Improving Laparoscopic training using mobile devices and interactive media with Augmented Reality (AR) technology.

Alex G Nagy, MD, Shahram Payandeh, PhD, Andrew Nagy


Since the introduction of laparoscopic techniques, in general surgery in 1985, the question of how to best train new surgeons in laparoscopy continues to be a prevailing issue for practitioners. (Darzi, Smith & Taffinder, 1999)

In order to master laparoscopic skills, the trainee needs to develop an understanding of the spatial relationships and the related techniques to manipulate instruments and tissue in a two-dimensional (2D) video rendering of a three-dimensional (3D) operation field. Developing these skills before entering an operating room enables more focused and efficient performance, which minimizes time in the operating room and enhances patient safety. (Grantcharov 2004)

The requirement for more appropriate training methods has become more acute with the reduction in junior physician working hours and the resulting conflict between service commitment and training. Further impetus added by the greater need for transparency in terms of surgical outcomes and evidence of appropriate surgical competence, demanded by the public.

The estimated cost of training a resident in the OR is upwards of $48,000 or a total of $53 million annually. This cost reduces with more initial training moving into skills labs, instead of using costly operative time to acquire basic skills. (Bridges & Diamond, 1999) Teaching novices basic laparoscopic skills before a more complex laparoscopic task produces substantial cost savings. Additional studies are needed to assess the impact of such integrated curricula on ultimate educational benefit. (American College of Surgeons, 2010)

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 will follow a phased approach, testing 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 will evaluate 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.

Session: Poster Presentation

Program Number: P162

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