Surgeons as Educators A Guide for Academic Development and Teaching Excellence

77

Some simulators have integrated tracking capabilities, such as the Electronic
Data Generation for Evaluation (EDGE) device by the Simulab Corporation out of
Seattle, WA, shown with the FLS peg transfer task in Fig. 5.24a, b. EDGE utilizes
six sensors to measure exercise duration, path length, rotation, and force used on the
instruments in reality-based simulation. Depending on the goal of a particular train-
ing session, different tasks can be placed in the trainer. Comparison of expert and
novice tool tip paths with EDGE in Fig. 5.25a, b appears similarly to those mea-
sured with trakSTAR; dominating features are left- and right-hand distinctions as
well as discrete instrument paths traveled [ 10 , 17 ].
The haptic forces measured by EDGE can also distinguish between experts and
novices. The plots below (Fig. 5.26a, b clearly illustrate that novice surgeons use
more force and more frequently. This data is inherently valuable, as excessive force
can cause irreparable tissue damage during operative procedures).

ab

Fig. 5.24 (a, b) Simulab EDGE laparoscopic simulator

Novice Tool Tip Path - FLS Peg TransferExpert Tool Tip Path - FLS Peg Transfer

–6 –4 –2

–8–6

–4

–4

Y

–2

–2

0

0 z

2

2

4

4

0

x^246

–6 –4

–2

–6–5

–4

–4

Y

–3–2–1

–2

0 z

0

2

4

0

x^24

abLeft
Right

Left

Right

Fig. 5.25 Novice (a) and expert (b) instrument tip path during FLS peg transfer [ 27 ]

5 Performance Assessment in Minimally Invasive Surgery