EP2401713A2 - Procédé et appareil pour la formation chirurgicale - Google Patents

Procédé et appareil pour la formation chirurgicale

Info

Publication number
EP2401713A2
EP2401713A2 EP10709575A EP10709575A EP2401713A2 EP 2401713 A2 EP2401713 A2 EP 2401713A2 EP 10709575 A EP10709575 A EP 10709575A EP 10709575 A EP10709575 A EP 10709575A EP 2401713 A2 EP2401713 A2 EP 2401713A2
Authority
EP
European Patent Office
Prior art keywords
further step
simulation
anatomical
previous
surgical
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
EP10709575A
Other languages
German (de)
English (en)
Inventor
Paolo Fiorini
Debora Botturi
Davide Zerbato
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Surgica Robotica SpA
Original Assignee
Surgica Robotica SpA
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Surgica Robotica SpA filed Critical Surgica Robotica SpA
Publication of EP2401713A2 publication Critical patent/EP2401713A2/fr
Ceased legal-status Critical Current

Links

Classifications

    • G—PHYSICS
    • G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
    • G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
    • G09B23/30—Anatomical models

Definitions

  • the present invention relates to a method and an apparatus for surgical training.
  • patent US 5,791,907 illustrates an interactive device for medical training, comprising a processing unit provided with a visualisation unit or display, wherein the processing unit is programmed for teaching medical procedures and training medical staff.
  • Patent US 5,454,722 illustrates in its turn an interactive system provided with processor for training to surgical procedures from remote positions.
  • the system uses visual, sound and textual databases, to train students to surgical procedures, using a system based on personal computer provided with graphical and multimedia resources.
  • simulator devices that can be used for didactic and training scopes, also for robotic surgery, namely devices suitable to provide the user with a greater perception of the involved surgical procedure. Practically, such devices prearrange a simulation environment able to reproduce in a likely way both the tactile and visual reactions perceived while carrying out a particular procedure or the use of a particular surgical instrument. Therefore the user is called to make decisions in response to specific stimuli that are reproduced each time by the simulator at both the tactile and visual levels.
  • patent US 5,828,813 illustrates a force feedback input device, with six degrees of freedom, comprising an articulated arm, a wrist and a base provided with encoders and motor members.
  • the input device functions as a master manipulator of microsurgical teleoperation robot system, comprising a slave manipulator coupled to an amplifier chassis, which is coupled to a control chassis connected to a workstation provided with a graphical interface.
  • the amplifier chassis is coupled to the motor members of the master manipulator, while the control chassis is connected to the encoders of the master robot manipulator.
  • a force feedback can be applied to the input device and can be generated by the slave robot in a way as to allow the user to operate the slave robot through the input device without physically viewing the slave robot.
  • the force feedback can be generated by the workstation to represent fictitious forces to constrain the control of the slave robot to be within imaginary predetermined boundaries.
  • the known simulators have considerable drawbacks.
  • such devices are generally made of very voluminous apparatuses, therefore expensive and difficult to transport.
  • Moreover such devices can be used by one user at a time, further weighing on the training costs.
  • the known simulators do not allow to provide the correct tactile perception of the anatomical tissues involved in the simulation.
  • the task of the present invention is that of solving the aforementioned problems, devising a method and an apparatus for surgical training that allow to carry out in an efficient way the training of medical staff for any type of surgical procedure, in particular for both the minimally invasive surgeries and for computer aided and robot type procedures.
  • Another object of the present invention is that of providing an apparatus having a simple conception, a securely reliable functioning and versatile use, as well as relatively economic cost.
  • figure 1 shows a schematic perspective view of the training apparatus in hand
  • figure 2 shows a perspective view of a further embodiment of the apparatus according to the invention.
  • figure 3 shows a flow diagram indicating the operative steps of the training method according to the invention. Best Mode
  • the apparatus for surgical training is indicated in its entirety with 1.
  • the apparatus 1 is mainly constituted by a hardware component and a software component.
  • the hardware component which is schematically represented in fig. 1, comprises a processing unit 2, connected to a couple of force feedback control means 3, to at least a monitor 4 and to at least an alphanumeric keyboard 5.
  • Control means 3 are preferably constituted of joysticks of the force feedback type, that is suitable to enable the user to perceive forces due to the contact of the instruments with the virtual anatomy of the patient.
  • joysticks 3 are of the type specifically illustrated by patent US 5,828,813, that is constituted by respective robotized arms comprising a plurality of articulation points, for example in correspondence of the wrist and the elbow.
  • joysticks 3a of simpler construction see fig. 2
  • with one only articulation in any case of the force feedback type, can be provided.
  • Joysticks 3, 3a have preferably seven degrees of freedom for the force feedback, six of which are suitable to represent the forces and the torques generated by the anatomical simulations, while the remaining degree of freedom represents the operation of the chosen virtual surgical instrument, as better described in the following.
  • the monitor 4 is suitable to provide the user with a preferably stereo vision of the virtual anatomy of the patient while carrying out the selected surgical intervention.
  • the keyboard 5 enables the user to insert textual information in relation with the procedure decisions object of the study or simply to note observations.
  • the apparatus 1 preferably comprises auricular and vocal interaction means, for example microphones, not represented in the figures for simplicity, suitable to enable the user to simulate the verbal interaction inside the operating room.
  • the training apparatus shapes a training console 10 that provides for a seat 6 between the joysticks 3a, for housing a portable processing unit of the known type, not represented.
  • the console 10 thus turns out to be easily transportable, further than very versatile, as it requires the only availability of a portable PC.
  • the software component installable in the processing unit 2 of the apparatus 1 or im- plementable on a portable PC to be inserted in the seat 6 of the console 10, comprises an interface suitable to provide the user with the execution of a series of operative steps of preparation to the simulation.
  • the interface enables the access to the simulation, the choice of the type of surgical procedure to be simulated, the selection of the level of support required during the simulation as well as the end feedback and valuation level.
  • the software component also comprises a database containing real anatomical data of a plurality of patients.
  • the database can illustrate the model of the anatomy of the patient, but also films of specific procedures carried out on the model.
  • the software component further comprises an anatomical viewer suitable to provide a graphical model of the anatomical area of interest, integrated with direct images of the involved organs.
  • the apparatus comprises a video viewer suitable to show, as a film, the surgical procedure effectively followed by the user, partially or entirely.
  • the software component can further provide a database of textual information related to various procedures, preferably enriched with animations and pictures to which the user can access to examine specific aspects of the procedure more in detail.
  • the software component comprises a simulator module suitable to enable the user in training phase to perform the selected intervention or the surgical procedure on a physical model of the patient's anatomy. More precisely, the simulator module enables to process and integrate to the graphical simulation, the real data of the patient obtainable from the medical instrumentation, as for example those obtained through CAT (Computer Axial Tomography) or MRI (Magnetic Resonance Imaging). Transformation of the evidences of medical report is made through a segmentation process which returns a tridimensional picture, thus provided with volumes. To such a segmented picture are then assigned physical properties, as in particular mass, elasticity and viscosity of the organic tissues, in a way as to obtain a biomechanical tridimensional model of the anatomical area of interest.
  • CAT Computer Axial Tomography
  • MRI Magnetic Resonance Imaging
  • Assignment of the physical properties enables to simulate, as better described in the following, a realistic interaction of the virtual surgical instruments with the simulated anatomical area. More precisely, such an interaction enables to simulate the interaction forces between the surgical instruments selected by the user and the simulated organs, with a rendering rate of the order of 1 kHz. The greater is the rendering rate of the dynamic interaction, the less perceptible by the user is the delay between the virtual interaction and the return of the tactile sensations through the joysticks 3, 3a as better described in the following (see fig. 3).
  • a viewer module able to allow the access to one or more virtual cameras.
  • the virtual cameras are suitable to enable the user to view the anatomical area of interest from the desired angle.
  • a module enables to view, according to the choice of the user, the visible parts, or the inaccessible areas, through activation of further artificial cameras.
  • a logout and playback module is also prearranged, in order to enable the registration in chronological sequence of the actions performed by the user, of the positions and the forces applied by the used tools, and suitable to play back, immediately or at the end of the procedure, the actions performed by the user.
  • the software component is further provided with a random event generation module, suitable to simulate the onset of unexpected events in the course of the intervention.
  • the software component can further comprise a warning module, suitable to alert the user in the case of possible dangerous situations or to suggest alternate intervention approaches.
  • One or more mirror modules are prearranged to enable one or more teachers to supervise the procedure carried out by the student, to intervene through corrections and warnings, and in the end to evaluate the level of preparation and training.
  • a specific evaluation module can be prearranged in order to evaluate the quality of the procedural choices performed by the student during the simulated intervention.
  • the processing unit 2 provides textual and graphical information related to the procedure, shows a movie of the procedure actually performed, as well as a simulation of the procedure in the simulation, to enable the user to browse forward or backward the operative step of interest and to view the intervention from different viewpoints.
  • the processing unit 2 shows every available textual data in relation with the patient, in suitable medical format.
  • the same unit 2 further shows the pre-operative data, in a way as to enable the user to formulate a diagnosis and to decide an intervention execution plan.
  • the user can acquire initial instructions for the correct setting of the robot peripheral or of the laparoscopic instruments suitable for the execution of the intervention.
  • the software component is able to show the simulation of an anatomical environment, according to the selected modalities and to the data inserted by the user, such as for example the positioning of the cameras, the typology, number and access point of the instruments.
  • force feedback joysticks 3, 3a can be selectively connected to respective surgical instruments showed by the processing unit 2, suitable to virtually interact with the simulated anatomical environment.
  • the processing unit 2 activates the physical simulation of the anatomical environment wherein the selected surgical instruments are suitable to operate through the manipulation of the joysticks 3, 3a.
  • the processing unit 2 in the meanwhile, records in chronological sequence every action, moving, typing on the keyboard 5, interaction with the simulation environment, to be able to play back in the following any step of the intervention.
  • the software component processes and produces through the hardware component suitable sound, visual or tactile signals, suitable to guide the user during the training, bearing to his mind possible errors and divergences with respect to an optimal procedure.
  • suitable sound, visual or tactile signals suitable to guide the user during the training, bearing to his mind possible errors and divergences with respect to an optimal procedure.
  • the enabling of such signals, as well as the choice between the available warning typologies, can be performed as a function of the learning grade of the user, selected in the preparation step previously described.
  • the method and the apparatus for surgical training therefore allow to attain the scope of carrying out in an efficient way the training of the medical staff for any type of surgical procedure, in particular for both the minimally invasive surgical procedures and the processor assisted and robotic type procedures.
  • a characteristic of the proposed method consists of the fact of integrating textual, multimedia and tactile type information, so as to process a physical anatomical model on which the user is able to simulate various surgical procedures according to his choice.
  • the user is able to operate on a realistic model provided with as much realistic physical properties and therefore to perceive during the simulation of the intervention the same tactile and dynamical sensations he would perceive in the real operating execution.
  • This characteristic ensures an effective learning of the surgical procedure by the user.
  • a further advantageous aspect of the proposed methods consists in the fact that it enables the user to be guided by the processing unit, so as to learn the best modality and, in the same time, to know the risks of the unadvised choices for carrying out the intervention.
  • the warning module in fact, is able to process the best path for the selected surgical procedure, alerting the user in useful time to make suitable decisions.
  • An advantage of the described training method is given by the fact that it provides the possibility of evaluating the skill level of the user, on the diagnosis capacities, the undertaken actions and the effective carrying out of the surgical simulation.
  • the apparatus for surgical training according to the invention can be connected to a master station managed by the teacher, who can intervene in the simulation of the student, any time he considers it necessary, simply using respective joysticks 3, 3a.
  • the apparatus enables to realize a kind of virtual surgery laboratory, wherein a plurality of processing units 2 are connected to a same master processing unit, in a way as to allow the simultaneous connection of an entire class of students in learning phase, coordinated and supervised by one or more teachers.
  • An advantage of the apparatus in hand consists of the possibility of continuously making the simulated anatomical model up-to-date with data updated with respect to the real anatomy of the patient, simply reiterating the process of transformation of the clinical data previously described (fig. 3). In such a way the method is able to generate always new learning sessions about the same surgical procedure.
  • the training apparatus can be simply constituted by connecting the console 10 comprising the joysticks 3a with a portable computer of common use, wherein the pre-chosen modules of the formerly illustrated software component have been previously installed.
  • the learning method can thus be realized substantially everywhere, simply transporting the console 10 in the desired place, with extreme ease of use.
  • the evaluation module that can be implemented in the apparatus, able to evaluate the user, based on the instructions sent by means of the control joysticks as well as the times for responding to the stimulus generated from time to time by the random event generation module, turns out to be very efficient.

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  • Engineering & Computer Science (AREA)
  • Physics & Mathematics (AREA)
  • General Physics & Mathematics (AREA)
  • Mathematical Analysis (AREA)
  • Mathematical Physics (AREA)
  • Medicinal Chemistry (AREA)
  • General Health & Medical Sciences (AREA)
  • Algebra (AREA)
  • Computational Mathematics (AREA)
  • Chemical & Material Sciences (AREA)
  • Health & Medical Sciences (AREA)
  • Mathematical Optimization (AREA)
  • Medical Informatics (AREA)
  • Pure & Applied Mathematics (AREA)
  • Business, Economics & Management (AREA)
  • Educational Administration (AREA)
  • Educational Technology (AREA)
  • Theoretical Computer Science (AREA)
  • Instructional Devices (AREA)
  • Image Analysis (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)

Abstract

L'invention concerne un procédé et un appareil pour la formation chirurgicale. Le procédé de formation chirurgicale comprend les étapes d'introduction dans une unité de traitement(2) de données cliniques obtenues par une ou plusieurs images détectées par une instrumentation médicale appropriée ; le traitement des données cliniques de manière à obtenir par un procédé de segmentation un modèle anatomique tridimensionnel ; l'attribution au modèle anatomique tridimensionnel de propriétés biomécaniques respectives de manière à obtenir un modèle virtuel physique ; le pré-agencement d'instruments chirurgicaux virtuels et de moyens de contrôle des retours de force respectifs, appropriés pour simuler et refléter la perception tactile d'une interaction physique entre les instruments chirurgicaux virtuels et le modèle anatomique physique ; la simulation par l'utilisation des moyens de contrôle de procédures d'exploration et/ou de procédures chirurgicales sur le modèle anatomique physique au moyen des instruments chirurgicaux virtuels.
EP10709575A 2009-02-26 2010-02-25 Procédé et appareil pour la formation chirurgicale Ceased EP2401713A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ITBO2009A000111A IT1392871B1 (it) 2009-02-26 2009-02-26 Metodo e apparato di addestramento chirurgico
PCT/IB2010/050824 WO2010097771A2 (fr) 2009-02-26 2010-02-25 Procédé et appareil pour la formation chirurgicale

Publications (1)

Publication Number Publication Date
EP2401713A2 true EP2401713A2 (fr) 2012-01-04

Family

ID=42104533

Family Applications (1)

Application Number Title Priority Date Filing Date
EP10709575A Ceased EP2401713A2 (fr) 2009-02-26 2010-02-25 Procédé et appareil pour la formation chirurgicale

Country Status (3)

Country Link
EP (1) EP2401713A2 (fr)
IT (1) IT1392871B1 (fr)
WO (1) WO2010097771A2 (fr)

Families Citing this family (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9773347B2 (en) 2011-11-08 2017-09-26 Koninklijke Philips N.V. Interacting with a three-dimensional object dataset
EP3414753A4 (fr) * 2015-12-07 2019-11-27 M.S.T. Medical Surgery Technologies Ltd. Système autonome d'évaluation et de formation basé sur des objectifs destiné à la chirurgie laparoscopique
CN107767719A (zh) * 2016-08-17 2018-03-06 天津博诺智创机器人技术有限公司 一种工业机器人模拟训练机
WO2018118858A1 (fr) 2016-12-19 2018-06-28 National Board Of Medical Examiners Instruments, procédés et systèmes d'apprentissage médical et d'évaluation de performance
CN109509555A (zh) * 2018-11-26 2019-03-22 刘伟民 一种基于三维影像的外科手术预演评估方法以及系统
CN117130489A (zh) * 2023-10-25 2023-11-28 苏州阿基米德网络科技有限公司 一种基于vr的医疗设备培训方法、电子设备及存储介质

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US5255211A (en) * 1990-02-22 1993-10-19 Redmond Productions, Inc. Methods and apparatus for generating and processing synthetic and absolute real time environments
US5454722A (en) 1993-11-12 1995-10-03 Project Orbis International, Inc. Interactive multimedia eye surgery training apparatus and method
US5828813A (en) 1995-09-07 1998-10-27 California Institute Of Technology Six axis force feedback input device
US5791907A (en) 1996-03-08 1998-08-11 Ramshaw; Bruce J. Interactive medical training system
CA2296274A1 (fr) * 1998-05-13 1999-11-18 Acuscape International, Inc. Procede pour generer des modeles en 3d a partir d'images medicales
AU2001275308A1 (en) * 2000-06-06 2001-12-17 Frauenhofer Institut Fuer Graphische Datenverarbeitung The extended virtual table: an optical extension for table-like projection systems
CA2484586C (fr) * 2002-05-10 2011-06-14 Haptica Limited Simulateur d'entrainement chirurgical
US7376903B2 (en) * 2004-06-29 2008-05-20 Ge Medical Systems Information Technologies 3D display system and method
EP2067131A4 (fr) 2005-08-29 2010-07-07 Go Virtual Medical Ltd Systeme d'enseignement medical
WO2009005901A2 (fr) * 2007-05-18 2009-01-08 The Uab Research Foundation Systèmes et procédés de présence interactive virtuelle

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Title
See references of WO2010097771A2 *

Also Published As

Publication number Publication date
WO2010097771A3 (fr) 2010-11-25
ITBO20090111A1 (it) 2010-08-27
IT1392871B1 (it) 2012-04-02
WO2010097771A2 (fr) 2010-09-02

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