Needs Analysis for Developing a Virtual Reality NOTES Simulator
Identifieur interne : 002289 ( Main/Curation ); précédent : 002288; suivant : 002290Needs Analysis for Developing a Virtual Reality NOTES Simulator
Auteurs : Ganesh Sankaranarayanan ; Kai Matthes ; Arun Nemani ; Woojin Ahn ; Masayuki Kato ; Daniel B. Jones ; Steven Schwaitzberg ; Suvranu DeSource :
- Surgical endoscopy [ 0930-2794 ] ; 2012.
Abstract
Natural orifice translumenal endoscopic surgery (NOTES) is an emerging surgical technique that requires a cautious adoption approach to ensure patient safety. High fidelity virtual reality-based simulators allow development of new surgical procedures and tools and train medical personnel without risk to human patients. As part of a project funded by the National Institutes of Health, we are developing a Virtual Transluminal Endoscopic Surgery Trainer (VTEST™) for this purpose. The objective of this study is to conduct a structured needs analysis to identify the design parameters for such a virtual reality-based simulator for NOTES.
A 30-point questionnaire was distributed at the 2011 NOSCAR meeting to get responses from the experts. Ordinal logistic regression and the Wilcoxon rank sum test were used for analysis.
A total of 22 NOTES experts participated in the study. Cholecystectomy (CE, 68%) followed by appendectomy (AE, 63%) (CE vs AE, p=0.0521) was selected as the first choice for simulation. Flexible (FL, 47%) and hybrid (HY, 47%) approaches were equally favorable compared to rigid (RI, 6%) with p<0.001 for both FL vs RI and HY vs RI. The transvaginal approach was preferred 3 to 1 to the transgastric. Most participants preferred two channel (2C) scopes (65%) compared to single (1C) or three (3C) or more channels with p<0.001 for both 2C vs 1C and 2C vs 3C. The importance of force feedback and the utility of a virtual NOTES simulator in training and testing new tools for NOTES were rated very high by the participants.
Our study reinforced the importance of developing a virtual NOTES simulator and clearly presented expert preferences. The results of this analysis will direct our initial development of the VTESTTM platform.
Url:
DOI: 10.1007/s00464-012-2637-1
PubMed: 23247736
PubMed Central: 3618859
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Ganesh Sankaranarayanan<affiliation><nlm:aff id="A1">Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute</nlm:aff>
<wicri:noCountry code="subfield">Rensselaer Polytechnic Institute</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A2">Department of, Anesthesiology, Perioperative and Pain Medicine Childrens Hospital, Harvard Medical School</nlm:aff>
<wicri:noCountry code="subfield">Harvard Medical School</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A1">Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute</nlm:aff>
<wicri:noCountry code="subfield">Rensselaer Polytechnic Institute</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A1">Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute</nlm:aff>
<wicri:noCountry code="subfield">Rensselaer Polytechnic Institute</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A3">Department of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School</nlm:aff>
<wicri:noCountry code="subfield">Harvard Medical School</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A4">Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School</nlm:aff>
<wicri:noCountry code="subfield">Harvard Medical School</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A5">Department of Surgery, Cambridge Health Alliance, Harvard Medical School</nlm:aff>
<wicri:noCountry code="subfield">Harvard Medical School</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A1">Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute</nlm:aff>
<wicri:noCountry code="subfield">Rensselaer Polytechnic Institute</wicri:noCountry>
</affiliation>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Introduction and Study Aim</title>
<p id="P1">Natural orifice translumenal endoscopic surgery (NOTES) is an emerging surgical technique that requires a cautious adoption approach to ensure patient safety. High fidelity virtual reality-based simulators allow development of new surgical procedures and tools and train medical personnel without risk to human patients. As part of a project funded by the National Institutes of Health, we are developing a Virtual Transluminal Endoscopic Surgery Trainer (VTEST™) for this purpose. The objective of this study is to conduct a structured needs analysis to identify the design parameters for such a virtual reality-based simulator for NOTES.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">A 30-point questionnaire was distributed at the 2011 NOSCAR meeting to get responses from the experts. Ordinal logistic regression and the Wilcoxon rank sum test were used for analysis.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">A total of 22 NOTES experts participated in the study. Cholecystectomy (CE, 68%) followed by appendectomy (AE, 63%) (CE vs AE, p=0.0521) was selected as the first choice for simulation. Flexible (FL, 47%) and hybrid (HY, 47%) approaches were equally favorable compared to rigid (RI, 6%) with p<0.001 for both FL vs RI and HY vs RI. The transvaginal approach was preferred 3 to 1 to the transgastric. Most participants preferred two channel (2C) scopes (65%) compared to single (1C) or three (3C) or more channels with p<0.001 for both 2C vs 1C and 2C vs 3C. The importance of force feedback and the utility of a virtual NOTES simulator in training and testing new tools for NOTES were rated very high by the participants.</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">Our study reinforced the importance of developing a virtual NOTES simulator and clearly presented expert preferences. The results of this analysis will direct our initial development of the VTEST<sup>TM</sup>
platform.</p>
</sec>
</div>
</front>
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