Virtual reality-based simulator for upper and lower digestive endoscopy and bronchoscopy

Technical features:

• Training system that includes cases of examination of the small bowel and full-length colon, probe handling exercises
• Due to advanced modeling technology, which displays in detail the anatomy of the human colon, and realistic tactile feedback, users can experience various complications and scenarios to build their confidence in the medical maneuvers performed. 

General system features:

• Includes a hardware platform: a height adjustable, ergonomically designed cart with touch screen control
• Haptic unit, with force feedback on insertion and rotation; the unit is detachable
• Endoscope handles feature disks, irrigation and suction buttons, instrument channel
• Full-size probes can be inserted, one for endoscopy, one for colonoscopy
• It has a tool channel for therapeutic exercises
• Includes 3 software modules: basic skills, endoscopy, colonoscopy
• It has a user-friendly interface for course management and exercise setup
• Dynamic realistic graphics

Software modules included:

Basic skills module contains 13 exercises, including diagnosis and therapeutic interventions. It is not haptic.

Basic skills 1:

• Probe handling
• Button handling
• Handle operating
• Navigation skills
• Colon view

Basic skills 2:

• Preparation for assessment: Navigation
• Preparation for assessment: mucosal examination
• Preparing for assessment: Targeting
• Preparation for assessment: Retroflexia
• Preparing for assessment: Loop reduction

Therapeutic skills:

• Biopsy
• Polypectomy with biopsy
• Sclerotherapy

The equipment allows the user to repeatedly practice basic techniques at increasingly higher levels of difficulty. It offers the possibility to adapt to the scenarios and complications encountered by the trainee during the training. A detailed results table is displayed after each exercise, showing measurements and statistics, providing quick feedback on the user's progress.

How to perform a colonoscopy:

• Includes cases of complete intubation up to the cecum
• Allows practice in making and managing loops
• The colon model is very flexible, allowing for anatomical modifications and new cases to be presented
• Includes measurements and results page for evaluation during debriefing sessions

The endoscopy module:

• Features cases of complete intubation up to the duodenum
• Provides visualization and navigation guidance
• Provides the possibility for the user to practice biopsy sampling and photography
• Features two anatomical variations
• Provides results and measurements, including visual feeback on mucosal surfaces examined, targets reached, anatomical landmarks traversed, mucosal injury and more

How to perform ERCP:

• Provides the user the opportunity to practice endoscopic retrograde endoscopic cholangiopancreatography in a realistic environment
• It is particularly focused on bile duct cannulation
• Enables simultaneous viewing of endoscopic and fluoroscopic images
• Allows navigation with a 90° angled camera to the duodenum and the possibility of identifying the Vater papilla
• Allows correct positioning of the catheter before the Vater papilla
• Cannulation through the papilla and into the bile duct can be performed under radiologic guidance
• Allows handling of the guide wire and sphincterotome
• The pancreatic duct can be avoided
• Contrast substance may be injected and X-ray interpretation may be performed

How to perform bronchoscopy:

• Provides full and/or partial navigation, as well as the possibility to perform diagnostic and interventional procedures
• Advanced tactile feedback technology combines with unrivaled graphics
• Possibility to open a separate image on the same screen to track the position of the probe in real time
• Possibility to visualize the bronchial tree in 3D
• Ability to zoom, move, rotate
• Various anatomical details can be displayed with names
• The simulated bronchoscope has the same functionality as the real one; the handle has 4 digital buttons: a suction button, an instrument channel and a distal angulation control lever system  

Hardware unit:

• The haptic unit of the simulator uses one probe for endoscopy (Ø 8 mm), one probe for colonoscopy (Ø 13) and one for bronchoscopy.
• The haptic unit is detachable and functions as a stand-alone unit
• The height of the cart is adjustable between 85 and 97cm

The system includes:

• Haptic unit
• Two probes: for endoscopy and colonoscopy
• Software modules
• Monitor