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Haptic Technology: Training With Feeling
September 23, 2009
By Victoria Phillips
There isn't much opportunity for urologists to practice risk-free surgery on real-life patients. But Lumenis hopes its new product—which allows doctors to simulate the sense of touch—will be just as good.
TTeaming up with MySmartSimulations, an e-learning and interactive training developer, the laser-based technologies company produced the first life-like simulator that allows urologists to practice the intricate steps of prostate cancer surgery both risk-and cadaver-free.
Using a simple laptop, software, a foot pedal, and two hands to hold the touch-enabled haptic device simulating a scope, the user immediately is immersed in the movements of surgery replicated on the computer screen. And it can take place anywhere. "You have a couple of components you plug in, and away you go," says Chris O'Brien, chief technology officer for MySmartSimulations.
This Holmium Laser Enucleation of the Prostate (HoLEP) training simulator allows doctors to simulate the sense of touch—an important component of the prostate procedure. The particular type of haptics (force feedback) used for this device pushes back on users' hands so they feel resistance against the major muscle groups when they move the surgical tool on the computer screen, says Laura Wallace, director of marketing for SensAble Technologies, the haptic device provider. "The HoLEP training simulator is a virtual application that helps users literally feel the things they see on their computer," she says.
With a running timer and laser-level feedback, the simulator guides users through the procedure, allowing them immediate commentary on their surgical skills. "If you are too forward and slice into the sphincter in the simulator, you get an error message," O'Brien says.
The surgery normally is practiced upon cadavers; the simulator is meant to be a supplement to training—not an all-out replacement. It allows urologists learning the details of the procedure to practice hundreds of times before ever touching a patient.
According to Ray Choye, senior director of fractional and advanced systems for Lumenis, the goal in creating these simulators is to expose physicians to training before they ever set foot inside an operating room. "By doing this, the physician will be aware of the steps and processes it takes to do this surgical procedure before they ever look at it live," he says.
Typically the training is a three-step process with multiple visits between the training physician and expert physician, Choye says. Lumenis hopes to bring the learning curve down with the introduction of the simulator.
Right now there is no way to measure the effectiveness of the training, but the company hopes to conduct a study with one of its leading physicians. Ideally, the company would like to pit simulator- and non-simulator- trained residents against one another to determine their effectiveness by speed and competency.
"Typically, physicians are learning on the job," O'Brien says. "This allows them to learn offline in a controlled environment where they can be measured and monitored, and prove their competencies."
Not only does Lumenis hope to better prepare physicians, but another plus of simulator training is it's risk-free to patients—something important to the company. "We'll be turning out better trained doctors and having less risk for patients in these high-risk surgeries," says Joan Lockhart, vice president of sales and marketing for SensAble.
As health-care standards continue to change, these simulators represent an advance that has benefits to patients and to insurance rates, she adds. "In comparison to their traditional methods of training on cadavers, this is much more cost- effective and ethically better," O'Brien says.
The simulator made its first public debut at an American Urological Association trade show this April. Now beyond its preview stages, Lumenis hopes to have the full product out within the next two months.
What Choye calls a "basic product," the simulator will model a standard generic male with an average-size hyper-prostate with minimal complications. After the initial release to Lumenis' expert physicians, Choye says the company hopes to begin developing different scenarios to give the physicians newer challenges in gaining experiences on how to do the procedure.
"Every medical procedure can come with complications," he says. "In this safe environment of the simulator, we now can introduce these complications and have the physician learn how to manage them…that's pretty cool."
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