)-an open source medical simulation platform, that has been used to prototype virtual trainers for laparoscopic surgery, orthognathic surgery and other clinical applications. We will develop software templates for rare and adverse event simulation, including hemorrhage (due to vessel puncture and unintentional cutting), thermal injury, anatomical variation, and physiological modeling. In most cases, physiological models are developed separately without coordination with interactive surgical simulation limiting their capability. In this project, we will integrate Kitware’s open source Pulse Physiological Engine with iMSTK to build a closed-loop physiology model that handles local physiological changes and global, systemic physiological responses. This project is a collaboration between Kitware Inc. and the University at Buffalo School of Medicine and Biomedical Sciences (UB) with an End-User Advisory Group (EAG) from Children National Medical Center (CNMC) and Baylor University Medical Center (BUMC). The institutes have a long record of collaboration in simulation technology development projects. We will demonstrate the new software templates by building a virtual surgical simulator for cholecystectomy with bile-duct injury and other complications that can occur in this type of surgery. The End-User Advisory Group will meet with the technical team on regular basis to provide feedback on the technical development. We will conduct face, content, and construct validity test and learning assessment to validate the simulator.