Immersion Medical introduces new laparoscopic procedural skill module and OB/GYN module for LaparoscopyVR surgical simulator

San Jose 15 October 2007Immersion Medical has released a new procedural module for its laparoscopic surgical simulator, the LaparoscopyVR (LapVR) system, introduced this past June. Laparoscopic procedures account for as many as 70 percent of all high-volume surgeries in the United States and the trend is expected to continue (The U.S. Market for Medical Devices - Opportunities and Challenges for Swiss Companies. 2004. Swiss Business Hub USA, Chicago.). The new Running the Bowel (RtB) surgical simulation module trains procedural skills commonly needed during trauma, general, OB/GYN, bariatric, and colon-rectal surgery.


"Running the bowel requires careful technique, and Immersion Medical's LapVR simulator provides a remarkably realistic training environment to develop this skill", stated Dr. Andrew J. Duffy, assistant professor of surgery at Yale University School of Medicine. "The system reproduces the feel of handling the intestines and allows practice of the hand-over-hand technique and other bowel manipulations."

Suspected injury to the small intestine is commonly investigated through the running the bowel procedure, in which the surgeon inspects the length and all sides of the small intestine. The new RtB module makes the LapVR surgical simulator the first to provide interaction with the bowel's mesentery connective tissue, providing a very realistic training environment for learning inspection, measurement, and manipulation of the small intestine.

The new RtB surgical simulation module teaches a systematic approach to evaluating the small intestine and can help instill the ability to make accurate measurements of the bowel and to also use a stapler, such as for gastric bypass surgery. The procedure provides three different techniques for appropriately measuring lengths of bowel. Additionally the simulator provides metrics to evaluate the user's techniques, precision, movement, errors, and amount of inspection completed. The module supports hand-over-hand and side-to-side techniques to help the user acquire the necessary hand-eye co-ordination and dexterity before addressing actual patient cases.

"Immersion Medical's new Running the Bowel module allows trainees to learn to minimize injury to the bowel and mesentery", stated Dr. Kevin Kunkler, vice president and medical director of Immersion Medical. "The simulations allow use of different two-handed techniques and the mesentery adds an extra layer of realism. It's very important for students to understand, both visually and through resistance, bowel-mesentery interaction and how much the bowel can be stretched."

In addition, Immersion Medical has introduced the OB/GYN surgical simulation module. The new module makes the LaparoscopyVR surgical simulator the only platform for laparoscopic training of three commonly performed OB/GYN procedures: ectopic surgical intervention, tubal occlusion, and salpingo-oophorectomy or fallopian tube and ovary removal.

Since 1970, the frequency of ectopic pregnancy has increased six-fold, today occurring in 2 percent of all pregnancies. (Sepilian, Vicken P. 2007. Ectopic Pregnancy. Emedicine. - accessed August 23, 2007.) Ectopic pregnancy is the leading cause of maternal mortality in the first trimester and accounts for up to 15 percent of all maternal deaths. (Tenore, Josie L. 2000. Ectopic Pregnancy. American Family Physician. - accessed August 23, 2007.)

"Because of the emergent nature of ectopic pregnancy, there is a need for a high fidelity simulator to provide training for its laparoscopic treatment", stated Dr. Kevin Stepp, assistant professor, Case Western University at Metro Health Medical Center. "The OB/GYN module provides valuable training in both salpingostomy, which preserves the tube to maintain fertility, if possible, and salpingectomy, which removes the tube. Simulation training for OB/GYN laparoscopic procedures is an excellent and necessary adjunct to the training of future OB/GYN surgeons."

Second only to the birth control pill, tubal ligation is chosen by 27,6 percent of American women as their method of contraception. (U.S. Department of Health and Human Services, Health Resources and Services Administration, Women's Health USA 2006. 2006. - accessed August 23, 2007.) The LapVR OB/GYN module simulates three techniques for tubal ligation: bipolar electrosurgery, cutting, and clip application.

"Because tubal ligation is so common, it's a procedure that must be very well practised and understood by residents and fellows", stated Dr. Kelly H. Roy, clinical instructor at the University of Arizona, Phoenix Campus. "It's encouraging that we now have a much more complete OB/GYN laparoscopic surgical simulator that helps physicians learn independently, perfect their technique, and understand how to avoid complications, such as injury to the ureter and surrounding vital structures."

Salpingo-oophorectomy, the removal of the fallopian tubes and ovaries, is performed to treat ovarian or other gynaecological cancers or infections caused by pelvic inflammatory disease. With the availability of genetic testing for the breast and ovarian cancer (BRCA) gene, the rate of performing salpingo-oophorectomy for cancer risk reduction has increased. A BRCA gene change means a woman may have up to a 60 percent chance of getting ovarian cancer. (National Cancer Institute. 2002. Genetic testing for BRCA1 and BRCA2: It's your choice. - accessed August 7, 2007.) Salpingo-oophorectomy has been associated with an 85 percent reduction in ovarian cancer. (Kauff, Noah D., Deborah Goldfrank, and Richard R. Barakat. 2004. Preventing BRCA-related cancers: The case for oophorectomy. The Journal of Family Practice. - accessed August 23, 2007.)

"Immersion Medical's Salpingo-Oophorectomy procedure for the LapVR surgical simulator provides very realistic feel of the cut and coagulation aspect of salpingo-oophorectomy", stated Dr. Damian P. Alagia III, director of minimally invasive gynaecologic surgery at the George Washington University Hospital. "This simulation platform is a very welcome contribution to both experienced OB/GYN surgeons and surgeons in training."

All of the procedures in the new module can be performed on several simulated patients, each with different anatomy and physiology involving increasing levels of difficulty for the surgeon. This stepwise approach can serve to deepen the trainee's experience. Further, residents can use the surgical simulator to gain basic laparoscopic skills, a clearer understanding of the procedure, recognition of pertinent landmarks to help minimize complications, and unlimited virtual reality training. The medical simulator provides performance metrics after every procedure, which provide immediate user feedback and allow instructors to address individual needs.

"Our goal has always been to expand our LapVR modules to provide simulation training for multiple disciplines, making the system one of the most extensive in the virtual reality medical simulation field", stated Mark Meents, vice president of marketing and sales at Immersion Medical. "With our newest module release we are proud to now offer the most complete OB/GYN simulator in the field. The unique design of our LapVR surgical simulator, with both hardware and software designed by Immersion Medical, gives us a flexible platform for development of laparoscopic training modules for many disciplines."

The LapVR virtual reality surgical simulator is designed as a complete system with tightly integrated TouchSense haptic hardware and software. The surgical simulator provides a physics-based environment that allows authentic and realistic graphical movement of tissue and organs integrated with realistic tactile feedback forces felt through the trocar arms and handles. The surgical simulation system comes with widely viewable monitor suitable for team training, virtual camera, tools, and Administrator, Essential Skills, Adhesiolysis, and Lap Chole surgery or gall bladder removal modules - all packaged in an ergonomic, height-adjustable, wheeled cart. The LapVR surgical simulator includes a curriculum that follows industry training standards, providing key material needed to administer effective training programmes for both individuals and teams. Institutions can also import their own didactic video content directly into the surgical simulator for customized training.

Immersion Medical is committed to providing a wide range of multi-disciplinary simulation training modules that can have a positive impact on patient care. The company focuses on providing tightly integrated hardware and software solutions to deliver a realistic experience including the look and feel of laparoscopic surgeries.

Immersion Medical Inc. designs, manufactures, and markets computer-based surgical simulation training systems worldwide. The medical and surgical simulators integrate proprietary computer software and tactile feedback robotics to create highly realistic medical simulations that help train clinicians. The company's key product lines are the Virtual IV system, Endoscopy AccuTouch Simulator, CathLabVR surgical simulator, and LaparoscopyVR surgical simulation system.

Founded in 1993, Immersion Corporation is a recognized expert in developing, licensing, and marketing digital touch technology and products. Using Immersion's advanced touch feedback technology, electronic user interfaces can be made more productive, compelling, entertaining, or safer. Immersion's technology is deployed across automotive, entertainment, industrial controls, medical training, mobility, and three-dimensional simulation markets. Immersion's patent portfolio includes over 600 issued or pending patents in the United States and other countries.

More news on Immersion Medical is available in the VMW July 2007 article Immersion Medical introduces LaparoscopyVR Surgical Simulation System.

Leslie Versweyveld

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