Erden Utku, Gromski Mark A, De Suvranu, Demirel Doga
Department of Computer Science, Florida Polytechnic University, Lakeland, Florida, USA.
Division of Gastroenterology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
IGIE. 2024 Dec;3(4):453-462. doi: 10.1016/j.igie.2024.08.003. Epub 2024 Sep 18.
Obesity is a global health concern. Bariatric surgery offers reliably effective and durable weight loss and improvements of other comorbid conditions. However, the accessibility of bariatric surgery remains limited. Minimally invasive techniques, including endoscopic sleeve gastroplasty (ESG), have emerged to bridge this gap. To effectively complete the ESG procedure, one requires skill in multiple complex interventional endoscopic maneuvers. This requisite expertise poses challenges for training in this burgeoning field.
We designed the virtual bariatric endoscopic (ViBE) simulator software to mimic the ESG procedure accurately. The ViBE simulator features a detailed simulation of an endoscope equipped with an endoscopic suturing system and a high-resolution stomach, enhancing the visualization of procedural details. Furthermore, the simulator incorporates performance metrics using a reverse scoring system to evaluate users' proficiency in tasks such as argon plasma coagulation (APC) marking, suturing, and cinching. To validate the simulator, we conducted a study involving experts and novices at the Indiana University School of Medicine, where participants engaged with the simulation environment in a series of training tasks.
Twelve participants, comprising 5 experts and 7 novices, were asked to complete a post-training questionnaire featuring 7 items, rating each on a Likert scale. The APC task realism received the highest score, averaging 3.83. The usefulness of improving endoscopic technical skills averaged 3.08, with the realism of cinching the knot and suturing tasks receiving scores of 3.17 and 3.25, respectively, suggesting a generally positive reception. Automated performance metrics indicated that, on average, experts outperformed novices by 10.83 points.
The ViBE simulation strives to replicate the steps of the ESG within a virtual environment. Our primary objective in developing this simulator was to enhance the learning curve for endoscopic suturing and ESG techniques, thereby safely extending these skills to a broader patient base.
肥胖是一个全球性的健康问题。减肥手术能可靠地实现有效且持久的体重减轻，并改善其他合并症。然而，减肥手术的可及性仍然有限。包括内镜下袖状胃成形术（ESG）在内的微创技术应运而生，以弥补这一差距。要有效地完成ESG手术，需要掌握多种复杂的内镜介入操作技能。这种必备的专业知识给这个新兴领域的培训带来了挑战。
我们设计了虚拟减肥内镜（ViBE）模拟器软件，以精确模拟ESG手术。ViBE模拟器详细模拟了配备内镜缝合系统的内窥镜和高分辨率的胃，增强了手术细节的可视化。此外，该模拟器采用反向评分系统纳入性能指标，以评估用户在氩等离子体凝固（APC）标记、缝合和收紧等任务中的熟练程度。为了验证该模拟器，我们在印第安纳大学医学院进行了一项研究，参与者包括专家和新手，他们在一系列培训任务中使用了模拟环境。
12名参与者，包括5名专家和7名新手，被要求完成一份包含7个项目的培训后问卷，每个项目采用李克特量表评分。APC任务的真实感得分最高，平均为3.83。提高内镜技术技能的有用性平均为3.08，打结和缝合任务的真实感得分分别为3.17和3.25，表明总体反馈良好。自动性能指标显示，专家的平均表现比新手高出10.83分。
ViBE模拟致力于在虚拟环境中重现ESG的步骤。我们开发这个模拟器的主要目的是提高内镜缝合和ESG技术的学习曲线，从而安全地将这些技能推广到更广泛的患者群体。
