Scientific Publications ForceSense, ForceTRAP & TrEndo
Horeman T, “Force-based assessment of tissue handling skills,” Dissertation 2014, available in the Technical University Delft repository.
Conclusion:” A new force platform was developed and incorporated in a new Force and Motion Surgical Trainer (ForMoST) that be used to find force thresholds for training of tissue handling as well as for safety monitoring during suturing of incisions. It is shown that force parameters that reflect tissue handling or suture tension, can now be used to inform surgeons about the risk of tissue damage while training laparoscopic skills or suturing tissues.”
Rodrigues SP, Horeman T, Dankelman J, Dobbelsteen JJ van den, Jansen FW, “Tying different knots: What forces do we use?“, Surgical Endoscopy, 2014 Oct.
Conclusion:”Expert surgeons apply significantly higher forces during laparoscopic surgery compared to conventional surgery even though the same strategy is used. Aspects such as the limited visual and haptic feedback, and movement possibilities hampers surgeons’ ability to assess the applied interaction forces. Therefore it can be useful to provide additional force feedback about the applied interaction forces during training in nonclinical settings.”
Rodrigues SP, Horeman T, Sam P, Dankelman J, Dobbelsteen JJ van den, Jansen FW, “Influence of visual force feedback on tissue handling in minimally invasive surgery” British Journal of Surgery, 2014 Oct 21.
Conclusion:” The tissue handling skills of medical students improve significantly when they are given force feedback of their performance. This effect is seen mainly during the knot tying phase of the suturing task.”
Horeman T, Delft F van, Blikkendaal MD, Dankelman J, Dobbelsteen JJ van den, Jansen FW, “Learning from visual force feedback in box trainers,” Surgical Endoscopy, 2014 Jun;28(6):1961-70.
Conclusion: ‘The learning curves and the post-test indicate that training with visual force feedback improves tissue handling skills with no negative effect on the Task Time and instrument motions. Conventional laparoscopic training with visual time feedback improves instrument motion and Task Time, but does not improve tissue manipulation skills.’
Horeman T, Jansen FW, Dankelman J, Dobbelsteen JJ van den, “Assessment of laparoscopic skills based on force and motion parameters,” IEEE Biomedical Engineering 2014 Mar;61(3):805-13.
Conclusion: ‘The relatively high forces used by the Intermediates in combination with the apparent lack of correlation between force and motion parameters argues for the inclusion of training and assessment of force application during tissue handling in future laparoscopic skills training programs.’
Horeman T, Blikkendaal MD, Feng X, Dijke A van, Jansen FW, Dankelman J, Dobbelsteen JJ van den, ”Visual Force Feedback improves knot-tying security,” Surgical Education, vol.71(1), pp. 133-141, 2013.
Conclusion: ‘Participants that are trained with visual force feedback produce the most secure knots in the post-test and their suturing results in lower applied forces. Therefore, the results of this study indicate that visual force feedback supports students while learning to insert the needle smoothly, to effectively align the suture threads and to balance the force between instruments during knot tying. … ‘
Empel van P, “Minimally Invasive Surgical training, Learning, Assessment and Validation”, Dissertation nov-2013, available in the VU medical Center repository.
Conclusion:” We conclude that the TrEndo holds real potential to become a home training device. We demonstrated that an objective assesment method of a basic laparoscopic task by means of the TrEndo globally corrolates with the subjective gold standard of MIS skills, the Objective Structured Assesment of Techical Skills (OSATS). However, the TrEndo was more responsive than the OSATS and might be more effective at recording individual progress.”
Horeman T, Rodrigues SP, Dobbelsteen JJ van den, Jansen FW and Dankelman J, “Visual force feedback in laparoscopic training,” Surgical Endoscopy, vol. 26(1), pp. 242-248, 2011.
Conclusion: ‘…The real-time visualization of applied forces during training may facilitate acquiring tissue handling skills in complex laparoscopic tasks and could stimulate proficiency gain curves of trainees. … ‘
Horeman T, Rodrigues SP, Dankelman J, Dobbelsteen JJ van den, and Jansen FW, “Suturing intraabdominal organs: when do we cause tissue damage?,” Surgical Endoscopy, vol. 26(4), pp. 1005-1009, 2012.
Conclusion: ’ … With the results presented in this study, it is possible to provide clinically relevant and validated feedback to trainees about their tissue handling skills.’
Horeman T, Kertiva D, Valdastri P, Dobbelsteen JJ van den, Jansen FW, Dankelman J, ”The influence of instrument configuration on tissue handling force in laparoscopy,” Surgical Innovation, vol. 20(3), pp. 260-267, 2012.
Conclusion: ‘The force data indicates that the increased complexity in instrument handling with straight instruments in a Single Port configuration increases the tissue manipulation force.’
Horeman T, Rodrigues SP, Jansen FW, Dankelman J, Dobbelsteen JJ van den, “Force Parameters for Skills Assessment in Laparoscopy,” IEEE Transactions on Haptics, vol 5 (4), pp. 312-322, 2011.
Conclusion: ‘We conclude that force measurements in a box trainer can be used to classify the level of performance of trainees and can contribute to objective assessment of suture skills.’
Horeman,T, Rodrigues SP, Jansen FW, Dankelman J and Dobbelsteen JJ van den, “Force measurement platform for training and assessment of laparoscopic skills,” Surgical Endoscopy, vol. 24(12), pp. 3102-3108, 2009.
Conclusion: ‘The designed platform is easy to build, affordable, and accurate and sensitive enough to reflect the most important differences in e.g. maximal force, mean force, and standard deviation. Furthermore, the compact design makes it possible to use the force platform in most box trainers.’
Van Empel PJ, van Rijssen LB, Commandeur JP, Verdam MGE, Huirne JA, Scheele F, Bonjer HJ, Meijerink WJ. “Validation of a new box trainer-related tracking device: the TrEndo. ʺ Surg. Endosc. 2012.
Conclusion: Face, content, and construct validities of the TrEndo were established. The TrEndo holds real potential as a (home) training device.
Hiemstra E, Chmarra MK, Dankelman J, Jansen FW. “Intracorporeal Suturing: Economy of Instrument Movements Using a Box Trainer Model. ʺ Journal of Minimally Invasive Gynecology. 2011.
Conclusion: The construct validity has been suggested for time, path length, motion in depth, and motion smoothness for assessment of the laparoscopic suturing task using a box trainer. An expert level has been set for training and assessment purposes. The addition of economy of movement to time to complete the task has the potential to refine acquisition of skills.
Daniel F. Kott award for “Best new instrumentation” in Las Vegas, AAGL 2011.
Young Researcher Award for the research: “Force feedback in laparoscopy; Is it useful?” in Trondheim, SMIT2010.
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