AR-MIS Simulation Program

MIS(Minimally Invasive Surgery) is not easily accessible to patients nor surgical practitioners in most source-constrained countries;thus,since 2012, we have been committed to encourage it through open access personalized guiding,low-cost simulation training modules for MIS trainees surgical practitioners.

Most of simulation models have been designed and handmade within our teamwork,while developing surgical modules in 3 stages.The initial level has been focused in essential and general psycho-motor skills acquisition.The subsequent stages have looked for more complex and low frequency procedure-linked and specialty-linked abilities.We propose to develop low-cost DIY (do-it-yourself)physical models combined with AR(Augmented Reality)-solution app to guide and assess for essential and specific endoscopic suturing psycho motor skills acquisition in MIS training modules.

Each module will have app-powered academic,practical,hands-on and assessment sessions.
Lectures,tutorial-videos and AR-guiding support trainees to self-assess and accomplish pre- established skills acquisition objectives.Personalized learning-curve graph should be a good tool for self-tracing.Telementoring and debriefing by assigned educator can be requested.

Each app-powered module is carried out from any smart device (tab and pad type) and integrates:

1. The Academic Session that embraces pre-recorded masterclass, bibliography, and guidelines recommendations.
2. The Practical Session with step by step DIY tutorial-videos for the training model assembling; and task lectures-videos with emphasis in patient safety, ergonomics, discipline, technical issues, and specific psycho-motor tasks.
3. The Hands-On Session is AR-guided and allows trainees to self-assess and accomplish pre-established objectives as part of a comprehensive learning process for psycho-motor skills acquisition. Tele-assistance can be requested with a previously booked schedule.
4. The Assessment Session articulates the Academic Session evaluation and the Hands-On Session measurable skills assessment, reflected in a customizable graphical learning curve.
Satisfaction survey for feedback is a requisite. Telementoring and debriefing with an educator aligned with the program can be requested.

Specifically we have selected endoscopic suturing as the psyco-motor skill for the training module for its implied complexity that embraces fundamental MIS knowledge and care for the equipment, and integration of essential psyco-motor skills acquisition as for: posture ergonomics, safe trocar placement, effective instruments and tissue handling, hand–eye coordination, depth perception, active participation of the non-dominant hand, delicacy for range of movement, bimanual dexterity, safe needle grabbing-manipulation, and intracorporeal secure knot tying.

Our commitment has always been promoting accessibility of all patients to the benefits of MIS through the expertise achieved by the art of surgical education. We started MIS surgical simulation as a tool in our residency program curriculum as well as a surgical education fellowship since 2012. Our multidisciplinary work-team compounded by surgical simulation fellows of different specialties, scrub-nurses, technicians, and engineers have participated in the design and the validation of the low-cost, handmade models of own authorship; having gained experience in mentorship (telementoring since pandemic), and feedback of 700+ international trainees from LATAM. (Argentina, Peru, Brasil, Colombia, Costa Rica, Ecuador,
Spain, etc).
The acquired know-how through these lasts years, is prompting us to share what we have constructed to a greater scale, improving this prototype of simulation module to become accessible to any MIS surgical practitioner, trainees and educators in need of standardized training curriculum, encouraging the development of open-source, reproducible, in situ, low-
cost, continuing education programs.

María Marcela BAILEZ, MD Expert in Pediatric Surgery and Surgical Simulation - Garrahan Children´s Hospital, Buenos Aires. Delegate of this multi-centric and multidisciplinary team in the public hospital environment.

Georgina FALCIONI, MD - General and Pediatric Surgeon, Surgical Simulation Educator - Elizalde Children´s Hospital, Buenos Aires.
Maxiliano MARICIC, MD - Pediatric Surgeon, Teacher in Surgery, and Surgical Simulation Educator - Elizalde Children´s Hospital, Buenos Aires.
Juan ROJO, ENG- Computer Science Engineer
Hsien Chen YANG, MD - Ob & Gyn, Maternal-Fetal Medicine Specialist, Surgical Simulation Educator - Garrahan Children´s Hospital, Buenos Aires.

This team has encountered in the passion for the art of surgical education in MIS and has adopted the mission to share it professionally helping to achieve the expertise required in each surgeon, increasing pacientes’ access and outcomes.
We belong to an institution (Garrahan Children´s Hospital) with experts in diverse clinical and educational fields, including simulation as a continuous in situ practice.

Industrial designer and industrial engineer for low-cost models and instruments

Medical illustrator

Data analyst, data engineer