Lefor Alan Kawarai, Heredia Pérez Saúl Alexis, Shimizu Atsushi, Lin Hung-Ching, Witowski Jan, Mitsuishi Mamoru
Department of Bioengineering, School of Engineering, The University of Tokyo, Tokyo 113-8656, Japan.
Department of Surgery, Jichi Medical University, Tochigi 329-0498, Japan.
J Clin Med. 2022 Jul 17;11(14):4145. doi: 10.3390/jcm11144145.
The value of kinematic data for skill assessment is being investigated. This is the first virtual reality simulator developed for liver surgery. This simulator was coded in C++ using PhysX and FleX with a novel cutting algorithm and used a patient data-derived model and two instruments functioning as ultrasonic shears. The simulator was evaluated by nine expert surgeons and nine surgical novices. Each participant performed a simulated metastasectomy after training. Kinematic data were collected for the instrument position. Each participant completed a survey. The expert participants had a mean age of 47 years and 9/9 were certified in surgery. Novices had a mean age of 30 years and 0/9 were certified surgeons. The mean path length (novice 0.76 ± 0.20 m vs. expert 0.46 ± 0.16 m, = 0.008), movements (138 ± 45 vs. 84 ± 32, = 0.043) and time (174 ± 44 s vs. 102 ± 42 s, = 0.004) were significantly different for the two participant groups. There were no significant differences in activating the instrument (107 ± 25 vs. 109 ± 53). Participants considered the simulator realistic (6.5/7) (face validity), appropriate for education (5/7) (content validity) with an effective interface (6/7), consistent motion (5/7) and realistic soft tissue behavior (5/7). This study showed that the simulator differentiates between experts and novices. Simulation may be an effective way to obtain kinematic data.
运动学数据在技能评估中的价值正在研究中。这是首个为肝脏手术开发的虚拟现实模拟器。该模拟器使用PhysX和FleX并采用一种新颖的切割算法用C++编码，使用了源自患者数据的模型以及两种充当超声剪的器械。该模拟器由九名专家外科医生和九名外科新手进行评估。每位参与者在训练后进行了模拟转移瘤切除术。收集了器械位置的运动学数据。每位参与者完成了一项调查。专家参与者的平均年龄为47岁，9/9通过了外科手术认证。新手的平均年龄为30岁，0/9是认证外科医生。两组参与者的平均路径长度（新手0.76±0.20米对专家0.46±0.16米，P = 0.008）、动作（138±45对84±32，P = 0.043）和时间（174±44秒对102±42秒，P = 0.004）存在显著差异。在器械激活方面没有显著差异（107±25对109±53）。参与者认为模拟器逼真（6.5/7）（表面效度）、适合教育（5/7）（内容效度），具有有效的界面（6/7）、一致的运动（5/7）和逼真的软组织行为（5/7）。这项研究表明该模拟器能够区分专家和新手。模拟可能是获取运动学数据的有效方法。
