A Visuospatial Laparoscopic Surgical Training Module

A Visuospatial Laparoscopic Cholecystectomy
Surgical Training Module.

Randy Haluck, M.D.¹, Roger Webster, Ph.D.²,
Betty Mohler², Jeremy Sheaffer², Joshua Boyd², Jon Reeser², Nathan Charles², Aaron Benson²,

¹Department of Minimally Invasive Surgery
Penn State University College of Medicine
Milton S. Hershey Medical Center
Hershey, PA USA 17033
rhaluck@psu.edu

²Department of Computer Science
D&E Communications Inc. Wing

H. Justin Roddy Science and Technology Complex
Millersville University
Millersville, PA. USA 17551
webster@cs.millersville.edu

Abstract. This paper describes a visuospatial laparoscopic surgical training software system we are developing using the Immersion Virtual Laparoscopic Interface hardware. The intent is to provide an efficient method to learn the laparoscopic cholecystectomy procedure by measuring surgical skills in a simulator. A port of the software to the Immersion haptic Laparoscopic Surgical Workstation™ using our Virtual Reality Medical Toolkit API (VRMT) is currently underway.

1. Introduction.

A laparoscopic cholecystectomy is a complex surgical procedure that requires good hand-eye coordination and dexterous skill on the part of the surgeon. Incorrect techniques resulting from inadequate training can result in sub optimal outcomes. If the bile duct is severed then a possible liver transplant may be required. The possibility of incorrectly performing the procedure can be stressful for a beginning surgeon. With our system the surgeon can practice the virtual procedure at any time without the fear and anxiety of performing actual laparoscopic surgery on a real patient.

2. Hardware.

The laparoscopic simulator hardware used is the commercially available Virtual Laparoscopic Interface (VLI) by Immersion. The Virtual Laparoscopic Interface is a human computer interface tool designed for VR simulations of laparoscopic and endoscopic surgical procedures[1]. The frame unit acts like a sensored trocar which is connected to the computer system via a serial port. Different surgical tool handles can be attached to the sensory unit. The VLI tracks the motion of a pair of laparoscopic surgical instruments, each moving in 5 degrees of freedom. The trocar sensors provide an angular resolution of > 0.088 degrees, a linear position resolution of > 0.0005 inches, and can move up to 8 inches along the insertion axis. The latency is less than 1 ms[2]. The VLI system provides a fast, effective means of tracking laparoscopic and endoscopic surgical procedures. The development computer is a Windows workstation with dual Pentium processors and an OpenGL graphics accelerator.

Figure 1. Jon Reeser and Dr. Roger Webster at the Lap Choley Surgical Simulator.

Acknowledgements.

This project was funded, in part, by the National Science Foundation under grant numbers EIA-00116616, DUE-9950472, the Neimeyer-Hodgson Grants Program, the Havemeier-Gibson Endowment for Computer Science, Millersville University Noonan Fund, and by the Faculty Grants Committee of Millersville University.

References/Literature.

[1] A. Lasko-Harvill, C. Blanchard, J. Lanier, D. McGrew, "A Fully Immersive Cholyecystectomy Simulation", Paradism for Healthcare, Eds. Randy Satava, et.al. , IOS Press, 1995, pps. 182-186.

[2] Michael Downes, M. Cavusoglu, W. Gantert, L. Way, F. Tendick, "Virtual Environments for Training Critical Skills in Laparoscopic Surgery", Medicine Meets Virtual Reality 1998, San Deigo, California, January 28-31, 1998, IOS Press, pps. 316-322.

[3] Peter Oppenheimer, S. Weghosrt, L. Williams, A. Ali, J. Cain, M. MacFarlane, M. Sinanan, "A Laparoscopic Surgical Simulator and Port Placement", Medicine Meets Virtual Reality 2000, Newport Beach, California, January 20-24, 2000, IOS Press, 2000, pps. 233-235.

[4] Lennart Thurfjell, A. Lundin, J. McLaughlin, "A Medical Platform for the Simulation of Surgical Procedures", Medicine Meets Virtual Reality 2001, Newport Beach, California, January 23-27, 2001, IOS Press, 2001, pps. 509-514.

[5] Goran Rolfsson, A. Nordgren, S. Bindzau, J. Hagstrom, J, McLaughlin, L. Thurfjell, "Training and Assessment of Laparoscopic Skills using a Haptic Simulator", Medicine Meets Virtual Reality 2002, Newport Beach, California, January 24-26, 2001, IOS Press, 2002, pps. 409-411.

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Laparoscopic Surgical Workstation in action

Laparoscopic Surgical Workstation in action2

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Last Updated 11-17-2002