Paradoxical Movement trainer- for Instrument Handling
The device is designed in such a way
that paradoxical movements are
taught. One needs to be moving the
hand in opposite direction to perform
an action, which means when an object
is below and needs to be picked up the
hand holding the instrument has to be
moved upwards. Similarly when an
object is on the left side of the
instrument, the hand holding the
instrument has to be moved to the
right.
Periscope Trainer
This is a very cost-effective and
simple devise used for learning skills
required to perform laparoscopic
surgery. The device is designed in
such a way that a person is able to
keep looking vertically forward and
able to see objects on the ground.
Various surgical skills are taught to be
performed at a lower level while
watching it vertically without bending
down. This is required for acquiring a
skill called hand-eye co-ordination.
During the performance of
laparoscopic surgery we need to be
looking at a different direction and
performing an operation elsewhere
and this type of task required “hand-
eye co-ordination skill”.
The device is designed in such a way
that paradoxical movements are also
taught. Most of the tasks required to
perform complex laparoscopic and
other endoscopic surgeries can be
taught on this trainer. This is an ideal
trainer to be used by students
BEST Endotrainer
This is a very cost-effective trainer which has done away with all the expensive gadgets required to perform and train endoscopic surgical tasks. The equipment that would be required to train a doctor in the field of laparoscopic surgery are:
- A high definition CCD or CMOS camera which is designed to hold a surgical endoscopic with a coupler
- A cold-lightsource which could be mounted with halogen, halide, xenon or a LED bulb
- A fibre-optic cable to transmit the light from the light source to the endoscopic
- A high definition endoscopic which is a combination of a telescope with lens specially designed to give an angled view along with a rim of fibe-optic bundles to transmit light from an external source.
- A hollow cavity which would mimic a chest or an abdominal cavity in which an operation has to be performed
- Appropriate holes on the cavity from which sites the telescope and operative instruments can be inserted
- Instruments called trocar cannulas which are introduced through these sited, which facilitate introduction of operative instruments into the cavity to perform surgical tasks and procedures
- A high definition monitor which is used to view the image of an object inside the cavity using the light source, telescope and camera
All this is designed in such a way that there is no compromise on quality but the cost is reduced by more than 100 times. The endotrainer incorporates the following features:
- The direction of introduction of the telescope and operative instruments are similar to a realtime surgery being performed
- The distance and angulation of the instruments are maintained exactly the way it is done during performance of an operation
- The endotrainer has several gadgets which can be placed inside to perform tasks similar to a surgery and the direction at which they need to be viewed and approached is adjustable. The ports through which the instruments reach the internal object are designed similar to a real-time situation.
- Uniform illumination of the objects inside the cavity without a shadow being created as in a surgical situation is maintained
- Every type of instrument used in a surgical procedure can be used in this endotrainer
- The most unique feature is performance of surgical tasks and procedures in this trainer in all different sites, from a procedure being performed on the floor to a roof-top surgery. There is no single trainer across the globe that is designed and incorporated this feature.
Circulation Pump
This is a special device which “brings life to dead objects”. It is a device which
provides a “pulsatile flow” to liquids being infused into an object.
Normally we are operating on organs which have blood circulating in them. We see
blood oozing out of the tissues when we cut them.
It is important to perform an operation with minimal blood loss. For this there are
tasks that are performed to obliterate blood from flowing into an site that is
operating and also procedures that are followed to stop bleeding that is happening
from a tissue, blood vessel or an organ. The circulation pump is designed to mimic
the exact type of blood flow in the different parts of the body caused by a beating
heart. This is basically a “pulsatile flow” which means there is a variation in the
velocity of flowing liquid from a complete no-flow situation to a graduated high
velocity flow and then a gradual reduction in the velocity to a complete cessation.
The pump is connected to a fluid source on one end and a tube on the other end
which is introduced into harvested organs. The circulation pump creates a
simulation similar to a live surgery.
Virtual Reality Laparoscopic Surgery Training Module
This was jointly developed by B.E.S.T.
Institute & Research Centre along with
D.R.D.O. The best skills training can be
achieved outside a real-time situation
only be using virtual reality simulators.
This has been proved in various
situations including flight simulators.
The idea of developing a simulator for
teaching laparoscopic surgical skills
(which has a very steep learning curve
and is a dangerous thing to do on
patients) was mooted by Dr. M. Ramesh,
Director of B.E.S.T. Institute who
presented his views to Dr. A.P.J. Abdul
Kalam in March 2000 A.D., the then
Chief of D.R.D.O and Scientific Advisor
to the RakshanaManthri.
Dr. Kalam established a research and
development project at Centre of
Artificial Intelligence and Robotics for
development of a Virtual Reality
Laparoscopic Surgery Simulator, along
with Bangalore Endoscopic Surgery
Institute & Research Center. The Phase I
of the development was carried out from
2001-2003. The Phase II was
independently done by B.E.S.T. Institute
from 2003 – 2005 by establishing a
separate lab for the purpose. The project was funded by Society of
BioMedical Technologies(S.B.M.T), a
subsidiary of D.R.D.O. This is a simulator
which trains different tasks that are
required to perform laparoscopic
surgery. A precise assessment of each of
these skills is done by this simulator. The
simulator developed was the third of its
kind in the world and greatly
appreciated by both national and
international surgical community. A
transfer of technology has been given to
an Indian company called Bigsolve which
is involved in manufacturing the
simulator.
