Elsevier

Journal of Biomedical Informatics

Volume 75, November 2017, Pages 48-62
Journal of Biomedical Informatics

Virtual interactive suturing for the Fundamentals of Laparoscopic Surgery (FLS)

https://doi.org/10.1016/j.jbi.2017.09.010Get rights and content
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Highlights

  • The development of a virtual laparoscopic suturing simulator is presented.

  • A novel and interactive knot detection method is proposed.

  • A simple and robust collision detection algorithm is introduced.

  • The simulator can offer real-time objective assessment for the user’s performance.

  • A bimanual hardware interface enabling both forth feedback and grasping sensation.

Abstract

Background

Suturing with intracorporeal knot-tying is one of the five tasks of the Fundamentals of Laparoscopic Surgery (FLS), which is a pre-requisite for board certification in general surgery. This task involves placing a short suture through two marks in a penrose drain and then tying a double-throw knot followed by two single-throw knots using two needle graspers operated by both hands. A virtual basic laparoscopic skill trainer (VBLaST©) is being developed to represent the virtual versions of the FLS tasks, including automated, real time performance measurement and feedback. In this paper, we present the development of a VBLaST suturing simulator (VBLaST-SS©). Developing such a simulator involves solving multiple challenges associated with fast collision detection, response and force feedback.

Methods

In this paper, we present a novel projection-intersection based knot detection method, which can identify the validity of different types of knots at haptic update rates. A simple and robust edge-edge based collision detection algorithm is introduced to support interactive knot tying and needle insertion operations. A bimanual hardware interface integrates actual surgical instruments with haptic devices enabling not only interactive rendering of force feedback but also realistic sensation of needle grasping, which realizes an immersive surgical suturing environment.

Results

Experiments on performing the FLS intracorporeal suturing task show that the simulator is able to run on a standard personal computer at interactive rates.

Conclusions

VBLaST-SS© is a computer-based interactive virtual simulation system for FLS intracorporeal knot-tying suturing task that can provide real-time objective assessment for the user’s performance.

Keywords

Suturing simulation
Medical training
Virtual reality
Knot identification
Collision detection
Self-collision
Haptics

Cited by (0)

1

Co-first author.