1. Challenges in Surgical Simulators Muhammad Muddassir Malik Muhammad Adil Usman SEECS, NUST, Islamabad School of Electrical Engineering & Computer Science, National University of Sciences & Technology, Pakistan 1 Muhammad Muddassir Malik C C U U I I

2. Survey on Surgical Simulators 2Muhammad Muddassir Malik C C U U I I

3. Survey on Surgical Simulators Muhammad Muddassir Malik3 C C U U I I

4. System Components Dataset Mechanical Object Tissue Modeling and Characterization Illumination Mechanism Collision Detection Teaching Resources Assessment through metrics and feedback Performance Monitoring Video 4Muhammad Muddassir Malik C C U U I I

5. Dataset Geometric (derived from a scan?) – Triangular – Tetrahedral Volumetric (CT and MRI) (video) (video Multimodal Biomechanical 5Muhammad Muddassir Malik C C U U I I

6. Mechanical Object Position Tracking (multi degree freedom) Feedback – Visual – Hepatic Force Tactile Bi-directional Communications To Ensure Correct Frame rate 6Muhammad Muddassir Malik C C U U I I

7. Tissue Modeling and Characterization Biomechanical properties Physics Stress-strain Relationship * Topological Changes with wear and tear (viscoelastic) Inhomogeneous and Direction dependant Tissue Behavior* Fluid and movement (video)video 7Muhammad Muddassir Malik C C U U I I

8. Illumination Mechanism Global Light and Spot Light Shadows Depth Perception 8Muhammad Muddassir Malik C C U U I I

9. Collision Detection Two stage collision detection (Boundary, Loci) Collision Types: – Bounding Spheres – Axis-Aligned Bounding Boxes – Oriented (along Eigen Vector) Bounding Box Hardware Acceleration for Loci calculation 9Muhammad Muddassir Malik C C U U I I

10. Teaching Resources and Assessment Implementing Laparoscopic Training Manual and specific scenarios Cues, Feedback and comparisons Assessment through metrics and qualitative feedback – Errors – Movement – Time – Forces 10Muhammad Muddassir Malik C C U U I I

11. Performance Depends on Implementation Platform Study of Hardware and Software resources Dry Run for Efficiency 11Muhammad Muddassir Malik C C U U I I

12. Discussion Muhammad Muddassir Malik12 C C U U I I

13. Four Modules Simulation Engine – Based on Simulation Open Framework Architecture – Modeling and Simulation Basic Training Module – Fundamentals of Laparoscopic Surgery Curriculum for Surgeon Training Advanced Training Module – Simulation of complex laparoscopic procedures – Videos provided by Holy Family Hospital of different scenarios of laparoscopic surgery Evaluation Module – Evaluation of surgeons on the basis of simulator training Muhammad Muddassir Malik13 C C U U I I

14. The short comings in General Dataset Haptic Feedback Stress-strain Relationship Topological Changes with wear and tear (viscoelastic) Inhomogeneous Tissue behaviour Shadows Depth Perception Simulation of Complex procedures Muhammad Muddassir Malik14 C C U U I I

15. Major Undecided Issues Multimodal or Tetrahedral Dataset – Create or Acquire Laparoscopic Arms to use: No open source communication protocol available Muhammad Muddassir Malik15 C C U U I I