Einar Haug

Senior Scientist, SimSurgery AS

”Digital Training Simulator for Robotic Assisted Endoscopic CABG”

New robotic assisted procedures require quite different skills than conventional surgical techniques, thus, the need for facilitating the education and training process is very  important. Virtual reality surgical training is an educational method ideal with telemanipulating systems. We here report our experiences in developing a simulator for robotic assisted endoscopic CABG procedure by first focusing on the anastomosis part of the operation. We wanted to produce a virtual environment that in addition to instrument coordination also reflects the anatomy and tissue mechanics similar to clinical situations.

METHODS:
In collaboration with the surgical simulator company SimSurgery(tm)  (http://www.SimSurgery.no) we explored a new mathematical tissue representation suitable for surgical simulators that exhibit simulated tissue responses similar to the real viscoelastic anatomy. A computer simulated suture model was also developed.

RESULTS:
In our prototype the suture model was integrated with our new platform for modeling three-dimensional (3D) tissue structures comprising a simulated IMA and a simulated LAD, integrated with simulated model of a beating heart. Interaction between the simulated tissue and instruments, like the suture penetrating the vessel walls, appeared realistic, but need further development before essential features as bleeding and tactile responses can be implemented.

CONCLUSIONS:
By computer assisted training the number of animal trails in training with robotic systems can be reduced, and more important, the overall clinical performance can be significantly improved. The technology and experience obtained from simulating robotic procedures render training methods applicable also to conventional techniques.