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

Abstract

OBJECTIVE: 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. METHODS: 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. RESULTS: Objective and subjective evaluations of the system demonstrate its utility for surgical training and establish various levels of its validity. CONCLUSION: A hybrid virtual/physical configuration of the trainer can efficiently and realistically reproduce the primary steps of the procedure. SIGNIFICANCE: 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.