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Development of a Serious Game for Laparoscopic Suture Training

Abstract. Surgeon training in laparoscopic suturing is very important because this task generally requires an high level of experience from the surgeon. Serious gaming refers to a computer games technology where the primary goal is to train the player. In this kind of training the education goal is achieved also ensuring the entertainment and the engagement factors typical of a traditional game. This paper presents the development of a serious game for training on suturing in laparoscopic surgery that is focused on the physical modeling of the virtual environment and on the definition of a set of parameters used to assess the level of skills developed by the trainees.

Keywords: Serious game • Simulation • Surgical training • Laparoscopic suturing.

1 Introduction

The spreading of Minimally Invasive Surgery (MIS) reduced the trauma and surgical cut on patients. The use of this type of surgical technique has led to an increasing demand of education and training of surgeons. Furthermore traditional approach to learning and teaching based on the use of animals, cadavers or dummies appears obsolete.

As compared to traditional surgical techniques (i.e. open surgery), in MIS surgeons operate in a very small workspace, without having a direct view of the organs that are visualized by means of a camera. For this reason, in this context, some skills such as eye-hand coordination are fundamental for the success of the surgical operation. Surgeons need to have an accurate training with this type of technique.

The introduction of the simulation based on the Virtual Reality (VR) technology has completely changed the education and training tools and, since 1998, the virtual simulators are officially accepted as training tools for surgeons. Several studies have demonstrated how the virtual reality-based simulators, compared to training based on traditional methods, can significantly reduce the intra-operative errors [1].

The VR-based simulators allow reproducing different surgical scenarios without risks for the patient. They have also the advantage of the repeatability of the training sessions in order to evaluate and study the mistakes. In addition, these simulators provide an objective measurement of the developed skills. It is also possible to reuse many times the simulator because the virtual environment does not undergo the degradation of the traditional toolbox used for training.

Nowadays VR-based laparoscopic simulators have achieved a high level of accuracy. The use of haptic devices able to provide a force feedback to the user has contributed to the spread of the virtual simulators developed for surgery training.

Laparoscopic suture is one of the most frequently performed task in minimally invasive surgery. It is used to close the incisions made during the surgical procedure. This task need an high level of surgeon experience in order to be carried out correctly reducing unwanted side effects. It needs much training.

A new trend in the development of virtual surgical simulators is represented by "serious games". A serious game is a computer game whose primary purpose is not entertainment, but teaching and learning. Although virtual simulators and serious games are conceptually similar and the same technology (hardware and software) can be used, the serious game approach introduce an entertainment factor and include some of the highlights typical of a videogame: challenge, risk, reward and defeat.

Serious gaming in healthcare and surgery has the goal to educate and train people about treatments, medical and surgical procedures, involving them with an entertainment factor typical of a videogame.

In this paper we present a serious game for training surgeons on suturing in laparoscopic surgery. In particular, our system is focused on an accurate physical modeling of the virtual environment and on the definition of a set of parameters used to assess the level of skills developed by the trainees. A pair of haptic devices has been utilized in order to simulate the manipulation of the surgical instruments. NVIDIA PhysX physics engine is used to simulate the physics of the simulated environment and Ogre3D is used for graphical rendering.

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