Haptic Communication to Support Biopsy Procedures Learning in Virtual Environments

Chellali, Amine; Dumas, Cédric; Milleville-Pennel, Isabelle

doi:10.1162/pres_a_00128

Cited by 25 publications

(29 citation statements)

References 27 publications

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“…Moreover, the subjects rated the quality of the system’s force feedback low even though they acknowledged the usefulness of haptic feedback, suggesting that the displayed haptic feedback was not appropriate. In fact, haptic feedback has been shown to be an important component for laparoscopic skill training [12, 13, 14, 15, 16, 17]. The quality of the system’s haptic feedback may have altered the users’ performance in the peg transfer task.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, they permit unlimited training without the expense of consumables. They can also provide haptic feedback, which has already been shown to be an essential component of minimally invasive surgery simulations [12, 13, 14, 15, 16, 17]. VR-based simulators have already been shown to transfer effective technical skills to the operating room environment [16, 18, 19].…”

Section: Introductionmentioning

confidence: 99%

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Validation of the VBLaST peg transfer task: a first step toward an alternate training standard

et al. 2014

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Background The FLS trainer lacks objective and automated assessments of laparoscopic performance and requires a large supply of relatively expensive consumables. Virtual reality simulation has a great potential as a training and assessment tool of laparoscopic skills and can overcome some limitations of the FLS trainer. This study was carried out to assess the value of our Virtual Basic Laparoscopic Surgical Trainer (VBLaST©) in the peg transfer task compared to the FLS trainer and its ability to differentiate performance between novice, intermediate and expert groups. Methods Thirty subjects were divided into three groups: novices (PGY1-2, n = 10), intermediates (PGY3-4, n=10), and experts (PGY5, surgical fellows and attendings, n = 10). All subjects performed ten trials of the peg transfer task on each simulator. Assessment of laparoscopic performance was based on FLS scoring while a questionnaire was used for subjective evaluation. Results The performance scores in the two simulators were correlated, though subjects performed significantly better in the FLS trainer. Experts performed better than novices only on the FLS trainer while no significant differences were observed between the other groups. Moreover, a significant learning effect was found on both trainers, with a greater improvement of performance on the VBLaST©. Finally, 82.6% of the subjects preferred the FLS over the VBLaST© for surgical training which could be attributed to the novelty of the VR technology and existing deficiencies of the user interface for the VBLaST©. Conclusion This study demonstrated that the VBLaST© reproduced faithfully some aspects of the FLS peg transfer task (such as color, size and shape of the peg board, etc.) while other aspects require additional development. Future improvement of the user interface and haptic feedback will enhance the value of the system as an alternative to the FLS as the standard training tool for laparoscopic surgery skills.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Validation of the VBLaST peg transfer task: a first step toward an alternate training standard

et al. 2014

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“…They are based on three-dimensional computer generated images with which the user can interact through a physical interface. Previous research has shown that virtual task trainers can actually improve intraoperative skills in minimally invasive surgery similar to that of physical task trainers (Seymour, Gallagher, Roman, O’ Bri, Andersen, & Satava, 2002; Chellali, Dumas, & Milleville-Pennel, 2012; Ullrich & Kuhlen, 2012; Yiannakopoulou, Nikiteas, Perrea, & Tsigris, 2015). …”

Section: Related Workmentioning

confidence: 98%

Achieving interface and environment fidelity in the Virtual Basic Laparoscopic Surgical Trainer

Chellali

Mentis

Miller

et al. 2016

International Journal of Human-Computer Studies

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Virtual reality trainers are educational tools with great potential for laparoscopic surgery. They can provide basic skills training in a controlled environment and free of risks for patients. They can also offer objective performance assessment without the need for proctors. However, designing effective user interfaces that allow the acquisition of the appropriate technical skills on these systems remains a challenge. This paper aims to examine a process for achieving interface and environment fidelity during the development of the Virtual Basic Laparoscopic Surgical Trainer (VBLaST). Two iterations of the design process were conducted and evaluated. For that purpose, a total of 42 subjects participated in two experimental studies in which two versions of the VBLaST were compared to the accepted standard in the surgical community for training and assessing basic laparoscopic skills in North America, the FLS box-trainer. Participants performed 10 trials of the peg transfer task on each trainer. The assessment of task performance was based on the validated FLS scoring method. Moreover, a subjective evaluation questionnaire was used to assess the fidelity aspects of the VBLaST relative to the FLS trainer. Finally, a focus group session with expert surgeons was conducted as a comparative situated evaluation after the first design iteration. This session aimed to assess the fidelity aspects of the early VBLaST prototype as compared to the FLS trainer. The results indicate that user performance on the earlier version of the VBLaST resulting from the first design iteration was significantly lower than the performance on the standard FLS box-trainer. The comparative situated evaluation with domain experts permitted us to identify some issues related to the visual, haptic and interface fidelity on this early prototype. Results of the second experiment indicate that the performance on the second generation VBLaST was significantly improved as compared to the first generation and not significantly different from that of the standard FLS box-trainer. Furthermore, the subjects rated the fidelity features of the modified VBLaST version higher than the early version. These findings demonstrate the value of the comparative situated evaluation sessions entailing hands on reflection by domain experts to achieve the environment and interface fidelity and training objectives when designing a virtual reality laparoscopic trainer. This suggests that this method could be used successfully in the future to enhance the value of VR systems as an alternative to physical trainers for laparoscopic surgery skills. Some recommendations on how to use this method to achieve the environment and interface fidelity of a VR laparoscopic surgical trainer are identified.

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“…Virtual Reality (VR) technology provides a safe and versatile practice medium for teaching laparoscopic skills [10] and can overcome some limitations of the physical trainer box. For example, the VR-based systems can be used multiple times, with no need of consumables.…”

Section: Introductionmentioning

confidence: 99%

“…They provide objective and automated measurement of performance, which can improve the evaluation process [11]. Furthermore, they can be designed to provide haptic feedback, an essential component for training minimally invasive surgery skills [10, 12, 13, 14, 15, 16]. However, before introducing this technology into training curricula, there is a need to demonstrate its validity as a training tool and also as an instrument for assessing skill in laparoscopic surgery [17].…”

Section: Introductionmentioning

confidence: 99%

Preliminary evaluation of the pattern cutting and the ligating loop virtual laparoscopic trainers

Chellali

Ahn²,

Sankaranarayanan³

et al. 2014

Surg Endosc

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Introduction The Fundamentals of Laparoscopic Surgery (FLS) trainer is currently the standard for training and evaluating basic laparoscopic skills. However, its manual scoring system is time-consuming and subjective. The Virtual Basic Laparoscopic Skill Trainer (VBLaST©) is the virtual version of the FLS trainer which allows automatic and real time assessment of skill performance, as well as force feedback. In this study, the VBLaST© pattern cutting (VBLaST-PC©) and ligating loop (VBLaST-LL©) tasks were evaluated as part of a validation study. We hypothesized that performance would be similar on the FLS and VBLaST© trainers, and that subjects with more experience would perform better than those with less experience on both trainers. Methods Fifty-five subjects with varying surgical experience were recruited at the Learning Center during the 2013 SAGES annual meeting and were divided into two groups: experts (PGY 5, surgical fellows and surgical attendings) and novices (PGY 1–4). They were asked to perform the pattern cutting or the ligating loop task on the FLS and the VBLaST© trainers. Their performance scores for each trainer were calculated and compared. Results There were no significant differences between the FLS and VBLaST© scores for either the pattern cutting or the ligating loop task. Experts’ scores were significantly higher than the scores for novices on both trainers. Conclusion This study showed that the subjects’ performance on the VBLaST© trainer was similar to the FLS performance for both tasks. Both the VBLaST-PC© and the VBLaST-LL© tasks permitted discrimination between the novice and expert groups. Though concurrent and discriminant validity has been established, further studies to establish convergent and predictive validity are needed. Once validated as a training system for laparoscopic skills, the system is expected to overcome the current limitations of the FLS trainer.

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Haptic Communication to Support Biopsy Procedures Learning in Virtual Environments

Cited by 25 publications

References 27 publications

Validation of the VBLaST peg transfer task: a first step toward an alternate training standard

Validation of the VBLaST peg transfer task: a first step toward an alternate training standard

Achieving interface and environment fidelity in the Virtual Basic Laparoscopic Surgical Trainer

Preliminary evaluation of the pattern cutting and the ligating loop virtual laparoscopic trainers

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