Methodologies for the analysis, design and evaluation of laparoscopic surgical simulators


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The problem addressed in this PhD thesis is how to offer an effective and efficient VR means of training in laparoscopic surgery. And more focused to the design of the simulator, the question is to determine what makes it a useful didactic tool. This b


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Gegevens


Uitgever
Presses universitaires de Louvain
Auteur
Pablo Lamata de la Orden,
Uitgegeven door
Similar,
Collectie
SIMILAR
Taal
Engels
BISAC Subject Heading
COM000000 COMPUTERS
Onix Audience Codes
06 Professional and scholarly
CLIL (2013)
3238 Réseaux et Télécommunications
Voor het eerst gepubliceerd
2007
Type werk
Thesis

Paperback


Publicatie datum
2007
ISBN-13
9782874630507
Omvang
Aantal pagina's hoofdinhoud : 235
Code
75170
Formaat
16 x 24 x 1,3 cm
Gewicht
393 grams
Aanbevolen verkoopprijs
12,50 €
ONIX XML
Version 2.1, Version 3

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SUMMARY......................................................................................................7

CHAPTER I : INTRODUCTION................................................................11

1. VR SIMULATION FOR LAPAROSCOPIC TRAINING AND SKILLS ASSESSMENT13

1.1. How to offer an effective and efficient training ................................15

2. PROBLEM STATEMENT: OPTIMAL SIMULATOR DESIGN...............................17

3. JUSTIFICATION FOR THE RESEARCH...........................................................18

4.METHODOLOGICAL APPROACH .................................................................18

5. STRUCTURE OF THESIS AND FRAMEWORK .................................................19

CHAPTER II : STATE OF THE ART........................................................21

1. INTRODUCTION .........................................................................................23

1.1. Related research fields .....................................................................23

1.2. Simulation design: requirements and specifications ........................24

2. REQUIREMENTS: LAPAROSCOPIC TRAINING AND SKILLS ASSESSMENT.......26

2.1. Laparoscopic surgery .......................................................................26

2.2. How surgeons learn?........................................................................31

2.3. How surgical skills are assessed? ....................................................36

2.4. Objectives and needs definition........................................................39

3. THE MEANS: VR SURGICAL SIMULATORS..................................................41

3.1. Kinds of simulators...........................................................................41

3.2. The added value of VR surgical simulation......................................46

3.3. VR Simulation technologies..............................................................48

3.4. Validation and acceptance ...............................................................55

4. OPTIMAL SIMULATION SPECIFICATIONS ....................................................64

4.1. Building a VR simulator ...................................................................64

4.2. Simulation fidelity.............................................................................65

4.3. Human factors in laparoscopic VR simulation.................................68

5. OVERVIEW................................................................................................74

CHAPTER III : HYPOTHESES AND OBJECTIVES............................. 77

1. HYPOTHESES............................................................................................ 79

2. OBJECTIVES ............................................................................................. 81

CHAPTER IV : CONCEPTUAL FRAMEWORK FOR THE ANALYSIS, DESIGN AND EVALUATION OF SURGICAL SIMULATORS... 83

1. INTRODUCTION......................................................................................... 85

2. TAXONOMY OF DIDACTIC RESOURCES IN LAPAROSCOPIC VR................... 86

2.1. Fidelity resources............................................................................. 88

2.2. Teaching resources .......................................................................... 92

2.3. Assessment resources....................................................................... 94

3. ANALYSIS AND COMPARISON OF LAPAROSCOPIC SIMULATORS................. 95

3.1. Materials and methods..................................................................... 95

3.2. Results.............................................................................................. 96

4.METHODOLOGICAL APPROACH FOR DESIGNING AN OPTIMAL SIMULATION ............................................... 103

4.1. Building research hypotheses ........................................................ 104

4.2. Designing experimental methods................................................... 106

4.3. Example: study of the importance of different resources in suture training...................... 109

5. DISCUSSION ........................................................................................... 116

5.1. Scope and limitations of the taxonomy .......................................... 116

5.2. Setting standards to compare simulators....................................... 117

5.3. The value of each resource for an optimum design ....................... 119

6. CONCLUSION.......................................................................................... 121

CHAPTER V : TISSUE CONSISTENCY PERCEPTION ANALYSIS AND MODELLING............................. 123

1. INTRODUCTION....................................................................................... 125

2. TISSUE CONSISTENCY PERCEPTION ANALYSIS ........................................ 126

2.1. Material and Methods.................................................................... 126

2.2. Results............................................................................................ 131

2.3. Discussion...................................................................................... 135

3. FORCE INTERACTION CHARACTERIZATION: OBJECTIVE PARAMETERS..... 139

3.1. Material and methods .................................................................... 139

3.2. Results............................................................................................ 142

3.3. Discussion...................................................................................... 144

4. DISCUSSION: MODELLING FORCE PERCEPTION........................................ 145

4.1. Scope and limitations of proposed model.......................................146

4.2. Comparing subjective perception with objective data....................146

4.3. FF requirements: model of force perception..................................148

4.4. Other applications ..........................................................................151

5. CONCLUSION...........................................................................................152

CHAPTER VI : DESIGN OF LAPAROSCOPIC VR SIMULATORS AND A VALIDATION APPROACH................153

1. INTRODUCTION .......................................................................................154

2. DESIGN OF A BASIC SKILLS VR SIMULATOR ............................................155

2.1. Simulation requirements: basic training objectives .......................155

2.2. Simulation specifications: 17 VR didactic exercises ......................156

3. DESIGN OF A NISSEN VR SIMULATOR .....................................................163

3.1. Simulation requirements: Nissen training objectives.....................163

3.2. Simulation specifications: 3 Nissen sub-tasks ................................167

4. VALIDATION APPROACH .........................................................................169

5. DISCUSSION ............................................................................................170

5.1. Developing a “basic skills” optimum curriculum..........................170

5.2. Developing simulators for surgical procedures .............................174

5.3. Implementing a surgical simulator.................................................176

5.4. Validation approach .......................................................................177

6. CONCLUSION...........................................................................................178

CHAPTER VII : DISCUSSION AND CONCLUSION ...........................179

1. DISCUSSION ............................................................................................181

1.1. A global approach for VR simulation design .................................181

1.2. A framework for comparing simulators and guiding research ......183

1.3. A simple model of pulling interaction forces..................................186

1.4. Is the proposed simulator an optimum? .........................................188

1.5. So, what’s the rational use of a VR alternative for surgical training? ..........................................................190

1.6. The future of VR simulators............................................................192

2. CONCLUSIONS.........................................................................................194

3. FUTURE RESEARCH .................................................................................197

3.1. Approaches towards an effective and efficient surgical training ...197

3.2. The future of MIS driven by technical research .............................204

GLOSSARY AND REFERENCES........................................................... 209

1.1. Glossary ......................................................................................... 209

1.2. Acronyms........................................................................................ 211

2. REFERENCES .......................................................................................... 213

ACKNOWLEDGEMENTS ....................................................................... 229

TABLE OF CONTENTS ........................................................................... 232