Design of a New Instrumented Forceps: Application to Safe Obstetrical Forceps Blade Placement

Moreau, Richard; Pham, Minh Tu; Silveira, Ruimark; Redarce, Tanneguy; Brun, Xavier; Dupuis, Olivier

doi:10.1109/tbme.2006.889777

Cited by 25 publications

(22 citation statements)

References 20 publications

(16 reference statements)

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“…This manikin is instrumented with an electro-pneumatic component to simulate the dynamic process of a childbirth. A forceps has been 5854 31st Annual International Conference of the IEEE EMBSinstrumented with two (one in each blade) electromagnetic sensors with the ability to measure six degree of freedom [4]. With such instrumentation, it is possible to record forceps blade paths in order to analyze and compare them.…”

Section: A the Birthsim Simulator And Its Instrumented Forcepsmentioning

confidence: 99%

“…To avoid situations, which could be dramatic to the patients, several medical simulators have been developed over the last decades to offer an alternate training: simulator training. Some companies offer medical simulators to hospitals (Simulaids 1 , Laerdal 2 , Simulution 3 , Limbandthings 4 , Gaumard 5 , etc.). All these simulators provide an anthropomorphic interface, which allows doctors to find the same landmarks than in normal operative conditions.…”

Section: Introductionmentioning

confidence: 99%

“…For instance, simulators are now available for obstetricians [1]- [4], hysteroscopic procedures [5], otologic surgery [6], endoscopic surgery [7], anesthesiologists [8], palpatory diagnostics [9], suture/ligature training [10], physiotherapists [11] (this list is not exhaustive).…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of medical gestures based on a global performance index

Moreau

Ochoa

Pham

et al. 2009

2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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Abstract-This paper presents a method to evaluate medical gestures. The objective is to objectively assess a gesture carried out by novice doctors. The proposed method is based on the study of the curvature of the 3D gesture and provide a global performance index for one manipulation. The study of the number of peaks on the curvature indicates if the gesture is smooth or not. The application is the obstetric gestures linked to the forceps use but the method can be applied to different gestures without loss of generality. Seven residents carried out 30 forceps blade placements. The results clearly show a difference between the gestures carried out. This highlights the difficulty of the gesture according to the fetal head presentation.

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Section: A the Birthsim Simulator And Its Instrumented Forcepsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of medical gestures based on a global performance index

Moreau

Ochoa

Pham

et al. 2009

2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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“…Moreover, these simulators enable the practitioner to increase his experience due to the similarities between the anatomical representation given by plastic parts and reality. Some of these tools permit the simulation of instrumented deliveries using forceps [2]. For example, the Hopkins-designed birth simulator is oriented towards shoulder dystocia [3], [4] and the Noelle TM simulator marketed by Gaumard offers a complete robotized anthropomorphic system including fetal cardiac rhythm [5].…”

Section: Introductionmentioning

confidence: 99%

Biomechanical simulation of the fetal descent without imposed theoretical trajectory

Buttin

Zara

Shariat

et al. 2013

Computer Methods and Programs in Biomedicine

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Abstract-The medical training concerning childbirth for young obstetricians involves performing real deliveries, under supervision. This medical procedure becomes more complicated when instrumented deliveries requiring the use of forceps or suction cups become necessary. For this reason, the use of a versatile, configurable childbirth simulator, taking into account different anatomical and pathological cases, would provide an important benefit in the training of obstetricians, and improve medical procedures. The production of this type of simulator should be generally based on a computerized birth simulation, enabling the computation of the reproductive organs of the parturient woman and fetal interactions as well as the calculation of efforts produced during the second stage of labor. However, apart from the commercially available robotized dummy simulators, very few virtual training tools using computational technologies have been developed. Unfortunately, all of these simulators approximate the expulsive forces of childbirth by imposing a pre-computed fetal trajectory. They have rather limited possibilities and would be unlikely to meet the versatility requirements described above. Besides, much research work has been carried out to simulate precisely birth-induced pelvic floor dysfunction and organ prolapse, with damage to levator ani muscles. All these simulators perform a detailed modeling of the levator ani muscles in interaction with a rigid fetal head, at high computational cost. However, they do not take into consideration many pelvic organs involved in the process of childbirth.To reconcile the accuracy of results and computation time, we propose an approach that lies between the two classes of simulator described above in order to perform a realistic simulation of the descent of the fetus through the birth canal. In this paper we present the first stage of this work by focusing on the geometrical and biomechanical modeling of the main organs involved (i. e. the uterus, abdomen and pelvis of the parturient woman interacting with the fetus) based on the laws of continuum mechanics. At this stage, to verify the correctness of our hypothesis, we use finite element analysis, because of its reliability, precision and stability. In sum, our study improves work performed on childbirth simulators because:• our childbirth model takes into account all the major organs involved in birth process, thus enabling many childbirth scenarios to be considered, • fetal head is not treated as a rigid body and its motion is computed by taking into account realistic boundary conditions, i. e. we do not impose a pre-computed fetal trajectory, • we take into account the cyclic uterine contractions as well as voluntary efforts produced by the muscles of the abdomen, • a slight pressure is added inside the abdomen, representing the residual muscle tone.

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“…Finally this system can be used for operator evaluation, comparing junior and senior doctors' trajectories. Recent studies have demonstrated the value of simulation in obstetrics [19][20][21][22][23], in laparoscopic surgery [24,25], in endoscopic surgery [26,27], in orthopedic surgery [28] or in otologic surgery [29]. Studies are currently underway to evaluate the value of these new teaching techniques [30].…”

mentioning

confidence: 99%