Design and Evaluation of a Portable Laparoscopic Training System Using Virtual Reality

Abstract

The ubiquitous nature of laparoscopic surgery and the decreased training time available for surgeons are driving an increased need for effective training systems to help surgeons learn different procedures. A cost-effective and user-friendly simulator has been designed to imitate specific training tasks for laparoscopic surgery in virtual environments via image processing and computer vision. The capability of using various actual surgical instruments suited for these specific procedures gives heightened fidelity to the simulator. Image processing via matlab software provides real-time mapping of the graspers in the workspace to the virtual reality (VR) environment (vizard software). Two different tasks (peg transfer and needle passing) were designed to evaluate trainees and compare their performance with characteristics of expert surgeons. Pilot testing of the system was carried out with 11 subjects to validate the similarity of this device with an existing surgical box trainer. Task completion time and muscle activity have been used as metrics for evaluation. The decrease in completion time for all subjects suggests similarity of skills transfer for both simulators. In addition, the p-value of muscle activity showed no significant differences for most muscles in the peg transfer task when using either the VR or physical analog environment and no significant differences for about half of the muscles in the needle passing task. Based on the results, the new proposed VR simulator appears to be a viable alternative to help trainees gain laparoscopic skills.