Augmented reality simulator for ultrasound-guided percutaneous renal access
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ORIGINAL ARTICLE
Augmented reality simulator for ultrasound-guided percutaneous renal access Yanyu Mu1,2 · David Hocking3 · Zhan Tao Wang4 · Gregory J. Garvin3 · Roy Eagleson1,5 · Terry M. Peters1,2 Received: 14 November 2019 / Accepted: 26 March 2020 © CARS 2020
Abstract Purpose Traditional training for percutaneous renal access (PCA) relies on apprenticeship, which raises concerns about patient safety, limited training opportunities, and inconsistent quality of feedback. In this study, we proposed the development of a novel augmented reality (AR) simulator for ultrasound (US)-guided PCA and evaluated its validity and efficacy as a teaching tool. Methods Our AR simulator allows the user to practice PCA on a silicone phantom using a tracked needle and US probe emulator under the guidance of simulated US on a tablet screen. 6 Expert and 24 novice participants were recruited to evaluate the efficacy of our simulator. Results Experts highly rated the realism and usefulness of our simulator, reflected by the average face validity score of 4.39 and content validity score of 4.53 on a 5-point Likert scale. Comparisons with a Mann–Whitney U test revealed significant differences ( p < 0.05) in performances between the experts and novices on 6 out of 7 evaluation metrics, demonstrating strong construct validity. Furthermore, a paired T-test indicated significant performance improvements ( p < 0.05) of the novices in both objective and subjective evaluation after training with our simulator. Conclusion Our cost-effective, flexible, and easily customizable AR training simulator can provide opportunities for trainees to acquire basic skills of US-guided PCA in a safe and stress-free environment. The effectiveness of our simulator is demonstrated through strong face, content, and construct validity, indicating its value as a novel training tool. Keywords Augmented reality · Percutaneous renal access · Training simulator · Ultrasound-guided needle insertion
Introduction Background Percutaneous renal access (PCA) is a standard procedure used to relieve obstruction caused by kidney stones or tumors that block the flow of urine from the kidney to the bladder [1,2]. Such a procedure is also essential in the treatment of
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Yanyu Mu [email protected]
1
School of Biomedical Engineering, Western University, London, Canada
2
Robarts Research Institute, London, Canada
3
Department of Medical Imaging, Western University, London, Canada
4
Division of Urology, Western University, London, Canada
5
Department of Electrical and Computer Engineering, Western University, London, Canada
kidney stones and tumors, as it allows for a safe passage for surgeons to access the kidney with larger instruments. Thus, proper access to the kidney is vital to the success of the surgery and the recovery of patients. To reach the level of competency required to perform US-guided PCA, a trainee must have an understanding of renal anatomy, the ability to interpret US images, and proper skills to maintain needle alignment with the US beam for needle tip v
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