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Virtual reality machines to train endoscopists better

Engineers from the Indian Institute of Science have developed an endoscopy simulator that simulates the effect of physical contact. In the long run, this technology can be made economical and can be used to train endoscopists by providing them an immersive training environment.

Doctors use endoscopy to look inside the human body. They insert through the mouth, a flexible pipe with a camera at the tip, which beams the images of the inner walls of the gastrointestinal tracts onto a screen. But the most challenging task of endoscopy is to ensure that the endoscopic device has actually gone through the esophagus and not the larynx. Remember that the doctors can't 'see', and choose the correct route! With experience, they develop an instinct by knowing how it 'feels' to touch the esophagus through a tube: it's like choosing the right path in a pitch dark tunnel just by touching the walls. No wonder, this takes a lot of experience, and involves some unavoidable experimentation on patients!

“Endoscopy is a difficult medical technique to practice, and there are very limited ways to practice it efficiently. The idea to build haptic device that simulates an endoscopic procedure came to us through a discussion with doctors”, says Shanthanu Chakravarthy, a member of the research team that developed this device. Haptics is a field of science that recreates the sense of touch through technology.

Using computational data, the IISc researchers, led by Prof G K Ananthasuresh, calculated the various forces exerted on the endoscope by various parts of the gastrointestinal tract and recreated those forces in the device. Now, trainee endoscopists can practice with this new tool until they develop the necessary instincts. Interestingly, they gain experience without physically inserting an endoscope!

“This device can now show medical students a new way to learn this otherwise difficult technique. The students of medicine and those learning endoscopic procedures can become aware of the kind of forces or resistance that inserting an endoscope into the gastrointestinal tract can have,” explains Shanthanu. For instance, when the endoscope hits the wall of the stomach, students will actually be able to feel the resistance in the device and the endoscope will not be able to move ahead in that direction.

Using compliant mechanisms that have some flexibility built into them, a mechanism has been designed to emulate the effect of the endoscope entering the throat. This is something totally new, and it promises to be a handy tool in the future development of endoscope technology.

Apart from the new feature of simulating the entry through the throat, the endoscope simulator developed by the IISc Team also has the usual features that a few other commercially available endoscope simulators have.

About the authors:

G K Ananthasuresh is a Professor in the Department of Mechanical Engineering, Indian Institute of Science, Bangalore. Shanthanu Chakravarthy is a PhD student, and Aniruddh N Katti is a Project Assistant.

Contact: Shanthanu Chakravarthy, sc@mecheng.iisc.ernet.in

About the paper: The paper was presented at TrC-IFToMM Symposium on Theory of Machines and Mechanisms, Izmir, Turkey, in June 2015.