仮想の鏡「ハイパーミラー」を用いた内視鏡下鼻内手術の遠隔手技指導実験(<特集>臨床現場のVR)

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[Objective] A distance-learning system for manual skills training in Endoscopic Paranasal Sinus Surgery has been developed and a remote teaching experiment using the system successfully conducted between Kanazawa Medical University (Ishikawa) and AIST (Ibaraki), 200 miles away. [Equipment] The system consists of trainee and trainer sites connected using commercial internet services. Both sites have the same equipment: surgical instruments, a precise nasal model, and four monitors. Monitors 1 and 2 show the trainee and trainer endoscope view, and 3 and 4 are front and side view virtual mirrors, called the HyperMirror (HM) interface, which show trainee and trainer images side-by-side and horizontally flipped. HM monitors enable the postures of the two surgeons conducting the same procedure to be compared. [Procedure] One expert surgeon at AIST remotely taught 11 medical students (5th grade) two surgical tasks. A 10-minute lesson on each task was repeated 3 times over two days. Trainees performed each task themselves before the remote teaching, just after each lesson, after all lessons, and two months later. [Results] Trainer's subjective scores of the trainees significantly improved after remote teaching and the acquired skills were retained two months later. Task completion time fell significantly for the easier task as remote training proceeded, but not for the more difficult task. Average and maximum force applied to the patient model increased as remote training proceeded. In the easier task, it had fallen significantly after two months. [Conclusion] Surgical skills can be remotely taught using this system. Force is a good skill measure, because it directly represents tissue damage and completion time seemed to decrease even when force increased.
2009-12-31

仮想の鏡「ハイパーミラー」を用いた内視鏡下鼻内手術の遠隔手技指導実験(<特集>臨床現場のVR)

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