讲座题目：Design of a Virtual Endolumenal Surgery Simulator (VESS) for Endoscopic Submucosal Dissection (ESD)

主讲人：夏兆辉 博士

地点：动力与机械学院报告厅

时间：2019年7月1日（周一）上午09:30

欢迎各位师生踊跃参加！

主讲人简介

1986年9月出生于江西丰城；2016年6月获得华中科技大学机械制造及其自动化专业工学博士学位；2009年6月与2011年12月分别获得武汉科技大学工学学士及硕士学位；自2016年9月起在美国伦斯勒理工学院从事博士后研究工作，与哈佛大学的教授、医生与心理学家等共同研究虚拟手术；自2018年6月起在哈佛-贝斯以色列女执事医疗中心作为合作研究员从事虚拟手术的临床阶段研究。

主要研究方向包括高效数值计算方法、新一代CAD/CAE设计分析软件集成、结构最优化设计以及临床医学虚拟手术等领域。相关成果在数值计算方法、工程软件以及医学等领域的国际著名期刊发表论文9篇，另有数篇SCI论文在审。目前作为研发组长参与美国国立卫生研究院(NIH)-R01项目2项，参与美国国立卫生研究院SBIR项目1项。其中虚拟气管内插管术训练系统获得权威医学专家的认可，并获得《泰晤士联盟报》等媒体的采访与报道。

报告摘要：

INTRODUCTION: Colorectal cancer is one of the most common cancers in the United States. Endoscopic Submucosal Dissection (ESD) is an emerging minimally invasive technique that allows complete en-bloc resection and a much lower recurrence rate at long-term follow-ups. However, performing colorectal ESD is technically demanding since the colorectal wall is thin and constantly moving, and potentially higher rates of complications (e.g., bleeding and perforations), and there is lack of a sufficient number of expert instructors for ESD training in Western countries. One approach to reducing this gap is to design an ESD surgical simulator as part of a training curriculum.

OBJECTIVES: The aim of the study is to design a virtual endoluminal surgical simulator (VESS) with visual and haptic feedback along with assessment metrics based on a cognitive task analysis (CTA) approach. The simulator allows trainees to attain competence in a controlled environment with no risk to patients and can assess the trainees’ performance. Training tasks are built based on physics-based computational models of human anatomy with tumors.

METHODS: To design a virtual ESD simulator that will allow trainees to hone their ability to recognize and anticipate critical obstacles during the performance of ESD procedures, and enhance their decision-making skills, the results of a CTA are being integrated into the simulator as learning objectives and associated metrics. The main modules of the VR-based simulator for colorectal ESD as shown in Fi.g 1 involve (1) real-time rendering; (2) haptic interface; (3) physics-based simulation; and (4) performance recording and assessment metrics. The rendering engine allows surgical tasks to be performed in the three-dimensional virtual environment. Haptic feedback mechanisms allow users to physically feel the interaction forces. Physics-based simulation technologies are employed to enable the complicated simulation for performing virtual surgical tool-tissue interactions. The simulator can also collect learners’ performance data to offer feedback based on the built-in metrics.

RESULTS: Four training tasks involving marking, injection solution, circumferential cutting, and submucosal dissection as shown in Fig. 2 (the left is real surgery, while the right is virtual) are designed to practice skills with different surgical tools. The marking task aims to identify the lesion. The injection solution task minimizes the risk of bleeding and perforation to protect the muscularis. In the circumferential cutting task, the objective is initial incision of the lesion with the surgical tools. The objective of the dissection task is to remove the tumor from the connective tissue of the submucosa under the lesion.

CONCLUSIONS: This study presents a CTA-based approach to design a virtual ESD simulator that involves high-fidelity anatomical organ modeling, physics-based tool-tissue interactions, and performance metrics. The simulator enables realistic ESD tasks to provide a possibility for designing, validating and objectively evaluating the performance metrics in colorectal ESD training, and offers an opportunity to rise up the learning curve before application to patients.