Effects of Real Time Feedback on Novice's Laparoscopic Learning Curve.

Objective: Analyze the learning curve of medical students when they are trained with a laparoscopic box trainer and are presented with different modes of real-time feedback on their performance in the laparoscopic suturing procedure.

Design: A prospective randomized controlled trial (RTC) was performed. Three groups were proposed: control, visual, and haptic.

Effect of three training programs on surgical performance in single-port laparoscopic surgery.

Objective: The aim of this study was to evaluate the effect of three training methodologies on the acquisition of psychomotor skills for laparoendoscopic single-site surgery (LESS), using straight and articulating instruments.

Methods: A prospective study was conducted with subjects randomly divided into three groups, who performed a specific training for 12 days using three laparoscopic tasks in a laparoscopic simulator. Group-A trained in conventional laparoscopy setting using straight instruments and in LESS setting using both straight and articulating instruments.

Image Guided Interpedicular Screw Placement Simulation System for Training and Skill Evaluation. Proof of Concept.

Background: The SpineST-01 system is an image-guided vertebrae cannulation training system. During task execution, the computer calculates performance-based metrics displaying different visual perspectives (lateral view, axial view, anteroposterior view) with the position of the instrument inside the vertebra. Finally, a report with the metrics is generated as performance feedback.

Novices' learning curve in single-port surgery using three surgical training programs.

Background: The objective of this study was to evaluate the novices' learning curves and proficiency level reached in laparoendoscopic single-site (LESS) surgery using three surgical training programs.

Material And Methods: Participants were randomly divided into three groups, who trained in a specific practice regimen for 12 days using a laparoscopic box simulator and three tasks. Group A trained in three stages using conventional laparoscopic surgery (CLS) with straight instruments, and LESS with straight and articulating instruments for four days each.

Objective Evaluation of Laparoscopic Experience Based on Muscle Electromyography and Accelerometry Performing Circular Pattern Cutting Tasks: A Pilot Study.

The aim of this work is to present a new physical laparoscopy simulator with an electromyography (EMG)/accelerometry-based muscle activity recording system, , and perform objective evaluation of laparoscopic skills based on the quantification of muscle activity of participants with different levels of laparoscopic experience. . EMG and ACC signals were obtained from 14 participants (6 experts, 8 medical students) performing circular pattern cutting tasks using a laparoscopic box trainer with the Trigno (Delsys Inc, Natick, MA) portable wireless system of 16 wireless sensors.

Objective psychomotor laparoscopic skills evaluation using a low-cost wearable device based on accelerometry: construct and concurrent validity study.

Background: Motion analysis of surgical maneuvers provides useful quantitative information for the objective evaluation of the surgeons. However, surgical simulation laboratories for laparoscopic training do not usually integrate devices that help quantify the level of skills of the surgeons due to their limited resources and the high costs of new technologies. The purpose of this study is to present the construct and concurrent validity of a low-cost motion tracking system, based on a wireless triaxial accelerometer, employed to objectively evaluate psychomotor skills of surgeons during laparoscopic training.

Face, content, and construct validity of the virtual immersive operating room simulator for training laparoscopic procedures.

Background: The aim of this work is to present the face, content, and construct validation of the virtual immersive operating room simulator (VIORS) for procedural training of surgeons' laparoscopic psychomotor skills and evaluate the immersive training experience.

Methods: The VIORS simulator consists of an HMD Oculus Rift 2016 with a visor on a 1080 × 1200 pixel OLED screen, two positioning sensors with two adapted controls to simulate laparoscopic instruments, and an acrylic base to simulate the conventional laparoscopic setup. The immersion consists of a 360° virtual operating room environment, based on the EndoSuite at Hospital Infantil de Mexico Federico Gomez, which reproduces a configuration of equipment, instruments, and common distractions in the operating room during a laparoscopic cholecystectomy procedure.

Protein Science Meets Artificial Intelligence: A Systematic Review and a Biochemical Meta-Analysis of an Inter-Field.

Proteins are some of the most fascinating and challenging molecules in the universe, and they pose a big challenge for artificial intelligence. The implementation of machine learning/AI in protein science gives rise to a world of knowledge adventures in the workhorse of the cell and proteome homeostasis, which are essential for making life possible. This opens up epistemic horizons thanks to a coupling of human tacit-explicit knowledge with machine learning power, the benefits of which are already tangible, such as important advances in protein structure prediction.

Needle path planning in semiautonomous and teleoperated robot-assisted epidural anaesthesia procedure: A proof of concept.

Background: Epidural anaesthesia is a Percutaneous Procedure (PP) which plays a crucial role in surgical procedures, where accurate needle insertion is still challenging. The objective of this work is to present a Tuohy needle path planning, which allows an anaesthesiologist to drive semiautonomously, with the assistance of a teleoperated robot, the tip of the needle during this PP.

Methods: We capture, analysed and modelled the anaesthetist hands' motion during the execution of this procedure, by synthetising, programing and simulating a parametrised and normalised kinematic constrains dependent on an insertion variable in a virtual robot.

Development of a 3D Motion Tracking System for the Analysis of Skills in Microsurgery.

Microsurgical skills of trainee surgeons have been subjectively evaluated due to the lack of technological tools. The objective of this investigation is to present the construct validity of the mitracks3D, which is a system designed to help in the objective evaluation of microsurgery trainees. To achieve this, a stereoscopic vision system records the 3D motion of two tweezers manipulated by surgeons during microsurgery training.

Steerable Surgical Instrument for Conventional and Single-Site Minimally Invasive Surgery.

This article aims to present an innovative design of a steerable surgical instrument for conventional and single-site minimally invasive surgery (MIS), which improves the dexterity and maneuverability of the surgeon while offering a solution to the limitations of current tools. The steerable MIS instrument consists of a deflection structure with a curved sliding joints design that articulates the distal tip in two additional degrees of freedom (DoFs), relative to the instrument shaft, using transmission by cables. A passive ball-joint mechanism articulates the handle relative to the instrument shaft, improves wrist posture, and prevents collision of instrument handles during single-site MIS procedures.

Integration of Comprehensive Metrics into the PsT1 Neuroendoscopic Training System.

Objective: Metric-based surgical training can be used to quantify the level and progression of neurosurgical performance to optimize and monitor training progress. Here we applied innovative metrics to a physical neurosurgery trainer to explore whether these metrics differentiate between different levels of experience across different tasks.

Methods: Twenty-four participants (9 experts, 15 novices) performed 4 tasks (dissection, spatial adaptation, depth adaptation, and the A-B-A task) using the PsT1 training system.

Construct validity of the SurgForce system for objective assessment of laparoscopic suturing skills.

Background: Laparoscopic surgery requires a new set of skill to be learned by the surgeons, of which the most relevant is tissue manipulation. Excessive forces applied to the tissue can cause rupture during manipulation or ischemia when confronting both sides of the tissue. The aim of this study is to establish the construct validity of the SurgForce system for objective assessment of advanced laparoscopic skills, based on the force signal generated during suture tasks, and the development of force parameters for evaluating tissue handling interaction.

Development and Preliminary Validation of a Rabbit Model of Duodenal Atresia for Training in Pediatric Surgical Skills.

Duodenal atresia is a congenital defect that requires advanced surgical skills. The objective of this study is to present an anatomical defect of duodenal atresia using a rabbit model and evaluate the preliminary experience for the training of surgical skills with pediatric surgeons. Adult white New Zealand male rabbits weighing 3.

Orthogonal cameras system for tracking of laparoscopic instruments in training environments.

Introduction: Motion analysis is a valuable tool for assessment of psychomotor skills in laparoscopy. Nonetheless, it requires technologies for tracking the activity of the laparoscopic instruments during training. This paper presents a sensor-free system to track the movements of laparoscopic instruments based on an orthogonal camera system and video image processing.

Development of a Laparoscopic Box Trainer Based on Open Source Hardware and Artificial Intelligence for Objective Assessment of Surgical Psychomotor Skills.

Background: A trainer for online laparoscopic surgical skills assessment based on the performance of experts and nonexperts is presented. The system uses computer vision, augmented reality, and artificial intelligence algorithms, implemented into a Raspberry Pi board with Python programming language.

Methods: Two training tasks were evaluated by the laparoscopic system: transferring and pattern cutting.

Pediatric inguinal hernia repair with a single-incision approach using an Endo Close™ suturing device.

Background: Diverse techniques have been described for pediatric inguinal hernia repair, based on extraperitoneal [1-4] and intraperitoneal [5-8] methodologies. In this video, we describe a novel technique to repair pediatric inguinal hernia using an Endo Close™ suturing device by percutaneous puncture with a single incision.

Methods: With a transumbilical approach, a 5-mm trocar is inserted for a 30° laparoscope.

Construct validity of a video-tracking system based on orthogonal cameras approach for objective assessment of laparoscopic skills.

Purpose: This study was aimed to establish the construct validity of a video-tracking system based on orthogonal cameras approach for assessment of laparoscopic psychomotor skills in training environments.

Methods: The camera-tracking system consists of two webcams placed in orthogonal configuration at a distance of 13.5 cm.