Physically Realistic Virtual Surgery

物理逼真的虚拟手术 摘要 同时，基于虚拟现实(VR)的手术模拟技术也在不断发展，以改进腹腔镜 手术室外的手术培训(OR)，现有的模拟器主要集中在技术技能(TS)上 独立任务的手眼协调，很少涉及与两者相关的非技术技能(NTS) 决策的认知技能，以及人际沟通、团队合作和冲突的技能 决议。使基于VR的手术模拟器也能够在上一次赠款期间培训认知技能 我们成功地开发了下一代(Gen2)腹腔镜手术模拟器，它可以沉浸在 实习生在虚拟环境中或使用头盔显示器(HMD)系统，并引入干扰、干扰 和其他压力源来捕捉真实手术室的高压力环境。然而，在我们最好的情况下 知识，目前还没有基于VR的模拟器来培训 手术室团队的多学科整合，由外科医生、麻醉师和 围手术期护士。在其他学科的不良事件显著减少之后，例如 航空，通过采用强制性的基于模拟的团队培训(例如，机组人员) 管理)，由美国外科医生学院开发的国家外科技能课程 (ACS)和外科项目主任协会(APDS)规定了十项基于团队的培训 将在模拟设施(例如，OR endosuite)中执行的模块，具有基于场景的高- Fidelity人体模型模拟器。然而，这种以设施为基础的团队培训极其昂贵，而且 繁琐，需要专门的设施和教员时间，并需要大量的计划和时间表 培训生、技术人员和教职员工之间的协调。克服以设施为基础的或 团队培训，该项目的目标是扩展作为一部分开发的沉浸式VR技术(Gen2 将我们之前针对单个用户的拨款分配给整个OR团队，并利用云计算的最新进展， 基于移动设备的VR和人工智能以及机器学习来设计、开发和 评估虚拟手术室团队体验(VORTEX)模拟系统。漩涡将允许 OR团队以分布式方式(即，不在同一房间或模拟中)一起进行训练 设施)佩戴基于移动设备的头盔显示器系统，以进一步开发基于计算机生成的NT 模拟场景取代了物理场景。将对模拟场景进行评估 由一个基于动作后回放的专家团队异步进行。我们将为一个 由BIDMC的丹·琼斯博士共同开发和验证的腹腔镜胆囊切除术危急情况 并被采纳为ACS/APDS国家外科技能课程的团队训练模块之一。我们 假设涡旋将至少与传统的基于设施的涡旋一样好或更好 模拟为运营队提供非技术技能培训。

Physically Realistic Virtual Surgery Abstract While virtual reality (VR)-based surgical simulation technology is being developed to improve laparoscopic surgical training outside the operating room (OR), existing simulators focus mostly on technical skills (TS) of hand-eye coordination for isolated tasks and seldom on non-technical skills (NTS) associated with both cognitive skills of decision making, as well as interpersonal skills of communication, team-work and conflict resolution. To enable VR-based surgical simulators to also train for cognitive skills, in the previous grant period we successfully developed the next generation (Gen2) of laparoscopic surgical simulators that immerse the trainee in a virtual OR using a head-mounted display (HMD) system, and introduce distractions, interruptions and other stressors to capture the high-stress environment of the real OR. However, to the best of our knowledge, there exists no VR-based simulator for training interpersonal skills needed for the multidisciplinary integration of OR teams, which consist of surgeons, anesthesiologists, and perioperative nurses. Following the significant reduction of adverse events in other disciplines, such as aviation, by the introduction of mandatory simulation-based team training (e.g., crew resource management), the National Surgical Skills Curriculum developed by the American College of Surgeons (ACS) and Association of Program Directors in Surgery (APDS) has prescribed ten team-based training modules to be performed in a simulation facility (e.g., an OR endosuite) with scenario-based training on high- fidelity manikin simulators. However, such facility-based team training is extremely expensive and cumbersome, requires dedicated facility and faculty time, and entails significant planning and schedule coordination between trainees, technicians, and faculty. To overcome the challenges of facility-based OR team training, the goal of this project is to extend the immersive VR technology (Gen2) developed as part of our prior grant for a single user to the entire OR team, and harness recent advances in cloud computing, mobile device-based VR and artificial intelligence and machine learning to design, develop and evaluate a Virtual Operating Room Team Experience (VORTeX) simulation system. The VORTeX will allow the OR team to train together in a distributed fashion (i.e., not co-located in the same room or simulation facility) wearing mobile device-based HMD systems to develop further their NTS based on computer-generated simulation scenarios replacing the physical ones. Evaluation of the simulation scenarios will be performed asynchronously by a team of experts based on post-action replays. We will implement the VORTeX for a laparoscopic cholecystectomy crisis scenario, developed and validated by our Co-I Dr. Dan Jones at BIDMC and adopted as one of the team training modules of the ACS/APDS national surgical skills curriculum. We hypothesize that the VORTeX will be at least as good as or better than traditional facility-based simulation in providing non-technical skills training to OR teams.