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ProMIS: accelerating surgical performance through simulationSAGESPhoenix, AZ April 2009www.haptica.com | +1 617 342 7270 | info@haptica.com
ProMISSAGES09 © Haptica 2009
Accelerating performance through simulation
With simulation
Without effective simulation solution
Time
Adop
tion
; Pa
tien
t Sa
fety
• More surgeons doing
• more procedures • more proficiently – • in less time, • at lower cost and • at lower risk
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ProMISSAGES09 © Haptica 2009
The NEW ProMIS3™ surgical simulator:
100% of trainees felt that ProMIS "simulated reality effectively compared with only 38% in the VR group".
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JSLS(2008)12:219-226
ProMISSAGES09 © Haptica 2009
The NEW ProMIS3™ surgical simulator
• Real instruments interact with virtual and physical models, with comprehensive metrics on performance
• Outperforms pure VR for MIS training • Metrics are “Excellent predictors” of scores in
FLS; “predict readiness for FLS Certification”. • Basic Laparoscopic Skills and procedures• Meets ACS & ACGME RRC requirements for
simulation • Three surgical and technical innovation
awardsPage 4
Pure VR Task in ProMIS—using real instruments
‘Mixed reality’ Task: real anatomical model; real instruments; 3D graphics
Why ProMIS3?• Highly realistic camera image• Flexible positioning and zoom• Multiple real instruments in realistic port
positions• Team training and non-technical skills training• Multiple procedures• Improved metrics reporting and functionality• Build, adapt and integrate Modules and Tasks
—including FLS and local curriculum
ProMISSAGES09 © Haptica 2009 Page 5
ProMISSAGES09 © Haptica 2009
Developing proficiency with ProMIS
• Augmented reality, graphics, video & audio provide guidance and instruction
1. Show• Physical and/or
virtual anatomic model
• Tactile feedback
• Real instruments
2. Practice• Valid metrics &
proficiency• Records errors• User and group
records
3. Measure
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ProMISSAGES09 © Haptica 2009
ProMIS Basic Laparoscopic Skills Basic Laparoscopic Skills
Laparoscope Orientation Instrument Handling Dissection
Suturing & Knot-tying SAGES/ACS FLS Module
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ProMISSAGES09 © Haptica 2009
ProMIS LapAppendectomy• Full LapAppendectomy
procedure: Investigation Diathermy Loop placement Cutting
• Mixed reality approach (virtual reality with real instruments and real appendix model)
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ProMISSAGES09 © Haptica 2009
ProMIS Lap Colectomy• Full step-by-step procedure• Mix of virtual and physical
reality• Uses real instruments• Physical model enables
realistic tactile feedback• On-screen graphics,
animations, video, audio, text• Automatic metrics Page 9
ProMISSAGES09 © Haptica 2009
ProMIS for Single Incision Surgery (SIS)• First simulator for Single Incision
Surgery• Will work for current ProMIS
Modules• Place any instruments (and any
Task) in ProMIS and get proficiency metrics
• Ask now to participate in our trial to compare metrics on a FLS task when done pure lap vs SIS
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ProMIS Metrics• All tasks: measure
Time Path length Economy of movement Hand dominance
• Play back track of instrument • Play back video of performance
ProMISSAGES09 © Haptica 2009 Page 11
Learning Management System• Create users and Groups• View records of individual
and group performance• Query by user, group,
specific Module, etc.• Set proficiency levels• Export data to Excel• Network for remote access
ProMISSAGES09 © Haptica 2009 Page 12
ProMISSAGES09 © Haptica 2009
Integrating ProMIS into the curriculum
Use ProMIS
Modules
Record UsersUse with FLS
Use Your Own
Modules
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Customising and Developing Modules‘Open Module’:Put any existing Task
in ProMIS and get standard metrics (as has been validated with FLS Tasks).
ProMISSAGES09 © Haptica 2009 Page 14
ContentCreationTool• Design new measurable Tasks• Record/insert instruction video• Add audio cues and on-screen
text• Insert augmented reality,
graphics for on-screen guidance
• Set proficiency levels• Edit existing ProMIS Tasks
ProMISSAGES09 © Haptica 2009 Page 15
Proven with FLS; Better than VR; Preferred by Users
• 100% of trainees felt that ProMIS "simulated reality effectively compared with only 38% in the VR group" 8
• An “excellent predictor” of scores in FLS; “predict readiness for FLS Certification”1 2 3
• Delivers performance data with robotic instrumentation4
• “ProMIS scored significantly higher than SurgicalSIM; better than LapSim on all tested features”5 6
ProMISSAGES09 © Haptica 2009 Page 16
1 SAGES 2006 S064 Ritter et al2 SAGES 2006 P237 McCluney MD, et al3 SAGES 2007 P279 McCluney et al4 SAGES 2006 S065 Vuong et al5 SAGES 2006 P224 Fellinger, et al6 World J Surg. 2007 Apr. Botden et al7 SAGES 2007 S077 Lin et alJSLS(2008)12:219-226
ProMISSAGES09 © Haptica 2009
Why ProMIS wins in surgical simulation• Best curriculum
Basic skills, procedures, FLS• Best instructional approach
Real instruments, real haptics and VR; team training
• Best validation >25 studies validated Metrics; better than VR
• Best customization Edit and design new Tasks to integrate with
curriculumPage 17