Needs Analysis for Developing a Virtual Reality NOTES Simulator
Identifieur interne : 002393 ( Ncbi/Checkpoint ); précédent : 002392; suivant : 002394Needs 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
Affiliations:
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<author><name sortKey="Sankaranarayanan, Ganesh" sort="Sankaranarayanan, Ganesh" uniqKey="Sankaranarayanan G" first="Ganesh" last="Sankaranarayanan">Ganesh Sankaranarayanan</name>
<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>
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<wicri:noCountry code="subfield">Harvard Medical School</wicri:noCountry>
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<author><name sortKey="Nemani, Arun" sort="Nemani, Arun" uniqKey="Nemani A" first="Arun" last="Nemani">Arun Nemani</name>
<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>
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<wicri:noCountry code="subfield">Rensselaer Polytechnic Institute</wicri:noCountry>
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<wicri:noCountry code="subfield">Harvard Medical School</wicri:noCountry>
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<wicri:noCountry code="subfield">Harvard Medical School</wicri:noCountry>
</affiliation>
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<wicri:noCountry code="subfield">Harvard Medical School</wicri:noCountry>
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<wicri:noCountry code="subfield">Rensselaer Polytechnic Institute</wicri:noCountry>
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<series><title level="j">Surgical endoscopy</title>
<idno type="ISSN">0930-2794</idno>
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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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<affiliations><list></list>
<tree><noCountry><name sortKey="Ahn, Woojin" sort="Ahn, Woojin" uniqKey="Ahn W" first="Woojin" last="Ahn">Woojin Ahn</name>
<name sortKey="De, Suvranu" sort="De, Suvranu" uniqKey="De S" first="Suvranu" last="De">Suvranu De</name>
<name sortKey="Jones, Daniel B" sort="Jones, Daniel B" uniqKey="Jones D" first="Daniel B." last="Jones">Daniel B. Jones</name>
<name sortKey="Kato, Masayuki" sort="Kato, Masayuki" uniqKey="Kato M" first="Masayuki" last="Kato">Masayuki Kato</name>
<name sortKey="Matthes, Kai" sort="Matthes, Kai" uniqKey="Matthes K" first="Kai" last="Matthes">Kai Matthes</name>
<name sortKey="Nemani, Arun" sort="Nemani, Arun" uniqKey="Nemani A" first="Arun" last="Nemani">Arun Nemani</name>
<name sortKey="Sankaranarayanan, Ganesh" sort="Sankaranarayanan, Ganesh" uniqKey="Sankaranarayanan G" first="Ganesh" last="Sankaranarayanan">Ganesh Sankaranarayanan</name>
<name sortKey="Schwaitzberg, Steven" sort="Schwaitzberg, Steven" uniqKey="Schwaitzberg S" first="Steven" last="Schwaitzberg">Steven Schwaitzberg</name>
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