OpenHELP (Heidelberg laparoscopy phantom): development of an open-source surgical evaluation and training tool
Identifieur interne : 000691 ( Main/Merge ); précédent : 000690; suivant : 000692OpenHELP (Heidelberg laparoscopy phantom): development of an open-source surgical evaluation and training tool
Auteurs : H. G. Kenngott [Allemagne] ; J. J. Wünscher [Allemagne] ; M. Wagner [Allemagne] ; A. Preukschas [Allemagne] ; A. L. Wekerle [Allemagne] ; P. Neher [Allemagne] ; S. Suwelack [Allemagne] ; S. Speidel [Allemagne] ; F. Nickel [Allemagne] ; D. Oladokun [Allemagne] ; L. Maier-Hein [Allemagne] ; R. Dillmann [Allemagne] ; H. P. Meinzer [Allemagne] ; B. P. Müller-Stich [Allemagne]Source :
- Surgical Endoscopy [ 0930-2794 ] ; 2015.
Abstract
Apart from animal testing and clinical trials, surgical research and laparoscopic training mainly rely on phantoms. The aim of this project was to design a phantom with realistic anatomy and haptic characteristics, modular design and easy reproducibility. The phantom was named open-source Heidelberg laparoscopic phantom (OpenHELP) and serves as an open-source platform.
The phantom was based on an anonymized CT scan of a male patient. The anatomical structures were segmented to obtain digital three-dimensional models of the torso and the organs. The digital models were materialized via rapid prototyping. One flexible, using an elastic abdominal wall, and one rigid method, using a plastic shell, to simulate pneumoperitoneum were developed. Artificial organ production was carried out sequentially starting from raw gypsum models to silicone molds to final silicone casts. The reproduction accuracy was exemplarily evaluated for ten silicone rectum models by comparing the digital 3D surface of the original rectum with CT scan by calculating the root mean square error of surface variations. Haptic realism was also evaluated to find the most realistic silicone compositions on a visual analog scale (VAS, 0–10).
The rigid and durable plastic torso and soft silicone organs of the abdominal cavity were successfully produced. A simulation of pneumoperitoneum could be created successfully by both methods. The reproduction accuracy of ten silicone rectum models showed an average root mean square error of 2.26 (0–11.48) mm. Haptic realism revealed an average value on a VAS of 7.25 (5.2–9.6) for the most realistic rectum.
The OpenHELP phantom proved to be feasible and accurate. The phantom was consecutively applied frequently in the field of computer-assisted surgery at our institutions and is accessible as an open-source project at
Url:
DOI: 10.1007/s00464-015-4094-0
PubMed: 25673345
PubMed Central: 4607709
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<author><name sortKey="Suwelack, S" sort="Suwelack, S" uniqKey="Suwelack S" first="S." last="Suwelack">S. Suwelack</name>
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<country xml:lang="fr">Allemagne</country>
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<author><name sortKey="Maier Hein, L" sort="Maier Hein, L" uniqKey="Maier Hein L" first="L." last="Maier-Hein">L. Maier-Hein</name>
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<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Division of Medical and Biological Informatics, German Cancer Research Center (DKFZ), Heidelberg</wicri:regionArea>
<placeName><region type="land" nuts="1">Bade-Wurtemberg</region>
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<author><name sortKey="Dillmann, R" sort="Dillmann, R" uniqKey="Dillmann R" first="R." last="Dillmann">R. Dillmann</name>
<affiliation wicri:level="3"><nlm:aff id="Aff3">Institute for Anthropomatics, Karlsruhe Institute of Technology, Karlsruhe, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Institute for Anthropomatics, Karlsruhe Institute of Technology, Karlsruhe</wicri:regionArea>
<placeName><region type="land" nuts="1">Bade-Wurtemberg</region>
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<author><name sortKey="Meinzer, H P" sort="Meinzer, H P" uniqKey="Meinzer H" first="H. P." last="Meinzer">H. P. Meinzer</name>
<affiliation wicri:level="3"><nlm:aff id="Aff2">Division of Medical and Biological Informatics, German Cancer Research Center (DKFZ), Heidelberg, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Division of Medical and Biological Informatics, German Cancer Research Center (DKFZ), Heidelberg</wicri:regionArea>
<placeName><region type="land" nuts="1">Bade-Wurtemberg</region>
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<author><name sortKey="Muller Stich, B P" sort="Muller Stich, B P" uniqKey="Muller Stich B" first="B. P." last="Müller-Stich">B. P. Müller-Stich</name>
<affiliation wicri:level="3"><nlm:aff id="Aff1">Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg</wicri:regionArea>
<placeName><region type="land" nuts="1">Bade-Wurtemberg</region>
<region type="district" nuts="2">District de Karlsruhe</region>
<settlement type="city">Heidelberg</settlement>
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<series><title level="j">Surgical Endoscopy</title>
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<idno type="eISSN">1432-2218</idno>
<imprint><date when="2015">2015</date>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Apart from animal testing and clinical trials, surgical research and laparoscopic training mainly rely on phantoms. The aim of this project was to design a phantom with realistic anatomy and haptic characteristics, modular design and easy reproducibility. The phantom was named open-source Heidelberg laparoscopic phantom (OpenHELP) and serves as an open-source platform.
</p>
</sec>
<sec><title>Methods</title>
<p>The phantom was based on an anonymized CT scan of a male patient. The anatomical structures were segmented to obtain digital three-dimensional models of the torso and the organs. The digital models were materialized via rapid prototyping. One flexible, using an elastic abdominal wall, and one rigid method, using a plastic shell, to simulate pneumoperitoneum were developed. Artificial organ production was carried out sequentially starting from raw gypsum models to silicone molds to final silicone casts. The reproduction accuracy was exemplarily evaluated for ten silicone rectum models by comparing the digital 3D surface of the original rectum with CT scan by calculating the root mean square error of surface variations. Haptic realism was also evaluated to find the most realistic silicone compositions on a visual analog scale (VAS, 0–10).</p>
</sec>
<sec><title>Results</title>
<p>The rigid and durable plastic torso and soft silicone organs of the abdominal cavity were successfully produced. A simulation of pneumoperitoneum could be created successfully by both methods. The reproduction accuracy of ten silicone rectum models showed an average root mean square error of 2.26 (0–11.48) mm. Haptic realism revealed an average value on a VAS of 7.25 (5.2–9.6) for the most realistic rectum.</p>
</sec>
<sec><title>Conclusion</title>
<p>The OpenHELP phantom proved to be feasible and accurate. The phantom was consecutively applied frequently in the field of computer-assisted surgery at our institutions and is accessible as an open-source project at <ext-link ext-link-type="uri" xlink:href="http://www.open-cas.org">www.open-cas.org</ext-link>
for the academic community.</p>
</sec>
</div>
</front>
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