Development and validation of a Virtual Colorectal Surgical Trainer (VCoST)

虚拟结直肠手术训练器 (VCoST) 的开发和验证

• 批准号: 10470083
• 负责人: Suvranu De
• 金额: $ 66.44万
• 依托单位: RENSSELAER POLYTECHNIC INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-25 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10470083
• 关键词: 3-Dimensional; American; Anastomosis - action; Anatomy; Anus; Certification; Clinical; Cognitive; Colon and Rectal Surgeon; Colonoscopy; Colorectal; Colorectal Surgery; Computer Models; Computers; Control Groups; Credentialing; Decision Making; Detection; Development; Devices; Endoscopy; Enrollment; Environment; Evaluation; Excision; Face; Feedback; Goals; Hand; Healthcare Systems; Hemorrhage; Human; Ileal Reservoirs; Immersion; Interdisciplinary Study; Laparoscopic Surgical Procedures; Learning; Length of Stay; Manuals; Measures; Modeling; Morbidity - disease rate; Operating Rooms; Operative Surgical Procedures; Oral; Oral Examination; Patient-Focused Outcomes; Patients; Pelvis; Performance; Physics; Procedures; Process; Psychological Transfer; Recording of previous events; Rectal Prolapse; Research; Research Project Grants; Resolution; Risk; Sigmoid colon; Societies; Standardization; Structure; Surgeon; System; Tactile; Technical Expertise; Technology; Testing; Time; Touch sensation; Training; Translating; Treatment Cost; Validation; Visual; apprenticeship; base; computer generated; design; experimental study; force feedback; haptic feedback; haptic interface; haptics; head mounted display; healing; human old age (65+); human tissue; improved; in vivo; mortality; novel; operation; response; simulation; skills; skills training; success; three-dimensional visualization; tool; transfer learning; virtual; virtual reality; virtual reality environment; virtual reality simulation; virtual reality simulator

Development and validation of a Virtual Colorectal Surgical Trainer (VCoST) Abstract For the first time in the history of surgery, a hands-on surgical technical skills examination – the Colorectal Objective Structured Assessment of Technical Skills (COSATS), developed by the American Society of Colon and Rectal Surgeons (ASCRS) – has been introduced in the American Board of Colon and Rectal Surgeons (ABCRS) examination, starting in 2014. The COSATS requires an elaborate setup with eight different stations through which residents must circulate to perform five open surgical tasks (rectal prolapse, pelvic bleeding, ileal pouch anal anastomosis, coloanal anastomosis, handsewn anastomosis), two laparoscopic and a colonoscopic task. It is anticipated that a computer generated virtual reality (VR)-based simulator with both visual and haptic (touch) feedback could provide an integrated training and evaluation environment for colorectal residents to climb their "learning curves" without risk to actual patients, standardize the process of skill training and credentialing and allow objective quantification of performance, without the need for human proctors. While VR simulation technology is being developed for colonoscopy and laparoscopic surgical procedures, three major technical hurdles have thwarted the development of VR-based simulation of open surgical procedures, such as the ones in COSATS: (1) fully immersive 3D visualization to allow surgeons to interact with the patient’s anatomy directly using their hands as well as manipulate untethered surgical tools; (2) high fidelity stable computations for contact detection, response and physical simulations; and (3) full-hand bi-manual haptic interactions with the virtual anatomy and untethered surgical tools. Our aim, in this present proposal, is to overcome these challenges and design, develop, and evaluate, for the first time, a Virtual Colorectal Surgical Trainer (VCoST) for the five open surgical tasks in the COSATS. To achieve our goal, a multidisciplinary research team has been assembled to achieve the following specific aims: (SA1) Develop a VCoST platform. Specifically, we will develop: (1) highly realistic simulation of the five open COSATS tasks within an immersive 3D high definition (HD) head mounted display (HMD) system; (2) physics-based simulations based on in vivo experimental studies; (3) novel haptic interface devices (with both tactile and force feedback) that allow realistic full-hand interactions with the virtual anatomy and untethered surgical tools; and (4) real time assessment and feedback. (SA2) Establish the validity of the VCoST as a training tool. We will conduct experiments on voluntarily enrolled subjects to establish face and construct validity of the VCoST. We hypothesize that the VCoST tasks, like the COSATS tasks, will be capable of distinguishing the skill levels of graduating general surgery and colorectal surgery residents.(SA3) Evaluate the usefulness of the VCoST as a training tool. We will perform learning, retention, and transfer-of-learning studies on the VCoST. We hypothesize that residents who trained with VCoST will demonstrate learning and transfer in the clinical environment, and will perform better than a control group.

虚拟结直肠手术训练器的开发与验证 摘要 在外科史上第一次，动手术的外科技术技能考试-结直肠 技术技能客观结构化评估（COSATS），由美国社会开发的， 结肠和直肠外科医生（ASCRS）-已被引入美国结肠和直肠委员会 外科医生考试（ABCRS），2014年开始。COSATS需要一个精心设计的设置， 住院医生必须经过不同的站以执行五种开放手术任务（直肠脱垂， 盆腔出血、回肠贮袋肛管吻合术、结肠肛管吻合术、手工缝合吻合术），2例 腹腔镜和结肠镜检查任务。预计基于计算机生成的虚拟现实（VR） 具有视觉和触觉（触摸）反馈的模拟器可以提供集成的训练和评估 环境结直肠居民攀登他们的“学习曲线”没有风险的实际病人，标准化 技能培训和资格认证的过程，并允许客观量化的表现，而不 需要人类监督者。虽然VR模拟技术正在开发用于结肠镜检查， 腹腔镜手术，三大技术障碍阻碍了基于VR的发展 开放式外科手术的模拟，例如COSATS中的手术：（1）完全沉浸式3D可视化 允许外科医生直接用手与患者的解剖结构互动， （2）用于接触检测、响应和物理特性的高保真稳定计算 模拟;和（3）与虚拟解剖结构和无约束手术的全手双手触觉交互 工具.在本提案中，我们的目标是克服这些挑战，设计、开发和 首次评估虚拟结直肠手术培训师（VCoST）的五项开放手术任务 在COSATS。为了实现我们的目标，一个多学科的研究小组已经组装，以实现 （SA 1）开发VCoST平台。具体而言，我们将开发：（1）高度现实 在沉浸式3D高清（HD）头戴式显示器内模拟五个开放COSATS任务 (HMD)系统;（2）基于体内实验研究的基于物理的模拟;（3）新型触觉接口 允许与虚拟解剖结构进行真实的全手交互的设备（具有触觉和力反馈） 和不受约束的手术工具;和（4）真实的时间评估和反馈。(SA2)建立有效的 VCoST作为培训工具。我们将在自愿参加的受试者中进行实验，以建立面子， VCoST的结构效度。我们假设VCoST任务，如COSATS任务，将能够 区分普通外科和结直肠外科毕业生的技能水平。(SA3)评价 VCoST作为培训工具的实用性。我们将进行学习、保留和学习转移 关于VCoST的研究我们假设，接受VCoST培训的住院医生将展示学习和 在临床环境中转移，并将比对照组表现更好。

项目成果

Waveform-Dependent Electrosurgical Effects on Soft Hydrated Tissues.

对软水合组织的波形依赖性电外科效应。

• DOI: 10.1115/1.4042898
• 发表时间: 2019
• 期刊: Journal of biomechanical engineering
• 作者: Karaki,Wafaa;Lopez,CarlosA;Rahul;Borca-Tasciuc,Diana-Andra;De,Suvranu
• 通讯作者: De,Suvranu

Objective metrics for hand-sewn bowel anastomoses can differentiate novice from expert surgeons.

手工缝制肠吻合术的客观指标可以区分新手和专家外科医生。

• DOI: 10.1007/s00464-022-09584-1
• 发表时间: 2023
• 期刊: Surgical endoscopy
• 作者: Sankaranarayanan,Ganesh;Parker,LisaM;Khan,Aimal;Dials,James;Demirel,Doga;Halic,Tansel;Crawford,Alyson;Kruger,Uwe;De,Suvranu;Fleshman,JamesW
• 通讯作者: Fleshman,JamesW

Development and Validation of Task-Specific Metrics for the Assessment of Linear Stapler-Based Small Bowel Anastomosis.

• DOI: 10.1097/xcs.0000000000000389
• 发表时间: 2022-12-01
• 期刊: Journal of the American College of Surgeons
• 影响因子: 5.2

Training on a virtual reality cricothyroidotomy simulator improves skills and transfers to a simulated procedure.

• DOI: 10.1136/tsaco-2021-000826
• 发表时间: 2022
• 期刊: Trauma surgery & acute care open
• 影响因子: 2
• 作者: Sankaranarayanan G;Odlozil CA;Hasan SS;Shabbir R;Qi D;Turkseven M;De S;Funk G;Weddle RJ
• 通讯作者: Weddle RJ

Minimally Invasive Oncologic Surgery, Part I.

微创肿瘤手术，第一部分。

• DOI: 10.1016/j.soc.2018.08.004
• 发表时间: 2019
• 期刊: Surgical oncology clinics of North America
• 影响因子: 1.9
• 作者: Conrad,Claudius;FleshmanJr,JamesW
• 通讯作者: FleshmanJr,JamesW