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Needs analysis for developing a virtual-reality NOTES simulator

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Abstract

Introduction and study aim

Natural orifice translumenal endoscopic surgery (NOTES) is an emerging surgical technique that requires a cautious adoption approach to ensure patient safety. High-fidelity virtual-reality-based simulators allow development of new surgical procedures and tools and train medical personnel without risk to human patients. As part of a project funded by the National Institutes of Health, we are developing the virtual transluminal endoscopic surgery trainer (VTEST™) for this purpose. The objective of this study is to conduct a structured needs analysis to identify the design parameters for such a virtual-reality-based simulator for NOTES.

Methods

A 30-point questionnaire was distributed at the 2011 National Orifice Surgery Consortium for Assessment and Research meeting to obtain responses from experts. Ordinal logistic regression and the Wilcoxon rank-sum test were used for analysis.

Results

A total of 22 NOTES experts participated in the study. Cholecystectomy (CE, 68 %) followed by appendectomy (AE, 63 %) (CE vs AE, p = 0.0521) was selected as the first choice for simulation. Flexible (FL, 47 %) and hybrid (HY, 47 %) approaches were equally favorable compared with rigid (RI, 6 %) with p < 0.001 for both FL versus RI and HY versus RI. The transvaginal approach was preferred 3 to 1 to the transgastric. Most participants preferred two-channel (2C) scopes (65 %) compared with single (1C) or three (3C) or more channels with p < 0.001 for both 2C versus 1C and 2C versus 3C. The importance of force feedback and the utility of a virtual NOTES simulator in training and testing new tools for NOTES were rated very high by the participants.

Conclusion

Our study reinforces the importance of developing a virtual NOTES simulator and clearly presents expert preferences. The results of this analysis will direct our initial development of the VTEST™ platform.

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Acknowledgments

This work was supported by NIBIB/NIH Grant #R01EB009362.

Disclosures

Dr. Kai Matthes: Endosim, LLC (ownership), Ovesco Endoscopy USA Inc. (consultation, equipment support), Olympus America Inc. (equipment support). Arun Nemani and Drs. Ganesh Sankaranarayanan, Woojin Ahn, Masayuki Kato, Daniel B. Jones, Steven Schwaitzberg, and Suvranu De have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Mechanical, Aerospace and Nuclear Engineering, Center for Modeling, Simulation and Imaging in Medicine (CeMSIM), Rensselaer Polytechnic Institute, 110, 8th Street, Troy, NY, 12180, USA

    Suvranu De

  2. Department of Anesthesiology, Perioperative and Pain Medicine, Children’s Hospital, Harvard Medical School, Boston, MA, USA

    Kai Matthes

  3. Department of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Masayuki Kato

  4. Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Daniel B. Jones

  5. Department of Surgery, Cambridge Health Alliance, Harvard Medical School, Boston, MA, USA

    Steven Schwaitzberg

  6. Center for Modeling, Simulation and Imaging in Medicine (CeMSIM), Rensselaer Polytechnic Institute, 110, 8th Street, Troy, NY, 12180, USA

    Ganesh Sankaranarayanan, Arun Nemani & Woojin Ahn

Authors
  1. Ganesh Sankaranarayanan
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  2. Kai Matthes
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  4. Woojin Ahn
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  6. Daniel B. Jones
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  7. Steven Schwaitzberg
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  8. Suvranu De
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Corresponding author

Correspondence to Suvranu De.

Additional information

Presented as a poster at the SAGES 2011 Conference.

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Sankaranarayanan, G., Matthes, K., Nemani, A. et al. Needs analysis for developing a virtual-reality NOTES simulator. Surg Endosc 27, 1607–1616 (2013). https://doi.org/10.1007/s00464-012-2637-1

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  • DOI: https://doi.org/10.1007/s00464-012-2637-1

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