Hands-On Experience

Florida Poly Researchers Develop Technology to Train Surgeons

by PAUL CATALA

In the past, doctors and surgeons in training would have to work on a dummy or mannequin or perhaps a donated cadaver to get hands-on training for future surgeries. 

When those aspiring surgeons are learning to perform delicate operations in orthopedic surgery such as arthroscopic procedures, using operating tools in small incision openings, there isn’t much leeway for maneuvering and positioning. Even using a small camera to see inside also has constraints. 

However, thanks to research on the use of virtual computer-assisted technology, the process of getting experience can be easier and more efficient. Because of that improvement, a group of faculty and student researchers at Florida Polytechnic University in Lakeland have been working to make training easier and more efficient through technology.

Led by Dr. Doga Demirel, a Florida Poly assistant professor of computer science, the group has been working to update and improve the school’s Fundamentals of Arthroscopy Surgery Training (FAST) Program. They have been developing FAST in a virtual form, called “VFAST.” 

Demirel, who has been at Florida Poly since August 2019, says the school was in a partnership with Dr. Shahryar Ahmadi, assistant professor of orthopedic surgery and director of the Shoulder and Elbow Surgery Center at University of Arkansas for Medical Sciences, when the concept for VFAST was developed. 

Assisting Demirel and Ahmadi were Dr. Tansel Halic, associate professor and Dr. Sinan Kockara, professor at University of Central Arkansas, Conway, Arkansas. 

Demirel—who got his doctorate in computer sciences in December 2018 from the University of Arkansas at Little Rock—says in 2017, Ahmadi told the group about shoulder arthroscopic surgery and how there wasn’t much in the way of conventional training methods other than cadavers or FAST to use. 

“He said FAST is a physical workstation and only has one kind of difficulty. He said, ‘What if we created this and added a virtual environment and added different difficulty levels and certain metrics to be able give students subjective scores once they finish a session?’ ” says Demirel, 29.

Demirel says the effort has been ongoing and what’s being created is computerized training using haptic devices that provide touch feedback to users in real time. When operational difficulty increases, the student-trainees get to experience situations that could feasibly happen during actual surgeries. 

“That’s how we were able to connect to the computer and give the user the same sense of touch that is very similar to real life,” says Demirel, who adds he’s the only professor at Florida Poly utilizing Haptic devices for research.

Assisting Demirel in VFAST program development were Douglas Burnside and Jacob Barker, computer science majors who graduated in spring 2020. They will both continue to assist Demirel as graduate students.

Burnside, 23, will be starting his sixth year of studies and says he hopes to work as a simulation-game-software developer. He says going into the project, it seemed it would be difficult to include and use haptic devices since he had no prior experience with them.

However, using OpenHaptics software made learning to use the device easy, says Burnside, who’s from Lakeland. He says replicating live surgery was their primary focus. 

“While making the simulation, we had to try a few different options with our code and physics collisions to make it look realistic,” says Burnside. “We wanted to create a testing tool that could be comparable to the real thing and potentially used as an alternative.”

Besides the realism the VFAST gives, the development team has put together various metrics which grade users in real time, which allows for immediate feedback regarding any mistakes and offers ways the users can improve.

As far as the University of Central Arkansas, Demirel says initially the study was going to be in partnership with AdventHealth, but the coronavirus put that on hold. The collaboration began with the university in part because the professors were Demirel’s academic advisors for graduate studies. 

Since beginning the development of VFAST, Demirel says the ongoing work to complete the interdisciplinary computer-medical sciences project has been done daily between about 10 people from Florida Polytech, University of Central Arkansas and University of Arkansas for Medical Sciences. 

Demirel, who lives in Lakeland, says the main goal now is to get system validation studies done because “at the end of the day, without the validation, it would be similar to just a game.” He says VFAST will be provided to practicing surgeons and trainees to gain feedback

“Our goal is to be able to validate it, make sure with surgeons that it’s helping them learn the procedure, not just a game for them. That’s why we have the metrics…to help them understand and help them learn the concepts and be able to carry them out on the VFAST,” he says. 

The next goal for the team is to get a study paper published and get VFAST utilized and in the hands of surgeons. 

“The bottom line is to give the orthopedic surgeons … a platform to train on before starting to work on real patients,” he says. 

“This will help them have less errors when they’re working real patients and having less errors would be less time in the hospital and less cost to the hospital and the patients themselves.”

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