I-Corps: A Novel Surgical Simulator for Evaluating and Training Force-based Laparoscopic Skills

Clemson University, Clemson SC

Investigators

Abstract

Laparoscopic surgery is a minimally invasive surgical technique wherein surgeons insert long tools through small incisions made in the abdomen and perform surgery via camera images relayed on a monitor. Due to its desirable advantages to patients, there is an enormous demand for medical students (residents) to learn this surgical technique. However, acquiring the skills needed for proficient laparoscopy is extremely challenging because of the surgeon's "remoteness" to the surgical site. Due to this, most surgical errors during laparoscopic procedures are caused by the application of excessive forces on tissues. This project focuses on a new method to train surgery residents to apply controlled forces via a novel surgical simulator for force-based (or haptic) laparoscopic skills. Based on perceptual task decomposition from previous studies, three surgical tasks were identified where applying precise and controlled forces was crucial for successful surgical outcomes: grasping tissue, probing tissue, and sweeping tissue. Three prototypical simulators were initially developed as a proof-of-concept and were later integrated into a single "Core Haptic Skills" simulator. Initial studies with experienced surgeons and novices have demonstrated the efficacy of the simulator in both evaluating and training haptic skills of users. According to a recent report, approximately 100,000 people die every year as a result of medical errors. Other studies show that a majority of surgical errors are caused due to misapplication of force. The technology presented here could significantly reduce patient morbidity and mortality caused due deficiencies in surgeons' skill. Surgical simulators also efficiently prepare novice surgeons for the operating room by equipping them with a certain level of skill competence. As a result, expensive operating room training time is minimized and training costs are significantly reduced. If training time in the operating room can be reduced, then the number of animals used in the first phases of training is also reduced. Beyond training, surgical simulators could be used for objective skill assessment and certification.