IntelliVision Trainer

Project Name:

IntelliVision Trainer

One-line project summary:

Teaching cognitive skills using image guidance, virtual and augmented reality to perform safe laparoscopic cholecystectomy

Pitch your project.

Laparoscopic Cholecystectomy remains to be the most common laparoscopic surgery. One of the most challenging tasks in this operation is isolating and dissecting the cystic duct and artery in the Callot’s triangle. Using 3D images the course teaches the different scenarios of anatomy and pathological changes and ways to identify the different structures. Operative and animated videos are used to depict the complex situations and the complications that could occur during surgery. Critical decision making is taught using VR surgical simulation on a cost-effective platform such as an I Pad. This is an app based module that helps the trainee to master surgery using visual cues.

Using inanimate  models of tissues and organs, a training and assessment module is developed to master safe laparoscopic cholecystectomy. Tissues and organs are created using appropriate material to offer realistic haptic rendering. An algorithm based self - assessment module helps surgeons and residents master laparoscopic surgical skills. This is a simulator based training module that helps the trainee to master surgery using haptic cues.

What is your surgical training module?

Teaching safe laparoscopic cholecystectomy involves a detailed understanding of the various anatomical and pathological scenarios that one encounters in the Callot's triangle dissection. This is taught using a number of archived operative videos consisting of different types of inflammatory changes and complexities in tissue consistencies and adhesions. Acquisition of cognitive skills is achieved by demonstrating various dissection techniques and appropriate use of energy sources. An app based economical VR surgical module is developed to teach decision-making during a surgical procedure. Evaluation of cognitive skills is done at the end of each session.

The trainee goes on to operate on simulated 3-D models of gall bladder and liver in a trainer which has motion sensing capabilities.  A real-time assessment of skills is done using an algorithm based on position/ motion sensing and measurement of haptics while dissecting the models. 

What specific surgical skills are you teaching?

Mistakes happen due to wrong identification of the structures as well as inaccurate dissection. The first module aims at developing cognitive skills based on adequate knowledge of the various anatomical and pathological variations. This is required to decide on the steps of surgery to be followed and the surgical techniques to be used at every situation.

The second module which is an augmented reality trainer aims at teaching surgical skills of grasping, blunt, sharp and diathermy dissection, clipping, suturing, knotting and delicate handling of friable tissue.

The app based image guidance module helps in identifying structures like the common bile duct and the cystic duct and infuses confidence to perform safe laparoscopic cholecystectomy. 

Surgical simulation is a superior tool to teach psychomotor skills. A self-assessment module of surgical skills can be developed which helps the trainee surgeon to improve his skills. This type of trainer is needed not just for the developing world but for training of residents and junior surgeons across the globe. 

Who does your project serve, and in what ways will the project improve their skills?

Laparoscopic Cholecystectomy is one of the most common laparoscopic surgery being performed around the globe. This also happens to be the first laparoscopic surgery taught to surgical residents. There is a paradigm shift in the way an operation is performed when one starts laparoscopic surgery. The skills required are different and has a steep learning curve. Besides, there is a dire necessity for team-work which involves training of operating assistant, camera-assistant, nurse, technician and anesthetist. 

This is a holistic approach to teaching surgery. The initial phase consists of knowledge acquisition by watching a library of edited videos and animations. This is followed by learning of task-based psychomotor skills as well as decision-based  cognitive skills on simulators. An in-built surgical skill self -assessment module helps in extending expert teaching to the trainees' door-steps. There is both a significant economical advantage as well as rapid spread of knowledge and expertise of skills. An app based image guidance module further helps in obviating the need of experienced surgeons in the OR during surgery.

The module helps in training the whole operating team including the medical and nonmedical personnel. 

In what city, town, or region is your project team headquartered?

What is your project's stage of development?

Who is on your team?

I am both an educator and a clinician. I have an experience of 27 years of performing laparoscopic surgeries. I have been training surgeons to perform both basic and advanced laparoscopic surgeries at an institute which I have established - Bangalore Endoscopic Surgery Training Institute & Research Center since 1998. I have been running a basic comprehensive course similar to FLS in USA, advanced hernia and bariatric surgery courses. I have also been involved in developing a virtual reality task-based simulator.

My colleague Ms. Sudheera is a digital artist who creates 3-D models and animations.

Dr. Gaurang is a GI surgeon who is well versed with video-editing and learning management systems.

Mr. G.S. Rajshekar Reddy is an expert in augmented reality and virtual reality.

I would need one materials expert to create inanimate models of organs,  engineers for programming and hardware development

Who can join your team?

Clinician / Educator

Material experts to select appropriate tissue models 

Soft ware engineers