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8 Conclusions and Future Work

This work describes the design and development of a first prototype of serious game for training surgeons on suturing in laparoscopic surgery.

We focused our attention on as more as possible accurate physical modeling of the objects involved in the serious game (the virtual tissue, the suture thread and needle). Then we defined a methodology to evaluate and measure the skills of the trainee. The surgical instruments manipulated by the surgeon are replaced in the serious game by two haptic interfaces. These interfaces control the movements of the virtual tweezer that are used in order to manipulate suture thread and needle.

We cannot compare our surgical simulator with complete and complex commercial products like the LapSim. The first reason is that we focused our attention on a particular step of the laparoscopic procedure (suturing) and ignored all the other steps of laparoscopic surgery that require however an accurate training. This choice and the use of commercial haptic interfaces permitted to mantain very low the cost of the simulator. The second reason is that we've structured our simulator as a serious game to engage and motivate the players to improve their performance. We made this choice because we want to evaluate in a successive study the usefulness of a serious game training approach in laparoscopic suture training.

In the future the system can be improved with a more accurate modeling of the interaction between the tissue and suture thread. Algorithms for skills evaluation can also be improved with a software module that stores the results of users training sessions in order to evaluate the progress of performance in the execution of suturing task. We also plan to substitute the current haptic interfaces with more expensive ones to ensure a bigger dimension of the player's workspace. These interfaces can be then modified to include real surgical instruments in the handle in order to obtain a more realistic simulation. Last we want try to evaluate the game training usefulness with medical students and expert surgeons to understand if this can represent a valid training approach.


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