Di Vece Chiara, Luciano Cristian, De Momi Elena
Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Milan, 20133, Italy.
Department of Bioengineering and Simulation and Integrative Learning Institute, University of Illinois at Chicago, Chicago, 60607 (IL), USA.
Int J Comput Assist Radiol Surg. 2021 Apr;16(4):639-647. doi: 10.1007/s11548-021-02341-0. Epub 2021 Mar 12.
Veress needle (VN) insertion, if not correctly performed, could cause severe injuries to intra-abdominal organs and vessels. Therefore, cognitive and psychomotor skills training is needed. Virtual reality (VR) and haptic technologies have the potential to offer realistic simulations.
We developed a novel VR and haptic surgical simulator for VN insertion to teach trainees how to correctly puncture the abdominal wall, experiencing realistic tactile sensations throughout the simulation. The simulator allows for both procedural and realistic training. We released two different versions: the first using the OpenHaptics[Formula: see text] (OH) Toolkit and the second exploiting CHAI3D. We evaluated the learning effect using different performance indexes (time to perform the procedure, error in insertion angle, number of undesired contacts with organs) in an insertion task for both experienced urologists and students.
A general improvement of the chosen performance indexes was registered in the second repetition of the task for both groups. From the questionnaires, the simulator leveraging OH provides the trainee with a more precise haptic feedback, whereas the one exploiting CHAI3D allows them to perform the procedure more easily thanks to the better visualization of the virtual environment. The results proved that the participants appreciated both implementations, and the System Usability Scale (SUS) test resulted in a "good" usability.
The haptics-based and VR simulator has shown the potential to be an important resource for the basic urological training in obtaining the pneumoperitoneum and improving the acquisition of the necessary psychomotor skills, allowing for extended and more effective training without compromising patient safety.
Veress针（VN）插入操作若未正确执行，可能会对腹腔内器官和血管造成严重损伤。因此，需要进行认知和心理运动技能培训。虚拟现实（VR）和触觉技术有潜力提供逼真的模拟。
我们开发了一种用于VN插入的新型VR和触觉手术模拟器，以教导学员如何正确穿刺腹壁，并在整个模拟过程中体验逼真的触感。该模拟器允许进行程序和逼真的训练。我们发布了两个不同版本：第一个使用OpenHaptics[公式：见文本]（OH）工具包，第二个利用CHAI3D。我们在经验丰富的泌尿科医生和学生的插入任务中，使用不同的性能指标（执行程序的时间、插入角度的误差、与器官的意外接触次数）评估学习效果。
两组在任务的第二次重复中，所选性能指标都有普遍改善。从问卷中可知，利用OH的模拟器为学员提供了更精确的触觉反馈，而利用CHAI3D的模拟器由于虚拟环境的更好可视化，使他们能够更轻松地执行程序。结果证明参与者对两种实现方式都很满意，系统可用性量表（SUS）测试结果为“良好”的可用性。
基于触觉和VR的模拟器已显示出有潜力成为泌尿外科基础培训中的重要资源，用于获得气腹并提高必要心理运动技能的掌握，从而在不影响患者安全的情况下进行扩展且更有效的培训。
