TBNA is the most recent addition to Immersion Medical's product line, which includes simulations for numerous endoscopic, endovascular, and vascular access procedures. Roughly four hundred of the company's systems are applied worldwide in hospitals, universities, colleges, and nursing schools. "Our systems are revolutionising medicine the way flight simulators revolutionised the airline industry", commented Greg Merril, founder of Immersion Medical. "Saving lives and money by reducing medical errors, training time, operating room time and the need to replace expensive equipment, like bronchoscopes, are top priorities for the medical community."
Like all Immersion Medical simulations, the TBNA module mimics both the look and feel of performing an actual medical procedure. During TBNA procedures, physicians guide a scope equipped with a fibre-optic camera into a patient's lungs while viewing their progress on a video monitor. A special needle is then passed through a channel in the scope and into one or more lymph nodes in order to obtain specimens.
In the simulation, the scope is guided into a mannequin while the camera view is replaced by a view of realistic, interactive computer-generated anatomy based on actual patient data. To make the simulation complete, the system incorporates Immersion TouchSense technology, which causes users to feel the resistance of the scope colliding with the anatomy and of the needle penetrating the airway walls.
Simulation users may practise on a variety of patients, each of which has a different case history, exhibits unique symptoms, and responds to user actions with appropriate physiological responses. As in real life, patient anatomy moves with the beating of the heart and the breathing of the lungs while tissues deform, bruise, and bleed. The system generates a detailed evaluation after each session, enabling users and supervisors to measure the success of simulated procedures.
Immersion Medical has garnered international acclaim and high marks from the medical community for the system. "None of our pulmonary fellows is permitted to touch a patient before they have performed satisfactorily on the Flexible Bronchoscopy Simulator", explained Armin Ernst, MD, Director, Interventional Pulmonology, and Co-Director, Medical Critical Care, Division of Pulmonary and Critical Care Medicine, Beth Israel Deaconess Hospital.
Immersion Medical simulations reproduce the visual, the audio, and tactile sensations of the clinical environment by incorporating several advanced technologies. Patient-based three-dimensional anatomical models, designed in conjunction with clinical experts and medical illustrators, duplicate the appearance of organs and tissues. Proprietary interactive software enables these anatomical models to respond in the same way as they would during medical procedures. Completing the sensory cycle, Immersion TouchSense technology transmits delicate force feedback from interface devices, such as the AccuTouch Endoscopy mannequin, through medical instruments to the user, reproducing the feel of the procedures.
This type of application illustrates the importance of haptics, the science of touch, by adding tactile feedback to medical simulators. Touch is a crucial sensory tool that doctors rely upon heavily for accurate diagnostic and tactile confirmation in delicate procedures. Until recently, computers have been able to effectively simulate only the sight and sound of medical procedures. Now, it is possible to add the missing sense of touch to these important tools.
Early versions of similar systems cost hundreds of thousands of dollars to produce and ran on high-end computers unavailable to most users. Current Immersion Medical systems are available for a fraction of the cost and consist of a PC and monitor, an interface device, and proxy medical tools. AccuTouch Endoscopy simulations include: Introduction to Bronchoscopy, Endobronchial Sampling and Brochoalveolar Lavage (BAL), Paediatric Difficult Airways, and TBNA. In addition to the flexible bronchoscopy modules, the system equally runs a flexible sigmoidoscopy simulation. Immersion Medical also produces simulations for pacemaker lead implant procedures and intravenous catheterisation.
Founded in 1993, Immersion Corporation develops, licenses, and markets advanced hardware and software technologies that let people use their sense of touch to better interact with the digital world around them. Immersion's medical simulation systems allow health care professionals to improve their procedural skills and increase safety by using "digital patients". Immersion and its wholly owned subsidiaries hold over 95 issued patents worldwide. You can read more about the company's CathSim Vascular Access Simulator in the VMW April 2001 article New CathSim training system software to evaluate user's intravenous therapy skills.