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Martins C, Ribas EC, Rhoton AL, Ribas GC. Three-dimensional digital projection in neurosurgical education: technical note. J Neurosurg 2015; 123:1077-80. [PMID: 25884261 DOI: 10.3171/2014.10.jns13542] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Three-dimensional images have become an important tool in teaching surgical anatomy, and its didactic power is enhanced when combined with 3D surgical images and videos. This paper describes the method used by the last author (G.C.R.) since 2002 to project 3D anatomical and surgical images using a computer source. Projecting 3D images requires the superposition of 2 similar but slightly different images of the same object. The set of images, one mimicking the view of the left eye and the other mimicking the view of the right eye, constitute the stereoscopic pair and can be processed using anaglyphic or horizontal-vertical polarization of light for individual use or presentation to larger audiences. Classically, 3D projection could be obtained by using a double set of slides, projected through 2 slide projectors, each of them equipped with complementary filters, shooting over a medium that keeps light polarized (a silver screen) and having the audience wear appropriate glasses. More recently, a digital method of 3D projection has been perfected. In this method, a personal computer is used as the source of the images, which are arranged in a Microsoft PowerPoint presentation. A beam splitter device is used to connect the computer source to 2 digital, portable projectors. Filters, a silver screen, and glasses are used, similar to the classic method. Among other advantages, this method brings flexibility to 3D presentations by allowing the combination of 3D anatomical and surgical still images and videos. It eliminates the need for using film and film developing, lowering the costs of the process. In using small, powerful digital projectors, this method substitutes for the previous technology, without incurring a loss of quality, and enhances portability.
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Affiliation(s)
- Carolina Martins
- Hospital Pelópidas Silveira-IMIP, Recife, Brazil;,Department of Neurosurgery, Gainesville, Florida
| | - Eduardo Carvalhal Ribas
- Department of Neurosurgery, Gainesville, Florida;,LIM-02 Department of Surgery, Hospital of Clinics, Universidade de São Paulo Medical School, São Paulo
| | | | - Guilherme Carvalhal Ribas
- LIM-02 Department of Surgery, Hospital of Clinics, Universidade de São Paulo Medical School, São Paulo;,Neurosurgery, Hospital Israelita Albert Einstein, São Paulo; and.,Microsurgery Lab, Hospital Beneficência Portuguesa, São Paulo, Brazil
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Deshpande SV. Innovation in robotic surgery: the Indian scenario. J Minim Access Surg 2015; 11:106-10. [PMID: 25598610 PMCID: PMC4290110 DOI: 10.4103/0972-9941.147724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 12/28/2014] [Indexed: 11/17/2022] Open
Abstract
Robotics is the science. In scientific words a “Robot” is an electromechanical arm device with a computer interface, a combination of electrical, mechanical, and computer engineering. It is a mechanical arm that performs tasks in Industries, space exploration, and science. One such idea was to make an automated arm — A robot — In laparoscopy to control the telescope-camera unit electromechanically and then with a computer interface using voice control. It took us 5 long years from 2004 to bring it to the level of obtaining a patent. That was the birth of the Swarup Robotic Arm (SWARM) which is the first and the only Indian contribution in the field of robotics in laparoscopy as a total voice controlled camera holding robotic arm developed without any support by industry or research institutes.
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Affiliation(s)
- Suresh V Deshpande
- Department of Surgery, Swarup Hospital, 154, Dudhali, Kolhapur, Maharashtra, India
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Moran ME. Towards Keeping the Hippocratic Oath (Six Sigma). Urolithiasis 2014. [PMID: 23748923 PMCID: PMC7120875 DOI: 10.1007/978-1-4614-8196-6_32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Panah A, Patel S, Bourdoumis A, Kachrilas S, Buchholz N, Masood J. Factors predicting success of emergency extracorporeal shockwave lithotripsy (eESWL) in ureteric calculi--a single centre experience from the United Kingdom (UK). Urolithiasis 2013; 41:437-41. [PMID: 23748923 PMCID: PMC7120875 DOI: 10.1007/s00240-013-0580-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 05/25/2013] [Indexed: 01/22/2023]
Abstract
Few studies show that "emergency extracorporeal shockwave lithotripsy (eESWL)" reduces the incidence of ureteroscopy in patients with ureteric calculi. We assess success of eESWL and look to study and identify factors which predict successful outcome. We retrospectively studied patients presenting with their first episode of ureteric colic undergoing eESWL (within 72 h of presentation) over a 5-year period. Patient's age, gender, stone size and location, time between presentation and ESWL, number of shock waves and ESWL sessions, and Hounsfield units (HU) were recorded. 97 patients (mean age 40 years; 76 males, 21 females) were included. 71 patients were stone free after eESWL (73.2 %) (group 1) and 26 patients failed treatment and proceeded to ureteroscopy (group 2). The two groups were well matched for age and gender. Mean stone size in group 1 and 2 was 6.4 mm and 7.7 mm, respectively, (p = 0.00141). Stone location was 34, 21, and 16 in upper, middle and lower ureter in group 1 compared to 11, 5, and 10 in group 2, respectively. Mean HU in group 1 was 480 and 612 in group 2 (p value 0.0036). In group 2, significantly, more patients received treatment after 24 h compared with group 1 (38 vs 22.5 %). The number of shock waves, maximal intensity, and ESWL sessions were not significantly different in the two groups. No complications were noted. eESWL is safe and effective in patients with ureteric colic. Stone size and Hounsfield units are important factors in predicting success. Early treatment (≤24 h) minimizes stone impaction and increases the success rate of ESWL.
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Affiliation(s)
- A Panah
- Endourology and Stone Services, Barts Health NHS Trust, London, UK
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Bhatia PD, Bottoni DA, Malthaner RA. Telesurgical evaluation of stable thoracic trauma patients: a feasibility study. Eur J Trauma Emerg Surg 2011; 37:297. [PMID: 26815111 DOI: 10.1007/s00068-011-0094-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Accepted: 03/04/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND We evaluated a robotic telesurgical platform in managing thoracic trauma in an animal model. STUDY DESIGN The da Vinci(®) robot was used to evaluate and treat a random number of blinded injuries in ten porcine thoraces. RESULTS Ninety-five percent of injuries were correctly identified. The median survey time was 20.5 min (range 16-63 min). The mean time to repair lung lacerations was 19.8 min (range 14-27.5 min) and to evacuate the hemothoraces, it was 5.3 min (range 4.5-6.5 min). Diaphragmatic lacerations required repositioning of the ports and the robot. Only two out of five lacerations were successfully repaired (mean time 38.8 min, range 32.5-45 min). All aortic injuries were correctly identified. One subject died of a pre-existing pneumonia. CONCLUSIONS A robotic telesurgical approach to the evaluation of stable thoracic trauma patients is safe and feasible in a porcine model. Diaphragmatic injuries can be repaired but require repositioning of the robot.
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Affiliation(s)
- P D Bhatia
- Division of Thoracic Surgery, London Health Sciences Centre, 800 Commissioners Rd. East, Suite E2-124, London, ON, N6A 5W9, Canada
| | - D A Bottoni
- Division of Thoracic Surgery, London Health Sciences Centre, 800 Commissioners Rd. East, Suite E2-124, London, ON, N6A 5W9, Canada
| | - R A Malthaner
- Division of Thoracic Surgery, London Health Sciences Centre, 800 Commissioners Rd. East, Suite E2-124, London, ON, N6A 5W9, Canada.
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Norcini J, Talati J. Assessment, surgeon, and society. Int J Surg 2009; 7:313-7. [PMID: 19573630 DOI: 10.1016/j.ijsu.2009.06.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2009] [Accepted: 06/23/2009] [Indexed: 10/20/2022]
Abstract
An increasing public demand to monitor and assure the quality of care provided by physicians and surgeons has been accompanied by a deepening appreciation within the profession of the demands of self-regulation and the need for accountability. To respond to these developments, the public and the profession have turned increasingly to assessment, both to establish initial competence and to ensure that it is maintained throughout a career. Fortunately, this comes at a time when there have been significant advances in the breadth and quality of the assessment tools available. This article provides an overview of the drivers of change in assessment which includes the educational outcomes movement, the development of technology, and advances in assessment. It then outlines the factors that are important in selecting assessment devices as well as a system for classifying the methods that are available. Finally, the drivers of change have spawned a number of trends in the assessment of competence as a surgeon. Three of them are of particular note, simulation, workplace-based assessment, and the assessment of new competences, and each is reviewed with a focus on its potential.
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Affiliation(s)
- John Norcini
- Foundation for Advancement of International Medical Education and Research, Philadelphia, PA 19104, USA.
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Gomoll AH, O'Toole RV, Czarnecki J, Warner JJP. Surgical experience correlates with performance on a virtual reality simulator for shoulder arthroscopy. Am J Sports Med 2007; 35:883-8. [PMID: 17261572 DOI: 10.1177/0363546506296521] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The traditional process of surgical education is being increasingly challenged by economic constraints and concerns about patient safety. Sophisticated computer-based devices have become available to simulate the surgical experience in a protected environment. As with any new educational tool, these devices have generated controversy about the validity of the training experience. HYPOTHESIS Performance on a virtual reality simulator correlates with actual surgical experience. STUDY DESIGN Controlled laboratory study. METHODS Forty-three test subjects of various experience levels in shoulder arthroscopy were tested on an arthroscopy simulator according to a standardized protocol. Subjects were evaluated for time to completion, distance traveled with the tip of the simulated probe compared with a computer-determined optimal distance, average probe velocity, and number of probe collisions with the tissues. RESULTS Subjects were grouped according to prior experience with shoulder arthroscopy. Comparing the least experienced with most experienced groups, the average time to completion decreased by 62% from 128.8 seconds to 49.2 seconds; path length and hook collisions were more than halved from 8.2 to 3.8 and 34.1 to 16.8, respectively; and average probe velocity more than doubled from 0.18 to 0.4 cm/second. There were no significant differences for any parameter tested between subjects with video game experience compared to those without. CONCLUSIONS The study demonstrated a close and statistically significant correlation between simulator results and surgical experience, thus confirming the hypothesis. Conversely, experience with video games was not associated with improved simulator performance. This indicates that the skill set tested may be similar to the one developed in the operating room, thus suggesting its use as a potential tool for future evaluation of surgical trainees. CLINICAL RELEVANCE The results have implications for the future of orthopaedic surgical training programs, the majority of which have not embraced virtual reality technology for physician education.
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Affiliation(s)
- Andreas H Gomoll
- Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02114, USA
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Hourmont K, Chung W, Pereira S, Wasielewski A, Davies R, Ballantyne GH. Robotic versus telerobotic laparoscopic cholecystectomy: duration of surgery and outcomes. Surg Clin North Am 2004; 83:1445-62. [PMID: 14712878 DOI: 10.1016/s0039-6109(03)00167-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
This study found that robotic and telerobotic operations were accomplished with the same mortality, morbidity, blood loss, length of operations and length of stay. The DaVinci operations required longer total operating room time than the AESOP operations. Telerobotic laparoscopic cholecystectomy achieved the same clinical outcomes as standard robotic laparoscopic cholecystectomy in this small trial. This study justifies further comparison of these techniques in a randomized prospective trial.
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Affiliation(s)
- Katherine Hourmont
- Minimally Invasive and Telerobotic Surgery Institute, Hackensack University Medical Center, 20 Prospect Avenue, Suite #901, Hackensack, NJ 07601, USA
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Ballantyne GH, Moll F. The da Vinci telerobotic surgical system: the virtual operative field and telepresence surgery. Surg Clin North Am 2004; 83:1293-304, vii. [PMID: 14712866 DOI: 10.1016/s0039-6109(03)00164-6] [Citation(s) in RCA: 146] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The United States Department of Defense developed the telepresence surgery concept to meet battlefield demands. The da Vinci telerobotic surgery system evolved from these efforts. In this article, the authors describe the components of the da Vinci system and explain how the surgeon sits at a computer console, views a three-dimensional virtual operative field, and performs the operation by controlling robotic arms that hold the stereoscopic video telescope and surgical instruments that simulate hand motions with seven degrees of freedom. The three-dimensional imaging and handlike motions of the system facilitate advanced minimally invasive thoracic, cardiac, and abdominal procedures. da Vinci has recently released a second generation of telerobots with four arms and will continue to meet the evolving challenges of surgery.
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Affiliation(s)
- Garth H Ballantyne
- Hackensack University, Medical Center, 20 Prospect Avenue, Hackensack, NJ 07601, USA.
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Abstract
The use of minimally invasive techniques (MIT) in patient care is well documented in ancient history; however, it was not until the 1990s that advancements in technology enabled surgeons to realize the true potential of this approach. The minimally invasive approach has revolutionized surgical care, significantly reducing postoperative pain, recovery time, and hospital stays with marked improvements in cosmetic outcome and overall cost-effectiveness. It is now used around the world and in all major fields of surgery, compelling changes in training programs in order to assure quality control and patient safety. The bond between surgeons practicing minimally invasive surgery (MIS) and the high-tech industry is of utmost importance to future developments. Surgical robotic systems represent the most technologically advanced product of this collaboration, and their potential application in MIS shows much promise. As technology advances, additional developments in MIT are likely.
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Affiliation(s)
- Sir Ara Darzi
- The Department of Surgical Oncology and Technology, Imperial College London, Praed Street, W2 1NY London, United Kingdom.
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Talamini MA, Chapman S, Horgan S, Melvin WS. A prospective analysis of 211 robotic-assisted surgical procedures. Surg Endosc 2003; 17:1521-4. [PMID: 12915974 DOI: 10.1007/s00464-002-8853-3] [Citation(s) in RCA: 172] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2003] [Accepted: 03/05/2003] [Indexed: 12/21/2022]
Abstract
BACKGROUND The Academic Robotics Group prospectively studied 211 robotically assisted operations to assess the safety and utility of robotically assisted surgery. METHODS All operations took place at one of four member institutions between June 2000 and June 2001 using the recently FDA-approved daVinci robotic system. A variety of procedures were undertaken, including antireflux surgery (69), cholecystectomy (36), Heller myotomy (26), bowel resection (17), donor nephrectomy (15), left internal mammery artery mobilization (14), gastric bypass (seven), splenectomy (seven), adrenalectomy (six), exploratory laparoscopy (three), pyloroplasty (four), gastrojejunostomy (two), distal pancreatectomy (one), duodenal polypectomy (one), esophagectomy (one), gastric mass resection (one), and lysis of adhesions (one). RESULTS Average operating room time was 188 min (range 45 to 387, SD = 83), surgical time 143 min (range 35 to 462, SD = 63), and robot time 90 min (range 12 to 235, SD = 47). Median length of stay was 1 day (range 0 to 37). There were 8 (4%) technical complications during procedures, five minor (four hook cautery dislodgement, one slipped robotic trocar) and three major (system malfunctions, two of which required conversion to standard laparoscopy). In all cases, technical problems caused only delay, without apparent altered outcome. There were medical/surgical complications in nine patients (4%). Six (3%) were considered major, including one death unrelated to the robotic procedure. CONCLUSIONS The results of robotic-assisted surgery compare favorably with those of conventional laparoscopy with respect to mortality, complications, and length of stay. Robotic-assisted surgery is safe and effective and is a new reality for American surgery. The role of these devices in surgery will expand as the technology evolves.
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Affiliation(s)
- M A Talamini
- Department of Surgery, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA.
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Webster JA, Edmiston TB, Rodning CB. Ensuring excellence and competence in surgery: The imperative of mentorship from historical and philosophical perspectives. ACTA ACUST UNITED AC 2002; 59:479-84. [PMID: 15727794 DOI: 10.1016/s0149-7944(02)00636-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE How can the surgical disciplines (1) attract and recruit students of the highest capabilities and ideals; (2) ensure professional competency; and (3) maximize efficacy and safety of biotechnology translated to patient care? METHODS Critique of the occidental humanistic literature. RESULTS The imperative of mentorship is grounded in the philosophical traditions of occidental society dating from antiquity. CONCLUSION This essay affirms that imperative in relationship to the surgical disciplines from an historical perspective.
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Affiliation(s)
- John A Webster
- Department of Surgery, College of Medicine, Medical Center, University of South Alabama, Mobile, Alabama, USA
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Holcomb JB, Dumire RD, Crommett JW, Stamateris CE, Fagert MA, Cleveland JA, Dorlac GR, Dorlac WC, Bonar JP, Hira K, Aoki N, Mattox KL. Evaluation of trauma team performance using an advanced human patient simulator for resuscitation training. THE JOURNAL OF TRAUMA 2002; 52:1078-85; discussion 1085-6. [PMID: 12045633 DOI: 10.1097/00005373-200206000-00009] [Citation(s) in RCA: 196] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Human patient simulation (HPS) has been used since 1969 for teaching purposes. Only recently has technology advanced to allow application to the complex field of trauma resuscitation. The purpose of our study was to validate an advanced HPS as an evaluation tool of trauma team resuscitation skills. METHODS The pilot study evaluated 10 three-person military resuscitation teams from community hospitals that participated in a 28-day rotation at a civilian trauma center. Each team consisted of physicians, nurses, and medics. Using the HPS, teams were evaluated on arrival and again on completion of the rotation. In addition, the 10 trauma teams were compared with 5 expert teams composed of experienced trauma surgeons and nurses. Two standardized trauma scenarios were used, representing a severely injured patient with multiple injuries and with an Injury Severity Score of 41 (probability of survival, 50%). Performance was measured using a unique human performance assessment tool that included five scored and eight timed tasks generally accepted as critical to the initial assessment and treatment of a trauma patient. Scored tasks included airway, breathing, circulation, and disability assessments as well as overall organizational skills and a total score. The nonparametric Wilcoxon test was used to compare the military teams' scores for scenarios 1 and 2, and the comparison of the military teams' final scores with the expert teams. A value of p < 0.05 was considered significant. RESULTS The 10 military teams demonstrated significant improvement in four of the five scored (p < or = 0.05) and six of the eight timed (p < or = 0.05) tasks during the final scenario. This improvement reflects the teams' cumulative didactic and clinical experience during the 28-day trauma refresher course as well as some degree of simulator familiarization. Improved final scores reflected efficient and coordinated team efforts. The military teams' initial scores were worse than the expert group in all categories, but their final scores were only lower than the expert groups in 2 of 13 measurements (p < or = 0.05). CONCLUSION No studies have validated the use of the HPS as an effective teaching or evaluation tool in the complex field of trauma resuscitation. These pilot data demonstrate the ability to evaluate trauma team performance in a reproducible fashion. In addition, we were able to document a significant improvement in team performance after a 28-day trauma refresher course, with scores approaching those of the expert teams.
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Affiliation(s)
- John B Holcomb
- Joint Trauma Training Center, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.
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Kirkpatrick AW, Simons RK, Brown R, Nicolaou S, Dulchavsky S. The hand-held FAST: experience with hand-held trauma sonography in a level-I urban trauma center. Injury 2002; 33:303-8. [PMID: 12091025 DOI: 10.1016/s0020-1383(02)00017-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
AIMS To describe the effectiveness of a portable hand-held ultrasound machine when used by clinicians in the early evaluation and resuscitation of trauma victims. METHODS The study was a prospective evaluation in a level-I urban trauma center. The focussed assessment with sonography for trauma is a specifically defined examination for free fluid known as the focused assessment with sonography for trauma (FAST) exam. Seventy-one patients had a hand-held FAST (HHFAST) examination performed with a Sonosite 180, 2.4 kg ultrasound machine. Sixty-seven examinations were immediately repeated with a Toshiba SSH 140A portable floor-based machine. This repeat scan (formal FAST or FFAST) was used as a comparison standard between the devices for study purposes. Four patients had a HHFAST only, all with positive result, two being taken for immediate laparotomy, and two having a follow-up computed tomographic (CT) scan. Patient follow-up from other imaging studies, operative intervention, and clinical outcomes were also compared to the performance of each device. RESULTS There were 58 victims of blunt, and 13 of penetrating abdominal trauma. One examination was indeterminate using both machines. The apparent HHFAST performance yielded; sensitivity, specificity, positive predictive value, negative predictable value, and accuracy (S, S, PPV, NPV, A) of 83, 100, 100, 98, 98%. Upon review, a CT scan finding and benign clinical course found the HHFAST diagnosis to be correct rather than the FFAST in one case. Considering the ultimate clinical course of the patients, yielded a (S, S, PPV, NPV, A) of 78, 100, 100, 97, and 97% for the HHFAST and 75, 98, 86, 97, and 96% for the FFAST. Statistically, there was no significant difference in the actual performance of the HHFAST compared to the FFAST in this clinical setting. DISCUSSION Hand-held portable sonography can simplify early and accurate performance of FAST exams in victims of abdominal trauma.
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Affiliation(s)
- Andrew W Kirkpatrick
- Department of Surgery, Vancouver Hospital and Health Sciences Center, Trauma Services, 3rd Floor, 855 West 10th Avenue, Vancouver, BC, Canada V5Z 1L7.
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Cosman PH, Cregan PC, Martin CJ, Cartmill JA. Virtual reality simulators: current status in acquisition and assessment of surgical skills. ANZ J Surg 2002; 72:30-4. [PMID: 11906421 DOI: 10.1046/j.1445-2197.2002.02293.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Medical technology is currently evolving so rapidly that its impact cannot be analysed. Robotics and telesurgery loom on the horizon, and the technology used to drive these advances has serendipitous side-effects for the education and training arena. The graphical and haptic interfaces used to provide remote feedback to the operator--by passing control to a computer--may be used to generate simulations of the operative environment that are useful for training candidates in surgical procedures. One additional advantage is that the metrics calculated inherently in the controlling software in order to run the simulation may be used to provide performance feedback to individual trainees and mentors. New interfaces will be required to undergo evaluation of the simulation fidelity before being deemed acceptable. The potential benefits fall into one of two general categories: those benefits related to skill acquisition, and those related to skill assessment. The educational value of the simulation will require assessment, and comparison to currently available methods of training in any given procedure. It is also necessary to determine--by repeated trials--whether a given simulation actually measures the performance parameters it purports to measure. This trains the spotlight on what constitutes good surgical skill, and how it is to be objectively measured. Early results suggest that virtual reality simulators have an important role to play in this aspect of surgical training.
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Affiliation(s)
- Peter H Cosman
- Division of Surgery, Nepean Hospital, Sydney, New South Wales, Australia.
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Literature watch. J Endourol 2001; 15:325-30. [PMID: 11339402 DOI: 10.1089/089277901750161971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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