This Phase I effort will develop a training simulator for dilation and curretage (D&C), operative hysteroscopy, and endometrial ablation that will allow gynecologists to both see and feel the field of operation. Simulators allow the introduction of anatomic variation, simulation of untoward events, and collection of surgical performance data. Simulation with force feedback offers the ability to monitor forces on the virtual surgical instruments to permit concurrent assessment of operative maneuvers, and to improve training to reduce the risk of uterine perforation. As the value of hysteroscopy becomes more widely recognized, and as hysteroscopic equipment becomes more available, training needs will increase. This need exists not just in resident training programs, but also for continuing education by practicing physicians. Effective simulators could serve to raise the competency levels of physicians in private practice who infrequently perform hysteroscopic procedures, may be used by certifying agencies for establishing surgical competency, and by hospital quality assurance committees that evaluate surgical complications. Though increasing adoption of hysteroscopic procedures may red ice the number of blind procedures such as traditional D&C, force feedback simulators offer major benefits for the training of these procedures as well, since blind procedures rely entirely on the sense of touch.
The proposed work would lead to training simulators for gynecologic minimally-invasive surgery that could be sold worldwide to medical training institutions and physicians in private practice. The U.S. trains over 1300 ob/gyn physicians annually. 1.8 million minimally-invasive gynecologic procedures are expected to be performed annually in the U.S. by 2002, making gynecology one of the most commercially promising simulation markets.
