LapApp_Cursor_Dr. Nagy2

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LapApp_Cursor_Dr. Nagy2

  1. 1. Improving Laparoscopic skills training using mobile devices and interactive media with exploration into Augmented Reality (AR) technology. 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. LapApp Anatomy Procedures Tools ANATOMY VIEW LAPAROSCOPIC TROCAR Submit or Redo PROCEDURE VIEW TOOL VIEW DATABASE SAGES FLS INTRODUCTION 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 effectiveness. 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. METHODOLOGY PHASE 1 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 for assessment. SPECIAL ACKNOWLEDGEMENT TO MITACS RESEARCH ORGANIZATION FOR ACCELERATE INTERNSHIP PROPOSAL GRANT IT02208 – SCIENTIFIC OUTCOME IDENTIFY ANATOMY PERFORM TASKS 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 interface. 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. Background interactive information on each instrument. Interactive equipment models with navigational capabilities ASSESSMENT

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