Development of a Surgical Simulator for Endovascular Access Training

SimQuest将为血管内通路和管道升级设计一个原型模拟器， 提供最切合实际的培训。它将克服现有技术的缺点 模拟器，包含生物逼真触觉和新的指标，并允许重复练习，以便 熟练程度是明确定义的，是可以达到的。目标是为学员提供一种技术上的 先进的解决方案，允许开发和实践血管内通道/导管升级 具有精确的模拟工具和逼真的触觉。与其他培训人员不同，拟议的 模拟器将从穿刺针开始，通过刚刚- 插入针头，然后将导丝上移至导管上方。模拟器将 采用3D打印体能训练器元素、增强现实 (AR)、基于物理的模拟和触觉硬件接口。以促进扩展到其他 程序，它将使用SimQuest的开源平台OpenSurgSim开发。 在第二阶段，我们将为我们的新血管内手术训练器创造一个最先进的原型 基于开源软件的仿真。训练员将产生逼真的触诊提示 和超声定位，无需血液模拟器，将自动记录指标 针头和导管引导部分的任务，并将提供改善的触觉 反馈感觉与目前可用的血管内训练系统进行比较。跟随 第二阶段，原型将准备好进行验证、现场测试和产品化。 该项目将导致第一个模拟器提供完整的血管内通路和 管道升级，以现实生活的方式模拟实际任务。它将通过(1)改进临床实践 教学血管内通路、导丝/导管的使用和导管升高术作为一种无缝 流程；(2)通过创新的设计提供准确的触觉；(3)使用临床指标 由中小型企业定义；以及(4)包含组织幻影人体模型，提供触觉和 AR用于视觉增强。特定的病理将能够使用虚拟的 现实(VR)解剖组件。除了来自Prytime的该模拟器的直接请求之外 医疗方面，许多培训设施和设备制造商也要求进行这项创新。产品 发布将既是独立的，也是REBOA完整培训器的一部分，集成了 目前的RATT与本研究的产品，并应Prytime医疗的要求。 除了符合公众利益，并满足市场的实际需求外，减少 血管内手术错误进一步推动了NHLBI减轻心脏病负担的使命，以及 心血管科学校外研究计划部对干预措施的支持。

SimQuest will design a prototype simulator for endovascular access and conduit upsizing that provides the most realistic training available. It will overcome the shortcomings of existing simulators, contain biofidelic haptics and novel metrics, and allow repeated practice so that proficiency is clearly defined and attainable. The goal is to provide trainees with a technologically advanced solution that allows development and practice of endovascular access/conduit upsizing with accurately simulated tools and realistic haptic feel. Unlike other trainers, the proposed simulator will start at needle puncture, move seamlessly into guidewire insertion through the just- inserted needle and then to the over-guidewire upsizing of the conduit catheter. The simulator will be built with an innovative combination of 3D printed physical trainer elements, augmented reality (AR), physics-based simulation, and haptics hardware interfaces. To facilitate expansion to other procedures, it will be developed using SimQuest's open-source platform, OpenSurgSim. During Phase II we will create a state-of-the-art prototype for our new endovascular surgery trainer based on an open-source software simulation. The trainer will generate realistic palpation cues and ultrasound localization without requiring a blood simulant, will automatically record metrics for both the needlestick and catheter guidance portions of the task, and will provide improved haptic feedback sensations compared with currently available endovascular training systems. Following Phase II, the prototype will be ready for validation, field-testing, and productization. This project will result in the first simulator to offer complete training in endovascular access and conduit upsizing, simulating actual tasks in real-life fashion. It will improve clinical practice by (1) teaching endo-vascular access, use of guidewires/catheters, and conduit upsizing as a seamless process; (2) providing accurate haptic feel through an innovative design; (3) using clinical metrics defined by SMEs; and (4) containing a tissue-phantom mannequin providing sense of touch and AR for visual enhancements. Specific pathologies will be able to be incorporated using a virtual reality (VR) anatomical component. In addition to the direct request for this simulator from Prytime Medical, many training facilities and device manufacturers also requested this innovation. Product launch will be both stand-alone and as part of a complete trainer for REBOA, integrating the current RATT with the products of this research and at the request of Prytime Medical. In addition to being in the public interest, and filling a real need in the market, reduction of endovascular surgical errors furthers NHLBI's mission to reduce the burden of heart disease, and the Cardiovascular Sciences Extramural Research Program Division's support of interventions.