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).

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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