Homemade laparoscopic simulators for surgical trainees

Khine, Myo; Leung, Edward Ki Yun; Morran, Chris; Muthukumarasamy, Giri

doi:10.1111/j.1743-498x.2011.00441.x

Cited by 26 publications

(21 citation statements)

References 10 publications

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“…Instruments could then be inserted directly into the cavity or through a trocar. Use of a flexible covering material, such as neoprene [13, 18], and ring reinforcement around the port site [13, 32–35] were also described as methods to increase simulator authenticity.…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of low-cost laparoscopic simulators

George

2016

Surg Endosc

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BackgroundOpportunities for surgical skills practice using high-fidelity simulation in the workplace are limited due to cost, time and geographical constraints, and accessibility to junior trainees. An alternative is needed to practise laparoscopic skills at home. Our objective was to undertake a systematic review of low-cost laparoscopic simulators.MethodA systematic review was undertaken according to PRISMA guidelines. MEDLINE/EMBASE was searched for articles between 1990 and 2014. We included articles describing portable and low-cost laparoscopic simulators that were ready-made or suitable for assembly; articles not in English, with inadequate descriptions of the simulator, and costs >£1500 were excluded. Validation, equipment needed, cost, and ease of assembly were examined.ResultsSeventy-three unique simulators were identified (60 non-commercial, 13 commercial); 55 % (33) of non-commercial trainers were subject to at least one type of validation compared with 92 % (12) of commercial trainers. Commercial simulators had better face validation compared with non-commercial. The cost ranged from £3 to £216 for non-commercial and £60 to £1007 for commercial simulators. Key components of simulator construction were identified as abdominal cavity and wall, port site, light source, visualisation, and camera monitor. Laptop computers were prerequisite where direct vision was not used. Non-commercial models commonly utilised retail off-the-shelf components, which allowed reduction in costs and greater ease of construction.ConclusionThe models described provide simple and affordable options for self-assembly, although a significant proportion have not been subject to any validation. Portable simulators may be the most equitable solution to allow regular basic skills practice (e.g. suturing, knot-tying) for junior surgical trainees.

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Section: Resultsmentioning

confidence: 99%

“…The built-in light source from the laparoscope itself provided lighting for 17 % (10) of simulators, desk lamps for 13 % (8), and light-emitting diodes (LED) for 8 % (5). Other lighting methods described included fluorescent lights [18, 34, 39], webcam in-built [40, 41], fibre optics [42], and torchlight [30]. …”

Section: Resultsmentioning

confidence: 99%

A systematic review of low-cost laparoscopic simulators

George

2016

Surg Endosc

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“…Essas caixas têm dimensões semelhantes a um tórax humano inflado ou a um abdômen, e estão equipadas com câmeras conectadas a uma tela de computador [Vassiliou et al 2006]. As caixas pretas sãoúteis na fase inicial do treinamento em MIS, quando as habilidades motoras devem ser aprendidas e dominadas pelos alunos [Khine et al 2011]. As vantagens deste método de treinamento são a presença de feedback sensorial para o aluno e o baixo custo financeiro quando comparado a outros métodos de treinamento.…”

Section: Introductionunclassified

Avaliação do uso de realidade aumentada e gamificação para o treinamento de habilidades em laparoscopia

Silva

Valerio

Viana

et al. 2015

Anais Do XXVI Simpósio Brasileiro De Informática Na Educação (SBIE 2015)

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Abstract. Minimally Invasive Surgeries (MIS) require learning and training of non-conventional skills of surgeons (e.g., hand-eye coordination, manual dexterity and precision). In laparoscopic box-trainers, these skills can be practiced with simple navigation and coordination activities. In this paper, we propose to extend laparoscopic box-trainers with Augmented Reality (AR) and Gamification techniques. Our proposal introduces an extra camera, and uses tracking algorithms in order to monitor movements of the manipulated objects. With this approach, we are able to observe the user performance during the training activity (e.g., time to finish the activity, errors). We designed and developed two activities for navigation skills training. An initial user evaluation conducted with a group of eighteen users was implemented. Results indicate a good usability acceptance of the box-trainer. We also observed a significant difference in performance between surgeons and students of the first year of residency.Resumo. Cirurgias minimamente invasivas requerem aprendizagem e treinamento de habilidades não-convencionais de cirurgiões (por exemplo, coordenação mão-olho, destreza manual e precisão). Os processos de ensino e aprendizagem envolvem em geral o uso de caixas-pretas simuladoras para o treinamento dessas habilidades que podem ser praticadas com atividades de navegação com as pinças e de coordenação de movimentos simples. Neste trabalho, propomos estender caixas-pretas de treinamento laparoscópico com Realidade Aumentada (RA) e técnicas de gamificação. A proposta apresenta uma câmera adicional e utiliza algoritmos de rastreamento de objetos a fim de controlar os movimentos dos objetos manipulados. O simuladoré capaz de observar o desempenho do aprendiz durante a atividade de formação (por exemplo, tempo para terminar a atividade, erros). Foi implementada uma avaliação inicial de usabilidade com um grupo de dezoito usuários. Os resultados indicam uma boa aceitação da proposta. Foi observada também uma diferença significativa no desempenho entre os cirurgiões e os alunos do primeiro ano de residência, um indicativo positivo para a sua utilização no processo de ensinoaprendizagem de habilidades em MIS.

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“…Despite ongoing investment in virtual reality simulator development, synthetic physical simulators are still generally considered the most reliable, effective, and cost-efficient [3,8,12,21,23,25]. The employment of physical simulators, designed specifically for surgical training, has become a promising method for neurosurgery training that provides effective results at a reasonable cost [1,34,57,59].…”

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confidence: 99%

The role of simulation in neurosurgery

2014

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It is increasingly apparent that the standards for surgical training are shifting from time-based to criterion-based parameters that emphasize obtaining and maintaining competencies [24]. The formation of a surgeon demands significant dedication and effort, in addition to time [54]. Current, wellestablished methods of surgical training are being challenged as the environment becomes increasingly competitive and litigious with greater scrutiny of patient outcomes [14,17,40,44,50]. In order to increase patient safety and improve treatment outcomes, several strategies such as problem-based learning and objective structured clinical examinations have promoted the development of new curricula in surgical education [13,15,35,51,52].Some of these changes have been driven by events in the 1980s and 1990s such as medical misconduct and overworked, unsupervised resident staff that contributed to patient morbidity and mortality. This also coincided with a growing medical malpractice crisis. As a result, regulatory bodies began to initiate new standards of work hour restrictions and supervision for residents in training. The New York Health Code of 1989 compiled regulations restricting resident work hours (80 h per week) and one day free a week and placed limits on the number of calls [24,32]. Concerns arose about the long-established methods of training surgical residents, and solutions were sought to reduce preventable errors and perioperative complications [24,9].The airline industry, with the development of flight simulators and pilot coaching methods, proved to be an excellent precedent for innovation in surgical education. Many surgical educators believe such methods are keys to accelerating the acquisition of fundamental skills and the rate of performance improvement among surgical residents. A Yale University study demonstrated that criterion-based simulator training decreased operating time by 30 % and operative errors by 85 % [47,48].

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Homemade laparoscopic simulators for surgical trainees

Cited by 26 publications

References 10 publications

A systematic review of low-cost laparoscopic simulators

A systematic review of low-cost laparoscopic simulators

Avaliação do uso de realidade aumentada e gamificação para o treinamento de habilidades em laparoscopia

The role of simulation in neurosurgery

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