NOViSE 2 is a research project focused on development and validation of the first virtual reality based simulator for Natural Orifice Transluminal Endoscopic Surgery.
NOTES is an experimental surgical technique whereby "scarless" abdominal operations can be performed with an endoscope passed through a natural orifice, then through an internal incision in the stomach, vagina, bladder or colon, thus avoiding any external incisions or scars. A key aspect of this technique is the innovative use of sophisticated flexible endoscopes. NOTES creates many new challenges and produces extremely steep learning curve for clinicians.
Very little work has been done so far in training for this new type of surgical interventions. VR simulation of NOTES can contribute to surgical training without putting patients at risk, popularizing NOTES and keeping practitioners up to date with new methods.
The simulator set-up consists of a real-time software simulation and a physical, force feedback human-computer-interface (a haptic device). The simulator presently supports a complete trans-gastric hybrid cholecystectomy procedure. The behaviour of virtual flexible endoscope is modelled on a solid theoretical footing - the Cosserat rod. This model allows realistic recreation of all deformations of the endoscope, such as bending and twisting, as well as guarantees immediate response to user manipulations. The operator can choose from four types of actuators to clip and dissect the gallbladder: grasper, clipper, scissors and diathermy tool. The physical parameters of the virtual endoscope can be adjusted to match the behaviour of different models of real endoscopes. The operator interacts with the virtual endoscope via custom built haptic device.