WO2001088881A2 - Outils pour systeme endoscopique didactique - Google Patents

Outils pour systeme endoscopique didactique Download PDF

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Publication number
WO2001088881A2
WO2001088881A2 PCT/IL2001/000322 IL0100322W WO0188881A2 WO 2001088881 A2 WO2001088881 A2 WO 2001088881A2 IL 0100322 W IL0100322 W IL 0100322W WO 0188881 A2 WO0188881 A2 WO 0188881A2
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WIPO (PCT)
Prior art keywords
tool
cable
simulated
tool body
force
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Application number
PCT/IL2001/000322
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English (en)
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WO2001088881A3 (fr
Inventor
Edna Chosack
David Barkay
Ran Bronstein
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Simbionics Ltd.
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 Simbionics Ltd. filed Critical Simbionics Ltd.
Priority to AU48727/01A priority Critical patent/AU4872701A/en
Publication of WO2001088881A2 publication Critical patent/WO2001088881A2/fr
Publication of WO2001088881A3 publication Critical patent/WO2001088881A3/fr

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    • 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
    • G09B23/285—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine for injections, endoscopy, bronchoscopy, sigmoidscopy, insertion of contraceptive devices or enemas

Definitions

  • the present invention relates to tools for teaching and training students in medical procedures, and in particular to the use of such tools for training students in the procedure of endoscopy, in which the tools are able to simulate force feedback provided during the performance of the actual medical procedure on a living subject.
  • Endoscopy and in particular flexible gastro-endoscopy, are examples of minimally invasive medical procedures.
  • Flexible gastro-endoscopy is an important medical tool for both surgical and diagnostic procedures in the gastro-intestinal tract.
  • gastro-endoscopy is performed by inserting an endoscope, which is a flexible tube, into the gastro-intestinal tract, either through the mouth or the rectum of the subject.
  • the tube is manipulated by a trained physician through specialized controls.
  • the end of the tube which is inserted into the subject contains a camera and one or more surgical tools, such as a clipper for removing tissue samples from the gastro-intestinal tract.
  • the physician must maneuver the tube according to images of the gastro-intestinal tract received from the camera and displayed on a video screen.
  • Both devices include a mannequin in the shape of a human torso, with various points at which simulated surgical instruments are placed.
  • the devices are limited in that the positions of the simulated surgical instruments are predetermined, which is not a realistic scenario.
  • the visual feedback is based upon a stream of video images taken from actual surgical procedures.
  • such simple rendering of video images would result in inaccurate or unrealistic images as portions of the video data would need to be removed for greater processing speed.
  • the video processing would consume such massive amounts of computational time and resources that the entire system would fail to respond in a realistic time period to the actions of the student.
  • a dedicated graphics workstation would be required, rather than a personal computer (PC).
  • PC personal computer
  • U.S. Patent No. 4,907,973 discloses a device for simulating the medical procedure of flexible gastro-endoscopy.
  • the disclosed device also suffers from the deficiencies of the above-referenced background art devices, in that the visual feedback system is based upon rendering of video data taken from actual endoscopic procedures. As noted previously, displaying such data would either require massive computational resources, or else would simply require too much time for a realistic visual feedback response. Thus, the disclosed device also suffers from the deficiencies of the background art.
  • a truly useful and efficient medical simulation device for minimally invasive therapeutic procedures such as endoscopy would give real time, accurate and realistic visual feedback of the procedure, and would also give realistic tactile feedback, so that the visual and tactile systems would be accurately linked for the simulation as for an actual medical procedure.
  • such a device would enable the student to manipulate tools which may be required during the performance of the actual medical procedure.
  • tools for operation with such a simulation device are not currently taught or provided by the background art, nor is the device itself taught or provided in the background art.
  • the present invention features tools for use with a system for simulating the minimally invasive medical procedure of endoscopy, particularly of flexible gastro-endoscopy.
  • the tools support the close simulation of the actual medical procedure of endoscopy by simulating medical instruments in the context of providing tactile and visual feedback as the simulated procedure is performed on the simulated patient.
  • the present invention features a specific mechanism for providing force feedback on the tools for a more realistic and accurate operation thereof, as well as methods for correctly calculating the forces which should be applied to the tools through such a force feedback mechanism.
  • the inventors of the present invention have previously overcome the deficiencies of the background art, by providing a general simulation system, method and device, for enabling students to practice the medical procedure through an accurate, realistic simulation thereof, as disclosed in published PCT Application No.
  • a simulated medical tool for manipulation in a simulated organ by a user comprising: (a) a tool body; (b) a tool handle attached to the tool body for manipulation by the user; (c) a cable contained in the tool body; (d) a negative electrode attached to the cable; and (e) a positive electrode adjacent to the cable, the positive electrode being in electrical contact with the negative electrode without physically contacting the cable, such that an electrical circuit is formed for providing potentiometric resistance on the cable.
  • a system for simulating a medical procedure by a user comprising: (a) a simulated organ; (b) a simulated tool for entering into the simulated organ for performing the simulated medical procedure, the simulated tool comprising: (i) a tool body; (ii) a tool handle attached to the tool body for manipulation by the user; (iii) a cable contained in the tool body; (iv) a negative electrode attached to the cable; and (v) a positive electrode adjacent to the cable, the positive electrode being in electrical contact with the negative electrode without physically contacting the cable, such that an electrical circuit is formed for providing potentiometric resistance on the cable, an amount of the resistance being proportional to a distance traveled by the cable; and (c) a visual display for providing visual feedback according to the distance traveled by the cable in the simulated organ.
  • a simulated medical tool for manipulation in a simulated medical procedure by a user comprising: (a) a tool body; (b) a tool handle attached to the tool body for manipulation by the user; (c) an air-based force generating system for generating a force against the tool body to provide force feedback to the user, the air-based force generating system generating the force against the tool body according to air pressure to simulate the medical procedure.
  • the method of the present invention for preparing a model of the simulated organ, and for rendering the visual feedback of the simulated organ during the simulated medical procedure can be described as a plurality of instructions being performed by a data processor. As such, these instructions can be implemented in hardware, software or firmware, or a combination thereof. As software, the steps of the method of the present invention could be implemented in substantially any suitable programming language which could easily be selected by one of ordinary skill in the art, including but not limited to, C and C++.
  • simulated medical procedure refers to the simulation of the medical procedure as performed through the system and method of the present invention.
  • actual medical procedure refers to the performance of the medical procedure on an actual, living human patient with an actual endoscope, such that the medical procedure is "real” rather than "simulated”.
  • corresponding actual organ refers to the "real" organ of a human being or other mammal which is being simulated by the simulated organ of the present invention.
  • endoscopy includes, but is not limited to, the procedure of flexible gastro-endoscopy, as previously described, and medical diagnostic and surgical procedures in which an endoscope is inserted into the mouth or the rectum of the subject for manipulation within the gastro-intestinal tract of the subject.
  • subject refers to the human or lower mammal upon which the method and system of the present invention are performed or operated.
  • student refers to any human using the system of the present invention, being trained according to the present invention or being taught according to the present invention including, but not limited to, students attending medical school or a university, a medical doctor, a trained gastro-enterologist or other trained medical specialist.
  • FIG. 1 is an exemplary illustration of the system for medical simulation according to the present invention
  • FIG. 2 shows the visual processing and display system of Figure 1 in more detail
  • FIGS. 3 A and 3B are schematic block diagrams of the simulated biopsy device of the present invention
  • FIG. 4 is a cut-away side view of a preferred embodiment of the simulated biopsy device of Figures 3 A and 3B;
  • FIGS. 5A-5D are detailed views of portions of the device of Figure 4;
  • FIG. 6 is a schematic diagram of a cut-away view of an exemplary but preferred implementation of the force feedback mechanism for the tools according to the present invention.
  • the present invention features tools for use with a system for simulating the minimally invasive medical procedure of endoscopy, particularly of flexible gastro-endoscopy.
  • the tools support the close simulation of the actual medical procedure of endoscopy by simulating medical instruments in the context of providing tactile and visual feedback as the simulated procedure is performed on the simulated patient.
  • the tool of the present invention is described in the preferred exemplary embodiment of a simulated biopsy device, although clearly other tools could also be simulated.
  • the present invention is able to provide physical and visual feedback through the use of potentiometry, which involves an electrical current to generate resistance on the simulated tool.
  • potentiometric resistance is provided on a flexible, moving object, such as the flexible cable of the biopsy device, without attaching the entire electrical supply directly to the cable.
  • one electrode (shown below as the negative electrode) is attached directly to the cable, while the other electrode (shown below as the positive electrode) is attached indirectly, to a wire wrapped around the cable.
  • both electrodes are provided without directly attaching both to the flexible cable.
  • the present invention enables linear potentiometric resistance to be generated on the flexible cable of the simulated biopsy device, which is important both for accurately determining the resistance which is required, and for determining the distance which has been traveled by the flexible cable. The traveled distance is preferred for providing accurate visual feedback, in terms of the relative location of the simulated biopsy device within the simulated gastro-intestinal tract and/or endoscope of the present invention.
  • FIG. 1 depicts an exemplary, illustrative system for medical simulation for use with the tools according to the present invention.
  • a system 10 includes a mannequin 12 representing the subject on which the procedure is to be performed, a simulated endoscope 14 and a computer 16 with a video monitor 18.
  • a student 20 is shown interacting with system 10 by manipulating simulated endoscope 14 within mannequin 12.
  • Mannequin 12 includes a simulated organ into which simulated endoscope 14 is inserted. As student 20 manipulates simulated endoscope 14, tactile and visual feedback are determined according to the position of endoscope 14 within the simulated organ (not shown). The visual feedback are provided in the form of a display on video monitor 18. The necessary data calculations are performed by computer 16, so that realistic tactile and visual feedback are provided to student 20.
  • the system of Figure 1 provides a solution to a number of problems in the art of medical simulation, in particular for the simulation of the procedure of gastro-endoscopy.
  • This procedure involves the visual display of an interior portion of the gastrointestinal tract, such as the colon.
  • the colon is a flexible body with a curved structure.
  • the inner surface of the colon is generally deformable, as well as being specifically, locally deformable. All of these deformations in space must be calculated according to the mathematical model of the colon, and then rendered visually in real time in order to provide a realistic visual feedback response for the user.
  • FIG. 2 shows the visual processing and display system of Figure 1 in more detail.
  • a visual processing and display system 40 includes screen display 22 for displaying the processed visual data.
  • the visual data are constructed as follows. First, data are recorded from actual gastro-endoscopic procedures onto videotape, as shown in a recording block 42. The data are preferably stored on Super- HF videotape in order to obtain the highest quality representation of the visual images displayed on the screen during the actual endoscopic procedure, as shown in block 44. Next, at least a portion of the frames of the videotape, and preferably substantially all the frames, are abstracted individually by a frame-grabber 46 to form digitized images. Individual digitized images can then be selected for clarity and lack of artifacts such as reflections from the endoscopic apparatus itself. The images in the selected frames are then preferably enhanced and added to a texture mapping database 48.
  • the first type of texture mapping is intended to enhance the realistic visual aspects of the images, for example by removing visual artifacts.
  • the second type of texture mapping is intended to simulate the behavior of a live organ and a real endoscope, as represented by block 50.
  • the tissue of the colon moves somewhat, and the endoscope itself vibrates and wobbles. This movement is simulated visually by the addition of random animation of the images, and also by the addition of such effects as liquid flowing downward due to the influence of gravity.
  • Such animation enhances the realistic nature of the visual representation of the colon.
  • the images In order for the enhanced images to be correctly displayed, the images must correspond to the manipulation and location of the simulated endoscope within the simulated colon.
  • the texture mapping of the images should correspond to the location of the endoscope within the colon.
  • Such correspondence between the location of the endoscope within the colon and the texture mapping is provided by a texture mapping engine 52.
  • the texture mapping data is then readily accessed by the display portion of visual system 40, as shown by block 54.
  • visual processing and display system 40 includes a three-dimensional mathematical model of at least a portion of the gastro-intestinal tract 56.
  • model 56 is herein described as a three-dimensional model of the colon, it being understood that this is not meant to be limiting in any way.
  • Model 56 preferably features a plurality of segments 58, more preferably many such segments 58.
  • Locator 60 then instructs an object loader 62 to load the relevant segment 58 for access by visual system 40, as shown in block 54 and previously described.
  • segment optimizer 64 receives information from locator 60, as well as the series of images obtained from overlaying the texture mapping onto the relevant segment 58, and then feeds each specific image to a display manager 66 for display on screen display 22.
  • display manager 66 is assisted by a real-time viewer 68, preferably implemented in Direct 3DTM (Microsoft Corp., USA).
  • Real-time viewer 68 provides the necessary software support to communicate with a graphics card 70 for actual display of the images on screen display 22.
  • graphics card 70 can be of any suitable manufacture, preferably graphics card 70 has at least 8, and more preferably at least 16, Mb of VRAM for optimal performance.
  • An example of a suitable graphics card 70 is the 3Dfx Voodoo RushTM card.
  • the performance of real-time viewer 68 is enhanced by a math optimizer 72, preferably implemented in Visual C++.
  • segment optimizer 64 and display manager 66 on the one hand, and locator 60 on the other, is provided through a software interface 74, preferably implemented as a Direct Plug-inTM (Microsoft Corp, USA).
  • Software interface 74 enables locator 60 to communicate with the other components of visual system 40, in order to provide information regarding the location of the endoscope within the colon.
  • locator 60 includes a sensor 76, which can be obtained from Ascension Technology Corp., for example.
  • Sensor 76 senses positional information from within a simulated organ 77, which is described herein as a colon for the purposes of discussion and is not meant to be limiting.
  • Sensor 76 is controlled by a control unit 82.
  • the positional information is then relayed to a CPU controller 78, which is connected to a servo-motor 80 (Haydon Switch and Instrument Co.).
  • a servo-motor 80 Haydon Switch and Instrument Co.
  • Visual system 40 also includes a user interface 84, preferably implemented in Visual C++.
  • User interface 84 enables visual system 40 to interact with the preferred feature of a network interface 86, for example, so that other students can view screen display 22 over a network.
  • User interface 84 also permits the tutorial functions of at least one, and preferably a plurality of, tutorial modules 88 to be activated.
  • tutorial module 88 could include a particular scenario, such as a subject with colon cancer, so that different types of diagnostic and medical challenges could be presented to the student. The student would then need to respond correctly to the presented scenario.
  • Figures 3 A and 3B are schematic block diagrams of an exemplary tool, a simulated biopsy device, for use with the system of Figure 1 or another such system.
  • This biopsy device would simulate the actual biopsy device used to retrieve tissue samples from the gastro-intestinal tract during endoscopy.
  • the actual biopsy device is contained within the endoscope.
  • the biopsy device emerges from the tip of the endoscope, at which point it is visible on the display screen.
  • the jaws of the biopsy device are then opened and pushed onto the tissue.
  • the jaws are then closed, and the biopsy device retracted. The removal of the tissue causes pools of blood to appear as the remaining tissue bleeds.
  • the simulated biopsy device only appears on the display screen of the system of Figure 1 when the operator of the simulated endoscope causes the simulated biopsy device to emerge.
  • the jaws of the biopsy device are preferably rendered as animation, more preferably in relatively high resolution because the jaws are small, so that a high resolution would not prove unduly taxing for the computer.
  • the bleeding of the tissue and the resultant pools of blood are also be animated.
  • the simulated biopsy device of the present invention features a relatively minimal adaptation of an existing medical tool. These changes enable both tactile force feedback to be provided and the relative location of the simulated device within the simulated colon to be determined, thereby enabling both the physical and visual aspects of the medical procedure to be simulated.
  • Figure 3 A is a schematic block diagram of a simulated biopsy device 100 in a retracted position.
  • simulated biopsy device 100 features a tool body 102, to which a mobile handle 104 is attached.
  • the human operator moves mobile handle 104 in a lateral direction, such that mobile handle 104 is displaced.
  • the displacement of mobile handle 104 causes a flexible cable 106, to which mobile handle 104 is attached, to be moved.
  • the movement of flexible cable 106 in turn causes the position of a biopsy loop 108 to be displaced in the lateral direction.
  • the lateral displacement of biopsy loop 108 determines whether simulated biopsy device 100 is in the retracted position with regard to a simulated endoscope 110, as shown in Figure 3 A, or alternatively extended into simulated endoscope 110, as shown in Figure 3B.
  • biopsy loop 108 is extended into simulated endoscope 110. Suitable visual and tactile feedback must then be provided for the performance of the simulated biopsy procedure.
  • Simulated biopsy device 100 preferably provides such force feedback through potentiometry, which is the use of electrical current to generate and adjust physical resistance.
  • Potentiometry has a number of advantages over the use of mechanical components to provide such physical resistance, including the greater ability to adjust the resistance through potentiometry; the reduction in the number of mechanical moving parts which are required; and decreased physical wear on the simulated tool.
  • potentiometry is particularly preferred for providing tactile, force feedback for the simulated tool of the present invention.
  • potentiometric resistance is provided by passing an electrical current through simulated biopsy device 100.
  • the electrical current is supplied through an electrical supply 112, which is connected to flexible cable 106.
  • the amount of current is preferably adjusted in order to provide finely tuned physical feedback, by adjusting resistance on simulated biopsy device 100.
  • potentiometry has one drawback: it is extremely difficult to provide potentiometric resistance on a flexible, moving object, as potentiometry requires an electrical current to be passed through the object. There is no solution which is known in the background art for this problem
  • the simulated tool of the present invention solves this problem, as shown in Figure 4, by not directly attaching the entirety of electrical supply 112 to flexible cable 106. Instead, as shown in greater detail with regard to Figure 5A, only a negative electrode 114 is attached to flexible cable 106. Negative electrode 114 is held in place with a first screw 116 and a second screw 118, which hold a clamp 120 against flexible cable 106. The entire assembly is held within a tube 122.
  • a positive electrode 124 is shown in Figures 4 and 5B.
  • a pin 126 is held in place with a contactor 128. This assembly in held in place with screws 118. Electricity is passed through pin 126 to contactor 128, which does not contact flexible cable 106 directly. Instead, as shown with regard to Figure 5C, electricity is preferably passed indirectly, to a spiral wire 130 which is wrapped around flexible cable 106.
  • Spiral wire 130 is preferably made from a chrome-nickel alloy, and more preferably has a thickness of about 0.08 mm. In comparison, flexible cable 106 preferably has a thickness of about 1.1 mm. The relatively thinness of spiral wire 130 enables positive electrode 124 to be easily added to an existing medical device in order to form the simulated tool of the present invention.
  • Spiral wire 130 is preferably held against flexible cable 106 by tubing 132, which could be TeflonTM for example.
  • Positive electrode 124 and more particularly contactor 128, is preferably held in place within mobile handle 104 by a spring 134, as shown with regard to Figure 4.
  • biopsy loop 108 is preferably implemented as a straight cable 136.
  • Straight cable 136 is preferably contained within a guide 138, for attaching simulated biopsy device 100 to the simulated endoscope (not shown).
  • This assembly is preferably further held in place with a spring pad 140, and a clamp 142.
  • the present invention provides potentiometric resistance on a flexible, moving object, which had not been previously known in the background art.
  • the present invention has the advantage of providing such resistance in a linear manner, such that the amount of resistance is linear over the length of flexible cable 106.
  • the amount of resistance is optionally determined by receiving the analog electrical signal, and converting the signal to digital output. The digital output can then optionally be used with the computer of Figures 1 and 2, for example in order to determine the distance which has been traveled by flexible cable 106.
  • FIG. 6 is a schematic diagram of a cut-away view of an exemplary but preferred implementation of the force feedback mechanism for the tools according to the present invention.
  • the force feedback is provided through a mechanical device as shown, rather than through the generation of resistance through the application of an electric current. It is understood that some combination of both of these different types of force feedback systems could also optionally be used.
  • a simulated endoscope 200 features a tool port 210 for the insertion of a simulated tool 220.
  • simulated tool 220 is highly similar in appearance to the corresponding actual medical tool, optionally with the exception of some identifying marking on simulated tool 220 so as to prevent confusion.
  • Simulated tool 220 preferably features a cable 230 for insertion into simulated endoscope 200 through tool port 210. The student or other user then operates simulated tool 220 during the simulated medical procedure, for example according to visual feedback received through a video monitor (not shown).
  • Air-based force generating system 240 preferably features an air balloon 250 which presses against cable 230, such that the degree of inflation of air balloon 250 determines the amount of force which is applied against cable 230.
  • Air balloon 250 is in turn connected to an air-supply pipe 260 within simulated endoscope 200. Air-supply pipe 260 is then connected to a force-feedback air supply 270.
  • the degree of inflation of air balloon 250 is determined according to the amount of air supplied by force-feedback air supply 270.
  • force-feedback air supply 270 is more preferably controlled by a computational device 280, which operates an air supply control module 290.
  • Air supply control module 290 preferably calculates the required forces which should be applied to simulated tool 220 through air balloon 250, and then determines the amount of air which should be supplied to air balloon 250 from force-feedback air supply 270.
  • these forces may be described as having both an amount and a direction.
  • the forces themselves result from the requirement to simulate events during the simulation; for example, the "collision" of simulated tool 220 with an organ of the body of the subject (not shown). This collision does not need to occur, but any force(s) which would have been generated if the collision had occurred in the body of a living subject do need to be calculated.
  • each tool and each organ to be simulated need to be described according to a set of physical specifications, such as size, resiliency, and so forth.
  • the tissue of the organ would change geometrical shape, which would also affect the forces being generated.
  • the velocity and direction of tool movement need to be considered, in order to create a vector of forces generated by the tool itself.
  • forces generated on the tool, and by the tool are considered to be linear forces.
  • Such a simplification is still accurate when the actual tool features a long cable which must be inserted into the actual endoscope, as the length of the cable effectively renders the forces only as linear forces.
  • the procedure for calculating the force involved for the force feedback is preferably performed as follows, with regard to the illustrative, but non-limiting, example of a tool colliding with an organ.
  • the tool has a first velocity before the collision, and a second velocity after the collision.
  • the second velocity is preferably calculated according to a simulation model, and more preferably includes physical parameters of the tool and of the organ itself, such as resiliency for example.
  • the air pressure in air balloon 250 is then preferably adjusted, by increasing or decreasing the amount of air in air balloon 250, in order to create the correct amount of force as force feedback.
  • the calculation of the force is expanded to include a plurality of forces which should be generated against simulated tool 220.
  • a first force could optionally be the result of a collision between the tool and an organ, while the second force could optionally be the result of cutting a portion of another organ with this same tool.
  • These forces are more preferably all accurately represented in the simulation, and as such should more preferably be accurately applied to simulated tool 220. Therefore, these forces are preferably calculated for a specific tool with all organs in the simulation at any given point in time, and are then summed in order to determine the relative air pressure in air balloon 250, as shown with regard to the following equation:

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Abstract

La présente invention concerne un outil destiné à être utilisé avec un système permettant de simuler une intervention médicale endoscopique à effraction minimale, notamment une gastroscopie par endoscope souple. Ces outils favorisent une simulation dans des conditions proches des conditions réelles de l'intervention médicale endoscopique, en ce qu'ils simulent des instruments médicaux, tout en assurant une rétroaction tactile et visuelle, lorsque l'intervention simulée est réalisée sur le patient de simulation.
PCT/IL2001/000322 2000-05-19 2001-04-05 Outils pour systeme endoscopique didactique WO2001088881A2 (fr)

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AU48727/01A AU4872701A (en) 2000-05-19 2001-04-05 Tools for endoscopic tutorial system

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Cited By (6)

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WO2003058583A2 (fr) * 2002-01-08 2003-07-17 Keymed (Medical & Industrial Equipment) Ltd Instrument medical modele pour simulateur
JP2005514662A (ja) * 2002-01-08 2005-05-19 キーメッド（メディカル アンド インダストリアル イクイプメント） リミテッド シミュレータ内で使用するダミー医療機器
US6965370B2 (en) 2002-11-19 2005-11-15 Immersion Corporation Haptic feedback devices for simulating an orifice
US8206157B2 (en) 2004-09-21 2012-06-26 Keymed (Medical & Industrial Equipment) Limited Instrument for use in a medical simulator
US9711066B2 (en) 2009-08-18 2017-07-18 Airway Limited Endoscope simulator
US10810907B2 (en) 2016-12-19 2020-10-20 National Board Of Medical Examiners Medical training and performance assessment instruments, methods, and systems

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CN104537938B (zh) * 2014-12-21 2017-02-22 合肥德铭电子有限公司 一种具有柔和力反馈的内窥镜仿真训练系统

Citations (1)

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Publication number Priority date Publication date Assignee Title
WO1999038141A1 (fr) * 1998-01-26 1999-07-29 Simbionix Ltd. Systeme endoscopique didacticiel

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1999038141A1 (fr) * 1998-01-26 1999-07-29 Simbionix Ltd. Systeme endoscopique didacticiel

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2003058583A2 (fr) * 2002-01-08 2003-07-17 Keymed (Medical & Industrial Equipment) Ltd Instrument medical modele pour simulateur
WO2003058583A3 (fr) * 2002-01-08 2003-09-18 Keymed Medicals & Ind Equip Instrument medical modele pour simulateur
JP2005514662A (ja) * 2002-01-08 2005-05-19 キーメッド（メディカル アンド インダストリアル イクイプメント） リミテッド シミュレータ内で使用するダミー医療機器
JP4707953B2 (ja) * 2002-01-08 2011-06-22 キーメッド（メディカル アンド インダストリアル イクイプメント） リミテッド シミュレータ内で使用するダミー医療機器
US6965370B2 (en) 2002-11-19 2005-11-15 Immersion Corporation Haptic feedback devices for simulating an orifice
US7233315B2 (en) 2002-11-19 2007-06-19 Immersion Corporation Haptic feedback devices and methods for simulating an orifice
US8206157B2 (en) 2004-09-21 2012-06-26 Keymed (Medical & Industrial Equipment) Limited Instrument for use in a medical simulator
US9711066B2 (en) 2009-08-18 2017-07-18 Airway Limited Endoscope simulator
US11935429B2 (en) 2009-08-18 2024-03-19 Airway Limited Endoscope simulator
US10810907B2 (en) 2016-12-19 2020-10-20 National Board Of Medical Examiners Medical training and performance assessment instruments, methods, and systems

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