"As an exciting new product for Verefi that addresses one of the more challenging aspects of laparoscopic or minimally invasive surgery - laparoscopic suturing, LapFAST recently received excellent reviews by experts at the American College of Surgeons meeting", stated Verefi Technologies Inc. President, Dr. Randy Haluck. "LapFAST builds on Verefi's track record of useful abstract simulated environments for effective skill transfer."
Intended for training general surgeons, gynaecologists, and urologists in laparoscopic minimally invasive abdominal surgery, LapFAST helps novices develop suturing skills by targeting individual aspects of the suturing procedure with specific training exercises. The virtual reality trainer has seven modules that break down the suturing process into a series of specific steps for practising in the laparoscopic environment including preparation, orientation, approximation, rotation, co-ordination, separation, and termination. A scoring system is integrated into the trainer. Validation of LapFAST is based upon sound educational principles and adult learning techniques.
LapFAST completes Verefi's SkillSet Pro suite of basic laparoscopic skills training software that teaches key skills of touching, grasping, placing, holding objects, and suturing in the virtual environment.
LapFAST's seven learning modules break down the suturing process into a series of specific steps for practising in the laparoscopic environment. The learning steps include:
- Level 1: Preparation - A warm-up exercise designed to train in the simultaneous movement of the laparoscopic instruments that is required for laparoscopic suturing and tying. Target spheres appear and must be touched by both tools at the same time.
- Level 2: Orientation - For suturing, the needle must be loaded internally and held in the needle driver at an appropriate angle. This module allows the user to load the needle and adjust its angle with the other tool. The position and angle of the needle are then tested by holding it against a pad with a transverse stripe representing the suturing area.
- Level 3: Approximation - The needle must be threaded into the eyelet on top of a cylinder, which is then picked up and placed inside a target circle. The needle must then be regrasped near its tip and pulled through the eyelet without bumping or pulling the cylinder out of the target zone to stimulate the pulling of a needle through tissue.
- Level 4: Rotation - The needle must be grasped near its tip and aligned so that its swage end is parallel to and aligned with the tip of the opposing instrument. Once they are properly aligned and brought together, a dial appears on the needle's swage end. The dial must be spun in the indicated direction for two rotations by moving the needle and opposing instrument tip around each other.
- Level 5: Co-ordination - The needle driver tip must be placed near the shaft of the opposite tool, touching a sphere just behind its grasper jaws. Both tools must be moved in concert toward target spheres, which must be grasped by the opposite tool. This is to stimulate motion, required in knot tying, of moving both instruments together to grasp the tail of the suture.
- Level 6: Separation - Trains in the tool motions required to cleanly pull the suture's tail through the suture looped around the grasper's shaft. A funnel-shaped cylinder is held at its wide end by the needle driver. A sphere at its narrow end must be grasped by the other instrument. The sphere and cylinder must be moved in opposite directions simultaneously in order to pull the sphere through without contacting the cylinder walls.
- Level 7: Termination - Practice in the final stages of creating a suture, in which the knot is formed and pulled tight. Appropriate force must be applied by each tool as the knot is tightened in order to maintain its short tail.