Simulation Console Research Articles

Effective implementation and adaptation of structured robotic colorectal programme in a busy tertiary unit

BackgroundSafety and feasibility of robotic colorectal surgery has been reported as increasing over the last decade. However safe implementation and adaptation of such a programme with comparable morbidities and acceptable oncological outcomes remains a challenge in a busy tertiary unit. We present our experience of implementation and adaptation of a structured robotic colorectal programme in a high-volume center in the United Kingdom.MethodsTwo colorectal surgeons underwent a structured robotic colorectal training programme consisting of time on simulation console, dry and wet laboratory courses, case observation, and initial mentoring. Data were collected on consecutive robotic colorectal cancer resections over a period of 12 months and compared with colorectal cancer resections data of the same surgeons’ record prior to the adaptation of the new technique. Patient demographics including age, gender, American Society of Anesthesiologist score (ASA), Clavien–Dindo grading, previous abdominal surgeries, and BMI were included. Short-term outcomes including conversion to open, length of stay, return to theatre, 30- and 90-days mortality, blood loss, and post-operative analgesia were recorded. Tumour site, TNM staging, diverting stoma, neo-adjuvant therapy, total mesorectal excision (TME) grading and positive resection margins (R1) were compared. p values less than or equal to 0.05 were considered statistically significant.ResultsNinety colorectal cancer resections were performed with curative intent from June 2018 to June 2020. Thirty robotic colorectal cancer resections (RCcR) were performed after adaption of programme and were compared with 60 non-robotic colorectal cancer resections (N-RCcR) prior to implementation of technique. There was no conversion in the RCcR group; however, in N-RCcR group, five had open resection from start and the rest had laparoscopic surgery. In laparoscopic group, there were six (10.9%) conversions to open (two adhesions, three multi-visceral involvements, one intra-operative bleed). Male-to-female ratio was 20:09 in RCcR group and 33:20 in N-RCcR groups. No significant differences in gender (p = 0.5), median age (p = 0.47), BMI (p = 0.64) and ASA scores (p = 0.72) were present in either groups. Patient characteristics between the two groups were comparable aside from an increased proportion of rectal and sigmoid cancers in RCcR group. Mean operating time, and returns to theaters were comparable in both groups. Complications were fewer in RCcR group as compared to N-RCcR (16.6% vs 25%). RCcR group patients have reduced length of stay (5 days vs 7 days) but this is not statistically significant. Estimated blood loss and conversion to open surgery was significantly lesser in the robotic group (p < 0.01). The oncological outcomes from surgery including TNM, resection margin status, lymph node yield and circumferential resection margin (for rectal cancers) were all comparable. There was no 30-day mortality in either group.ConclusionImplementation and integration of robotic colorectal surgery is safe and effective in a busy tertiary center through a structured training programme with comparable short-term survival and oncological outcomes during learning curve.

Simulation-based training to enhance process safety in offshore energy operations: Process tracing through eye-tracking

Systemic risks and human errors are the root causes of process safety incidents in offshore operations. Human factor amounts for more than 70 % of offshore incidents and among those 75 % of them are due to perceptual errors involving rich information displays. Offshore drilling console is one such area where a display of hundreds of parameters and alarms maintains a constant cognitive load on the driller and upon his slight oblivion, severe consequences can follow. One way to study these errors is through a cognitive approach that focuses on the information accusation patterns rather than a behaviorist approach of focusing on the decision outcomes. In this research, we attempt to apply process tracing through eye-tracking methodology to look at information acquisition patterns of participants during a well control simulation. The simulation was designed on a commercial well control drilling simulator to observe the difference in performances by tracking information acquisition patterns of expert and novice participants. Fourteen (n=14) participants were paired into eight teams with each comprising of a driller and a supervisor. Eye-tracking glasses were used to record the fixation and saccade pattern of the participants over the simulator console and displays. For the analysis phase, four time of interests (TOIs) were selected as drilling break detection, kick detection, kick control, and kick circulation. For these TOIs the fixation and saccades pattern of participants on various areas of interest (AOIs) were analyzed through heat and gaze plots. Significant differences in information acquisition patterns of the novice and expert participants were linked to their performance to reveal valuable insights. Such insights are useful in identifying the dominating factors behind performance and can be used for targeted feedback to improve well control training and evaluation.

Does previous open surgical experience have any influence on robotic surgery simulation exercises?

IntroductionWithin the last years, there has been a trend in many hospitals to switch their surgical activity from open/laparoscopic procedures to robotic surgery. Some open surgeons have been shifting their activity to robotic surgery. It is still unclear whether there is a transfer of open surgical skills to robotic ones.AimTo evaluate whether such transfer of skills occurs and to identify which specific skills are more significantly transferred from the operative table to the console.Material and methodsTwenty-five volunteers were included in the study, divided into 2 groups: group A (15 participants) – medical students (without any surgical experience in open, laparoscopic or robotic surgery); and group B (10 participants) – surgeons with exclusively open surgical experience, without any previous laparoscopic or robotic experience. Participants were asked to complete 3 robotic simulator console exercises structured from the easiest one (Peg Board) to the toughest one (Sponge Suture). Overall scores for each exercise as well as specific metrics were compared between the two groups.ResultsThere were no significant differences between overall scores of the two groups for the easiest task. Overall scores were better for group B as the exercises got more complex. For the intermediate and high-difficulty level exercises, most of the specific metrics were better for group B, with the exception of the working master space item.ConclusionsOur results suggest that the open surgical skills transfer to robotic skills, at least for the very beginning of the training process.

Study of VANET in Intelligent Transportation System Based on OPNET

Vehicle Ad hoc Network are composed of the vehicle with wireless communication equipment, road construction collecting base station transmission network, background processing server and related acquisition and processing software system. Based on Internet of things simulation console, this paper designs vehicle to vehicle scenarios of Intelligent Transportation System, simulates its communication process , analyzes the simulation data of sending and receiving, evaluates the entire performance of the network, which can offer reference to designing and optimizing the Vehicle Ad hoc Network. In this paper we try to prove: In the low speed motion in vehicle to vehicle scenario of Vehicle Ad hoc Network, as the routing protocol in the network layer, AODV protocol is much better than DSR protocol.

MO‐DE‐BRA‐06: MrRSCAL: A Radiological Simulation Tool for Resident Education

Purpose:The goal of this project was to create a readily accessible, comprehensive‐yet‐flexible interactive MRI simulation tool for use in training and education of radiology residents in particular. This tool was developed to take the place of an MR scanner in laboratory activities, as magnet time has become scarce while hospitals are optimizing clinical scheduling for improved throughput.Methods:MrRSCAL (Magnetic resonance Resident Simulation Console for Active Learning) was programmed and coded using Matlab on a Mac workstation utilizing OS X platform. MR‐based brain images were obtained from one of the co‐authors and processed to generate parametric maps. Scanner sounds are also generated via mp3 convolution of a single MR gradient slew with a time‐profile of gradient waveforms.Results:MrRSCAL facilitates the simulation of multiple MR sequences with the ability to alter MR parameters via an intuitive GUI control panel. The application allows the user to gain real‐time understanding of image transformation when varying these said parameters by examining the resulting images. Lab procedures can be loaded and displayed for more directed study. The panel is also configurable, providing a simple interface for elementary labs or a full array of controls for the expert user.Conclusion:Our introduction of MrRSCAL, which is readily available to users with a current laptop or workstation, allows for individual or group study of MR image acquisition with immediate educational feedback as the MR parameters are manipulated. MrRSCAL can be used at any time and any place once installed, offering a new tool for reviewing relaxometric and artifact principles when studying for boards or investigating properties of a pulse sequence. This tool promises to be extremely useful in conveying traditionally difficult and abstract concepts involved with MR to the radiology resident and other medical professionals at large.

Development and Experiment of ESD Simulator Console

This paper put forwards the overall design idea and scheme for ESD simulator console, which conducts analysis on the two key technologies of motion control system, i.e. control motor and programmable control. In this paper, test comparison regarding the experiment of repeatability of air discharge current wave form of ESD simulator has been conducted. The results indicated that repeatability of air discharge current wave forms has been improved to some extent.

Dare II: Fast on-line digital simulation on a small computer

DARE II is a remarkably fast, on-line, all-digital, block-diagram-based simulation system which adds a convenient and inexpensive simulation console to a PDP-9 computer. Block statements, control logic, tabular functions, and data are entered and edited on a CRT keyboard. Solutions appear on a second CRT display and can be plotted or printed out for report preparation. A fully commented program and solution record can be printed out on a teletype and programs may be stored on punched paper tape to be run again at a later date. The DARE II system can be easily programmed to make optimal use of the computer, generating a much faster program than a FORTRAN compiler.

Interactive simulation terminals to the IBM 360/91 computer

This paper explains the multiprocessing-via-the- terminal approach to interactive simulation taken at the Applied Physics Laboratory. Two systems are discussed: (a) the simulation console (SIMCON) used for all-digital interactive computing, and (b) the 680 hybrid computer used for analog/digital computing. Hardware configura tion, software, operational characteristics, and cost of operation are detailed for these systems, which are operat ing as time-sharing terminals into an IBM 360/91 from a simulation laboratory 800 feet distant from this central processor. (Cable lengths are actually 1000 feet to allow for future movement of equipment within buildings. )