Virtual Reality Colonoscopy Simulation: A Compulsory Practice for the Future Colonoscopist?

Åhlberg, Gabrielle; Hultcrantz, Rolf; Jaramillo, Edgar; Lindblom, Annika; Arvidsson, Dag

doi:10.1055/s-2005-921049

Cited by 122 publications

(80 citation statements)

References 8 publications

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“…In medicine, haptic feedback has mostly been used for surgical training simulations [10]. Indeed, Ahlberg et al demonstrated that simulator training significantly improved the initial learning curve for the simulatortrained over the control group [11].…”

Section: Discussionmentioning

confidence: 99%

Will haptic feedback speed up medical imaging? An application to radiation treatment planning

Anderlind¹,

Noz²,

Sallnäs³

et al. 2008

Acta Oncologica

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Section: Discussionmentioning

confidence: 99%

Will haptic feedback speed up medical imaging? An application to radiation treatment planning

Anderlind¹,

Noz²,

Sallnäs³

et al. 2008

Acta Oncologica

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“…The total time trainees spent on VR simulator varied from 5 till 10 h [15][16][17][18]. One study showed that there is a need of a 20-h exposure for a novice trainee to reach the level of an expert in colonoscopy [18]. In our case, we are going to have a look at how many hours of exposure users need to do the whole procedure of PD independently without help and mistakes.…”

Section: Discussionmentioning

confidence: 99%

“…There are studies in which the exposure within formalized teaching settings was controlled. The total time trainees spent on VR simulator varied from 5 till 10 h [15][16][17][18]. One study showed that there is a need of a 20-h exposure for a novice trainee to reach the level of an expert in colonoscopy [18].…”

Section: Discussionmentioning

confidence: 99%

Virtual Reality Simulation in Peritoneal Dialysis Training: The Beginning of a New Era

Zgoura

Hettich²,

Natzel³

et al. 2018

Blood Purif

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Background/Aim: Peritonitis rates in peritoneal dialysis (PD) vary considerably not only across countries but also between centers in the same country. Patient education has been shown to significantly reduce infection rates but up till now training lacks standardization with patients being trained using different methods and media (e.g., illustrations, videos). As a result, patients may be insufficiently experienced in performing PD, which might be one of the causes for high peritonitis rates. To address these issues, we developed a PD training program based on virtual reality (VR). Methods: To become acquainted with the PD procedure, patients are equipped with a VR headset and controllers. They are presented with a virtual PD set, which simulates the feeling of sitting in front of a real PD set. The patient is enabled to run through the program as often as necessary to become familiarized with the whole PD procedure. The aim is to standardize, facilitate, and accelerate the individual learning process. To compare the effect of the applied training method to traditional training, a randomized controlled trial is underway. Conclusion: Previous studies on the effectiveness of learning showed that VR training applications are superior to traditional methods, such as text- or video-based training. However, no study has been undertaken in the context of dialysis. We believe that the implementation of VR training programs in clinical practice will be beneficial in improving the patient’s proficiency, and thereby the quality and safety of PD.

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“…Nevertheless, the average expert intubation time was with 438 seconds close to the 7 minutes on the same simulator case that trainees needed before starting clinical colonoscopies in the training study by Ahlberg et al [74]. Also, since all novices reached the endpoints, they were confirmed not too challenging.…”

Section: Discussionmentioning

confidence: 95%

“…In hindsight, the NP endpoint may have been too strict, making it too difficult to reach the learning curves endpoint. There are alternatives, such as requiring that more than 97% of the procedure time is free of patient discomfort, used by Ahlberg et al [74]. However, this was considered too easy for this task and would fail to enforce realistic loop detection and straightening techniques.…”

Section: Discussionmentioning

confidence: 99%

Robotic steering of flexible endoscopes

Rozeboom¹

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SummaryFlexible endoscopes were originally designed for non-invasive inspection of body cavities and hollow organs. Today, they are also used for complex minimal invasive interventions. Control of the endoscope is difficult and complexity rises with interventional procedures. Endoscopists suffer from long learning curves, ergonomic complaints and multi-person control is needed to steer endoscope and instrument(s).Robotics have the potential to overcome these problems. The combined forces of a technical university, mechatronic company and physicians from multiple hospitals led to the design of an add-on robotic platform. The platform aims to improve usability of conventional flexible endoscopes for complex interventions. These interventions require accurate and precise tip steering.This thesis describes the design and clinical evaluation of the platform's tip steering module. An optimal user interface and control algorithm was sought to improve usability of the endoscope in clinical practise.First, critical user aspects of conventional gastro-and colonoscopes were identified and copied to the robotic platform. The control module includes a remote interface that was evaluated by novices in a simulated colonoscopy environment. This study indicated that robotic steering, using a position-controlled touchpad or a ratecontrolled joystick increases efficiency and satisfaction. However, breaking the mechanical linkage between operator and endoscope tip led to a lack of force feedback on tip bending.The first results did not show a clear preference between two regular user interfaces and their control algorithms. A position-controlled touchpad has benefits for precise targeting (instrument placement), whereas a rate-controlled joystick is better suited for quick tip steering (lumen navigation). Endoscopy requires both quick and precise tip motions. The second study describes the design of a non-linear rate iii control algorithm. This study showed that between regular intuitive interfaces, the joystick with non-linear rate control showed highest efficiency and users' preference.A single-handed controller was introduced to further reduce the experienced workload of flexible endoscopy. The controller was compared to a bimanual interface and conventional control in a simulated colonoscopy procedure. Both the single-handed and a bimanual controller reduced the workload of colonoscopy without reducing efficiency or effectiveness. Despite the single-handed approach, novices appeared to steer the endoscope tip and shaft consecutively, not simultaneously. Making bimanual control the logical route to pursue.The first three studies indicated that the platform changed the current routine of handling an endoscope. A fourth study was designed to determine if expert endoscopists and endoscopists in training were able to perform the complex manoeuvres required in colonoscopy. Experts and PhD students without previous hands-on experience trained on a computer simulator to perform colonoscope intubation. Experts needed a relatively short ...

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Virtual Reality Colonoscopy Simulation: A Compulsory Practice for the Future Colonoscopist?

Abstract: Skills acquired using the AccuTouch simulator transfer well into the clinical colonoscopy environment. The results of this trial clearly support the plan to integrate simulator training into endoscopic education curricula.

Cited by 122 publications

References 8 publications

Will haptic feedback speed up medical imaging? An application to radiation treatment planning

Will haptic feedback speed up medical imaging? An application to radiation treatment planning

Virtual Reality Simulation in Peritoneal Dialysis Training: The Beginning of a New Era

Robotic steering of flexible endoscopes

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