Development and Validation of a Virtual Electrosurgical Skill Trainer (VEST)

虚拟电外科技能训练器 (VEST) 的开发和验证

• 批准号: 8921197
• 负责人: CAROLINE GL CAO
• 金额: $ 62.35万
• 依托单位: RENSSELAER POLYTECHNIC INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8921197
• 关键词: Advisory Committees; Am 80; American; Auditory; Blood Vessels; Board Certification; Cholelithiasis; Communities; Competence; Complex; Computational algorithm; Computer Simulation; Computers; Controlled Environment; Cues; Data; Development; Devices; Diagnosis; Dissection; Education; Educational Curriculum; Educational process of instructing; Electrocoagulation; Electrodes; Electrosurgery; Ensure; Environment; Feedback; Frequencies; Goals; Healed; Healthcare Systems; Hemorrhage; Hemostatic function; Image; Incidence; Individual; Injury; Interdisciplinary Study; Intestines; Laparoscopic Cholecystectomy; Laparoscopic Surgical Procedures; Learning; Length of Stay; Measures; Mentors; Minimally Invasive Surgical Procedures; Modeling; Morbidity - disease rate; Motor Skills; Movement; Operating Rooms; Operative Surgical Procedures; Organ; Outcome; Patients; Perforation; Performance; Physics; Physiological; Procedures; Process; Recording of previous events; Regimen; Reporting; Research; Research Project Grants; Risk; Societies; Surgeon; Surgical complication; Surgical sutures; System; Techniques; Technology; Time; Tissues; Touch sensation; Training; Translating; Treatment Cost; Validation; Visual; base; bile duct; design; experience; eye hand coordination; gastrointestinal; haptics; healing; improved; in vivo; instrument; minimally invasive; multidisciplinary; novel; pressure; programs; prototype; research study; seal; skills; skills training; soft tissue; tool; two-dimensional; vaporization; virtual; virtual reality

DESCRIPTION (provided by applicant): "Electrosurgery" is now becoming universally accepted as the technique of choice in most minimally invasive surgical (MIS) procedures for achieving a variety of tissue effects ranging from dissection to hemostasis (control of bleeding) using high frequency electrical energy. However, there exists no standardized curriculum or training regimen outside the operating room (OR), for the surgical community to safely and effectively use the complex electrosurgical instruments. It is anticipated that a virtual reality (VR)-based trainer, with visual and haptic (touch) feedback, will be invaluable for electrosurgical skill training, allowing the trainees to attain competence in a controlled environment that does not expose actual patients to the bare brunt of their "learning curves"; customization based on individual needs; and real time feedback, mentoring and objective assessment without the need for a proctor. While a few VR-based trainers exist for laparoscopic psychomotor skill training (i.e., training for hand-eye coordination and motor skills necessary for tasks such as tool movement, cutting, suturing, etc), none exists specifically for electrosurgical procedures as major technological hurdles must be overcome, including (1) realistic physics-based modeling of the complex bio- physics of tissue cutting, hemostasis and tissue joining; (2) physical in vivo experiments to determine tissue parameters and support modeling and validation; and (3) novel realistic VR interfaces. The goal of this project is to overcome these technological barriers and design, develop and evaluate the first Virtual Electrosurgical Skill Trainer (VEST). To accomplish the goals of the project, a multidisciplinary team has been assembled to achieve the following Specific Aims: (SA1) Develop physics-based computational technology for modeling, in real time, the interaction of electrosurgical devices with soft tissue: Specifically, we will develop physics-based computational models of electrosurgical tissue cutting, joining and hemostasis based on in vivo studies. Novel computational algorithms will be developed to allow real time performance. (SA2) Design and develop a realistic VEST platform: We will integrate the computational models and experimental data generated in SA1 and develop the prototype of the VEST with training scenarios for (1) tissue dissection; (2) arc fulguration and (3) coaptive vessel closure. VEST will include real time feedback identifying errors; visual, auditory and haptic cues to guide the trainee; display of physiological consequence of surgical complications; effects of alternate surgical procedures and devices as well as automatic real time assessment of surgical skill. (SA3) Establish the validity of the VEST as a training tool. We will conduct experiments at the Skills Lab at BIDMC to ensure that the tasks in VEST reflect the technical skills in electrosurgery, and the scores measured in VEST are the appropriate performance metrics in assessing training. (SA4) Evaluate the usefulness of the VEST as a training tool. By dividing subjects into practice and non-practice groups we will study whether training on the VEST transfers positively to the OR.

描述(申请人提供)：“电外科”现已被普遍接受为大多数微创外科(MIS)程序的首选技术，以利用高频电能实现从解剖到止血(控制出血)的各种组织效果。然而，在手术室(OR)之外，没有标准化的课程或培训方案，让外科社区安全有效地使用复杂的电外科器械。可以预见，具有视觉和触觉(触摸)反馈的基于虚拟现实(VR)的训练器将对电外科手术具有无价的价值 技能培训，允许受训者在受控环境中获得能力，不会使实际患者暴露在他们的“学习曲线”的赤裸裸的冲击下；根据个人需求进行定制；以及实时反馈、指导和客观评估，而不需要监考人员。虽然有一些基于VR的训练器用于腹腔镜精神运动技能训练(即手眼协调和执行工具移动、切割、缝合等任务所需的运动技能的训练)，但还没有专门用于电外科手术的训练器，因为必须克服主要技术障碍，包括(1)对组织切割、止血和组织连接的复杂生物物理学进行逼真的物理学建模；(2)用于确定组织参数并支持建模和验证的体内物理实验；以及(3)新颖的逼真的VR界面。本项目的目标是克服这些技术障碍，设计、开发和评估第一个虚拟电外科技能训练器(VEST)。为了实现该项目的目标，已经组建了一个多学科团队来实现以下具体目标：(SA1)开发基于物理的计算技术，用于实时模拟电外科设备与软组织的相互作用：具体地说，我们将在活体研究的基础上开发基于物理的电外科组织切割、连接和止血的计算模型。将开发新的计算算法以实现实时性能。(SA2)设计和开发一个现实的背心平台：我们将整合SA1中产生的计算模型和实验数据，并开发具有以下训练场景的马甲原型：(1)组织解剖；(2)弧形硫化；(3)粘合血管关闭。VEST将包括识别错误的实时反馈；指导受训者的视觉、听觉和触觉提示；手术并发症的生理后果展示；替代手术程序和设备的效果以及手术技能的自动实时评估。(SA3)确定背心作为培训工具的有效性。我们将在BIDMC的技能实验室进行实验，以确保穿着马甲的任务反映了电外科的技术技能，并且穿着马甲测量的分数是评估培训的适当表现指标。(SA4)评估背心作为培训工具的有用性。通过将受试者分为实践组和非实践组，我们将研究关于背心的培训是否正向转移到OR。