Development of a Surgical Simulator to training Laparoscopic procedures
Christian Díaz, Daniel Posada, Helmuth Trefftz, Jorge Bernal · 2008
The training process for laparoscopic surgeons is currently based on interacting with experienced surgeons during procedures in a surgical room. During this interaction, the expert surgeon provides feedback based on qualitative appreciations about the performance to the trainee, and based on this evaluation, the expert surgeon determines the level competence of the trainee to carry out the surgical procedure. The development of specific skills involved in laparoscopic surgery, however, claims for new training methods and tools, as well as for means for quantitative evaluation of the surgeon's performance. In this context, the virtual surgical simulator arise as a flexible tool to compensate for some deficiencies of the present training methodology. In the virtual surgical simulators the surgeon can train without time constraints and can polish or practice new interventional methods and techniques. Moreover, the simulator can provide feedback to the surgeon about his/her performance as the training protocol advances, without the need for an expert surgeon to supervise the process. The virtual surgical simulators have two different components: the physical interface and the virtual interface. Developing the physical user interface requires the study of the mechanical movements and forces involved in the interaction between surgeon and laparoscopic instruments. The virtual interface, on the other hand, builds on computer graphics and physical simulation in order to simulate a surgical task in an interactive and realistic way. In the work describe in this paper we focus on the process of development of a physical interface and virtual interface. Specifically, regarding the physical interface we describe: (i)a mechanism that simulates the same degrees of freedom of the laparoscopic surgical tools with (ii)additional devices to acquire digital information from the real environment, used to construct the virtual surgical environment. This information represents laparoscopic instrumental position and its state, which may be open or closed. Regarding the virtual environment we describe the development of a training scenario, including a scenario that simulates a real laparoscopic procedure.