From virtual reality simulation to collaborative surgery: Enabling data-driven teleoperated percutaneous nephrolithotomy****

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Percutaneous nephrolithotomy (PCNL) was quickly established as the leading procedure used for management of urinary calculi for large urinary stones. Despite over 40 years of development, PCNL remains a challenging procedure to learn. Particularly in less experienced hands, PCNL can lead to higher complication rates compared to other endoscopic procedures. Developing adequate expertise to achieve surgical competence is not trivial as it involves training in gaining access to the kidney, but also in stone fragmentation, tool navigation, and stone scavenging. Due to the procedure steep learning curve and inherent complexity, PCNL residents will inevitably perform a certain number of sub-optimal interventions during the training process. ****Marion Surgical has identified the need to improve PCNL training and maintain it as a safe and effective treatment for patients. The company has developed a virtual reality simulator that affords residents the opportunity to train in a systematic environment that does not compromise patient safety. The system reproduces what an operating room would look like, and offers real-time fluoroscopic images of the kidney to the operator, who manipulates a surgical tool using a force-feedback device. The latter emulates the sensation of touch with the human tissue and as in a real-world intervention. ****The purpose of this collaboration is to create a data-driven telerobotic system that co-manipulates the surgical tools in tandem with the surgeon in order to improve clinical outcomes of residents. The project will train two Master students in emerging areas of robot-aided surgey and the outcomes of this project will lead to better clinical outcomes during PCNL. It will allow Marion Surgical to develop some of the first-ever applications of machine learning to the growing area of virtual surgery and make a strong entry into the emerging surgical robotics market. ********