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We hypothesized that simulation based practice will results in skill improvement on trocar insertion task. Novices, junior trainees and surgeons inserted a trocar into a simulated abdomen. The depth of penetration (plunge) was the similar for novice and junior trainees (p=.98), and exceeded that observed for practicing surgeons (p<.05). Trocar insertion may be an important variable to consider for surgical skill training. To date, no virtual reality (VR) trainers allow for practice of this skill. We will present a prototype of a VR trainer designed.

Introduction: This study examined the validity of tensiometry as an objective method of assessing the improvements in the quality of knots and technical performance due to practice on suturing and knot-tying skills., Methods: We evaluated the quality of 1,830 knots produced by undergraduate medical students before training (pre-test), after (post-test), and after a week retention (retention-test) using tensiometry. These results were compared to expert-based assessments of products and performance., Results: Tensiometry, as well as expert-based assessments can detect changes in the quality of knots and technical performance from pre to post and retention-test ( p<0.05). However, these three methods may assess different dimensions of the same products and actions., Conclusions: The development of trainee evaluation criteria for the acquisition of surgical skills is a crucial element in surgical education. Based on our patterns of results it is hypothesized that tensiometry can serve as an economic first approximation of the quality of knots and suturing performance.

The purpose of this study was to investigate the ability to discriminate friction during surface exploration using a finger and surgical instrument under normal vision and when vision was absent. Participants explored surfaces with either with the finger or with an instrument and rated the slipperiness. Results showed that the explorations with the instrument were estimated to be more slippery and less sensitive than those for the finger. There were no effects for visual condition. This study showed that novices who use instruments to make estimations of tissue slipperiness require practice and training in order to adequately perceive friction. Novices' reduced ability to perceive friction with instruments should be integrated into simulator design.

Haptics, namely the sense of touch, has been playing an important role in medical simulation. However, most medical practitioners, who are best suited to create the training environments, do not have the engineering expertise necessary for programming a haptic environment. We propose a user-friendly interface that allows surgeons to arbitrarily select regions on a 3D model of an organ, similar to "painting-by-numbers", and tune the haptic properties of each region in an intuitive way. The selected region and tuned haptic properties are recorded in a lookup table in real-time. The proposed user interface is assessed by comparing the haptic effects of a tumor on a virtual liver created by a number of surgeons.