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Improving Laparoscopic skills training using mobile devices
and interactive media with exploration into Augmented Reality
Dr. Alexander Nagy, C.D., B.Sc., M.D., FRCSC Clinical Professor of Surgery, UBC,
General Laparoscopic Surgery & Endoscopy
Dr. Shahram Payandeh, B.Sc., M.A.Sc.Ph.D., School of Engineering, SFU
Andrew Nagy, Principle, Cursor Interactive, Inc.
Submit or Redo
The goal of this research is to develop an innovative mobile
training platform that provides laparoscopic residents and
surgeons-in-training introductory exposure to basic
minimally-invasive procedures in general surgery using
interactive endoscopic video and incorporating Augmented
Reality (AR) components; more so than existing mobile
applications. As a result, we hope to bridge the gap that
exists in training and skills-transfer by increasing both
exposure, and as a result, specialization, by adding to the
number of skilled practitioners specializing in laparoscopy,
while improving the quality of patient care.
Our primary research question is whether AR training on
mobile devices will have significant advantages in trainee
evaluation, skills transfer or adoption, and cost-efficiency
than current box trainers and various VR simulators –
specifically measuring how these methods complement or
surpass current training models and the effectiveness of
mobile devices in knowledge-transfer between existing
hands-on approaches. The proposed research and
development is following a phased approach, and plans to
test residents’ evaluation and cognitive response to the
application at each phase of development, while gathering
valuable intelligence on user experience and curriculum
Leveraging current laparoscopic
and AR research and development
from the SFU Experimental Robotics and
Multi-Modal Laboratory, this research project is evaluating
mobile platforms with related industry research of applicable
options for AR in laparoscopy training. As result of this
research, the group will develop a prototype laparoscopic
training application for mobile devices that incorporates
endoscopic video tutorials, directed by Dr. Alexander G.
Nagy, among other leading laparoscopic and hepatobilliary
surgeons. Using AR markers placed in a textbook, or
industry publication (i.e. “Basic Surgical Techniques, Chapter
7: Laproscopic Surgical Techniques,” E.J Patterson, A.G.
Nagy, 2000), the mobile platform will allow residents a better
understanding of the spatial relationships of 2D objects
within a 3D operational field using actual endoscopic video.
The user experience initially will evaluate simple procedures
including dialogue instruction/commentary by laparoscopic
surgeons. The group plans to expand research and
development of the platform to include more interactive user
capabilities associated to specific laparoscopic lessons and
maneuvers within the endoscopic video. The research focus
will expand in further phases to also incorporate interactive
AR methodologies and apply these principles to the
endoscopic procedural video footage where possible.
Determining the best mobile device platform and subsequent
development of content; incorporating published textbooks,
mobile website, while aligning existing UBC curriculum
studies, and testing through the UBC Dept of Surgery.
Phase 2 research: Exploring the application of interactive
media and AR principles to instructional endoscopic video
while developing lesson plans and associated platform
development with the educational and industry partners.
PHASE 2 While working with the Centre of Excellence in Simulation Education
and Innovation (CESEI) at Vancouver General Hospital (VGH), and
the Department of Surgery at University of British Columbia (UBC),
the proposed development plans to align with current curricula and
training associations, such as SAGES’ FLS Program, to administer
effective laparoscopic skills transfer within the application.
After each endoscopic tutorial procedure, Resident users' scores are
accumulated and submitted to their participating residency program
SPECIAL ACKNOWLEDGEMENT TO MITACS RESEARCH ORGANIZATION FOR ACCELERATE INTERNSHIP PROPOSAL GRANT IT02208 – SCIENTIFIC OUTCOME
EXPLORE TOOLS OF THE TRADE
Users explore the abdomen to gain 3D spatial
understanding of geography and can identify key anatomy
through an instructional interactive 2D touchscreen interface
within endoscopic video.
Anatomical elements highlight as they are selected and the
results will be accumulated in user profiles that score the
self-assessment exercises that will then follow through the
criteria of the SAGES’ FLS Program for self-assessment.
Users can follow along with the
expert surgeon’s procedure, or
p a u s e t h e v i d e o a n d
participate at key milestones
in the procedure by conducting
actions in advance, or
mimicking the senior surgeon,
u s i n g t h e t o u c h s c r e e n
Users receive haptic feedback
through a slight vibrating buzz
of the smartphone when con-
ducting the maneuver to best
represent required tactile
pressure on the mobile device.
Self-assessment scores are
logged in user profiles and
transferred to SAGES FLS
program for assessment.
information on each instrument.
Interactive equipment models with