Development of an instrumented thoracoscopic surgical trainer for objective evaluation of esophageal atresia/tracheoesophageal fistula repair.

Operative repair of complex conditions such as esophageal atresia and tracheoesophageal fistula (EA/TEF) is technically demanding, but few training opportunities exist outside the operating theater for surgeons to attain these skills. Learning them during surgery on actual neonates where the stakes...

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Publicado en:Medical & Biological Engineering & Computing Vol. 58; no. 3; pp. 601 - 610
Autores principales: Moorhead, Ashton A., Nair, David, Morison, Chris, Cook, Nicholas J., Beasley, Spencer W., Wells, Jonathan M.
Formato: Journal Article
Publicado: Springer Nature Mar2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2020
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s11517-019-02107-6
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        atl: Development of an instrumented thoracoscopic surgical trainer for objective evaluation of esophageal atresia/tracheoesophageal fistula repair.
      aug:
        au:
          Moorhead, Ashton A.
          Nair, David
          Morison, Chris
          Cook, Nicholas J.
          Beasley, Spencer W.
          Wells, Jonathan M.
        affil: Department of Medical Physics and Bioengineering, Christchurch Hospital, 155 Bream Bay Dr., Ruakaka, 0116, Christchurch, New Zealand
      sug:
        subj:
          Thoracoscopy Education
          Thoracoscopy Equipment and Supplies
          Esophageal Atresia Surgery
          Tracheoesophageal Fistula Surgery
          Linear Regression
          Computer Simulation
          Diagnostic Imaging
          Symptom Distress Scale
      ab: Operative repair of complex conditions such as esophageal atresia and tracheoesophageal fistula (EA/TEF) is technically demanding, but few training opportunities exist outside the operating theater for surgeons to attain these skills. Learning them during surgery on actual neonates where the stakes are high, margins for error narrow, and where outcomes are influenced by technical expertise, is problematic. There is an increasing demand for high-fidelity simulation that can objectively measure performance. We developed such a simulator to measure force and motion reliably, allowing quantitative feedback of technical skill. A 3D-printed simulator for thoracoscopic repair of EA/TEF was instrumented with motion and force tracking components. A 3D mouse, inertial measurement unit (IMU), and optical sensor that captured force and motion data in four degrees of freedom (DOF) were calibrated and verified for accuracy. The 3D mouse had low average relative errors of 2.81%, 3.15%, and 6.15% for 0 mm, 10 mm offset in Y, and 10 mm offset in X, respectively. This increased to - 23.5% at an offset of 42 mm. The optical sensors and IMU displayed high precision and accuracy with low SDs and average relative errors, respectively. These parameters can be a useful measurement of performance for thoracoscopic EA/TEF simulation prior to surgery. Graphical abstract Inclusion of sensors into a high-fidelity simulator design can produce quantitative feedback which can be used to objectively asses performance of a technically difficult procedure. As a result, more surgical training can be done prior to operating on actual patients in the operating theater.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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