A Virtual Reality Surgical Training System for Office Hysteroscopy with Haptic Feedback: A Feasibility Study

Abstract

Hysteroscopy is a widely used gynaecological procedure to evaluate and treat cervical and intra-uterine pathology. In the last few decades, technical refinements in the optics technology, surgical accessories and the reduction of the outer diameter of the instrument have made it possible to perform many hysteroscopic procedures, including some operative procedures, in the office setting and without any anesthesia. Mini-hysteroscopic procedures in the office setting are associated with less pain, lower complication rate and faster recovery compared hysteroscopic procedures in day surgery under general anesthesia. The main challenge for the clinician in performing office hysteroscopy is to pass the narrow cervical canal. Inaccurate motion or excessively applied force can lead to a cervical or uterine perforation. This study introduces a novel VR training platform for office hysteroscopy. The presented system was tested in the laboratory setting to prove the feasibility of using VR simulation for office hysteroscopy training. Conducted experiments demonstrated the potential of the system to transfer the essential skills and confirmed the set of proposed metrics for effective assessment.

An In-Office Hysteroscopy VR/Haptic Simulation Platform for Training in Spatial Navigation and Passage of the Cervical Canal

“…Execution time and trajectory length showed significant improvement, gradually decreasing in both mean and standard deviation for the novice and intermediate groups. These findings were somewhat expected, as previous studies in hysteroscopy training have also indicated positive change in these values [45] [46]. Another metric that showed great improvement over trials was the integral force.…”

“…Since the authors were not able to find any representation of this metric in the literature, it is too early to draw a direct link between this metric and a trainee's level of skills. At the moment, we can only outline the observed decreasing trend in this value, both in the presented study and our previous work [46]. Additional research is required to investigate the validity of this metric.…”