Development and Validation of a Hybrid Nuss Procedure Surgical Simulator and Trainer.

Abstract

This work presents the development and validation of an interactive simulation training platform for the minimally invasive repair of pectus excavatum, otherwise known as the Nuss procedure. The challenges and implications of developing both an all-virtual and an all-physical version of the simulator are investigated in a training context. A hybrid system is then developed that integrates virtual and physical constituents and a haptic interface to reproduce the primary steps of the procedure and to satisfy clinically relevant prerequisites for its training system. Furthermore, this work carries out a study to investigate the system's face, content, and construct validity. Objective and subjective evaluations of the system demonstrate its utility for surgical training and establish various levels of its validity. A hybrid virtual/physical configuration of the trainer can efficiently and realistically reproduce the primary steps of the procedure. Outside of this work, a simulation and training platform for the Nuss procedure is not available. This system was developed in close collaboration with the pioneers of this surgical technique.