2. Simulation for Training January 25 th, 2003 MMVR Simbionix Corp. 11000 Cedar Ave. Cleveland OH 44106

3.  State-of-the-art R&D capabilities: Simbionix specialized technologies include: Simbionix Simulation Engine (SSE-3D ™ ), organic tissue visualization engine, tracking & force feedback devices, internet connectivity and more  4 families of products: GI Mentor, URO Mentor, PERC Mentor & LAP Mentor  Vast library of add-on modules for diagnostic and therapeutic procedures  Over 140 customers worldwide A leader in MIS simulation

4. Simbionix ’ suite of MIS simulators: LAP Mentor Lap Chole procedure - Complete and continuous Basic generic skills URO Mentor Rigid and flexible scopes Cystoscope and ureteroscope Stones and strictures Basic tasks PERC Mentor Fluoroscopic procedures Percutaneous Nephrostomy (PCN) Normal and Obese patients Basic Tasks GI Mentor Colonoscopy Sigmoidoscopy Gastroscopy Emergency Bleeding ERCP EUS

5. The New Endoscopic Ultrasound (EUS) module Hands-on training in EUS procedures Linear and radial imaging Excellent learning aids

6. A didactic hands-on training system  Instructor mode: manages single or many trainees, assigns tailor-made program, reviews performance, assesses improvement over time, plays- back procedure  Case files: includes a variety of virtual patients with complete case files based on real cases. The case files include case history and imaging results  Virtual Instructor: provides comments and warning pop-up during procedure to assist with the learning process  Teaching Indicators: provides additional information necessary for teaching, such as pain indicator while performing GI procedures  Performance review: gives quantifiable parameters, play-back, compares to previous performances, detects problem patterns and difficulties, enables statistic analysis

7. GI Mentor Validation Studies  Evaluation of a virtual endoscopy simulator for training in gastrointestinal endoscopy. Published in Endoscopy 2002; 34(9): 698-702. A. Ferlitsch, P. Glauninger, A. Gupper, M. S. Schillinger, M. Haefner, A. Gangl, R. schoefl.  Flexible Sigmoidoscopy: Assessing Endoscopic Skills Using Computer- Based Simulator Abstract published at ACG meeting, October 2002 (Seattle, Washington). Mahmoud M.Yousfi, M.D.,Darius Sorbi, M.D. Todd Baron, M.D., David E. Fleischer, M.D., Mayo Clinic, Scottsdale, AZ  Basic endoscopy training: Usefulness of a computer based simulator. Presented as a Poster at the DDW, Atlanta, 2001 by Diego Fregonese et al., Cooperative Group for Training in Endoscopy, Rome.  Multi-institutional international study evaluating the use of simulation technology to train fellows in colonoscopy. Conducted by Brian J. Dunkin from Miami School of Medicine. In progress.

8. URO Mentor Validation Studies  Assessment of basic endoscopic performance using a virtual reality simulator. J.A.C.S., 195:675-681, 2002. Wilhelm, D.M., Ogan, K., Roehrborn, C.G., Cadeddu, J.A. and Pearle M.  A Randomized, prospective blinded study validating the acquisition of of ureteroscopy skills using a computer based virtual reality endourological simulator. The Journal of Urology, November 2002; Vol, 168, 1928-1932. James D. Watterson, Darren T. Beiko, James K Kuan and John D. Denstedt  Six abstracts on topics involving the URO Mentor ™ simulator were published and presented at the 20th World Congress on Endourology and SWL, 18th Basic Research Symposium, September 19-22, 2002 in Genoa, Italy. The articles were selected for presentation in the plenary session of "Highlights of Basic Research Symposium". The full abstracts are available in the Journal of Endourology Abstracts, volume 16, Supplement1, September 2002.  Three abstracts on topics involving the URO Mentor ™ simulator were published and presented at the AUA exhibition in Orlando, Florida, May 26 - 29, 2002. The full abstracts are available in the Proceedings of the AUA Exhibition.