Development and evaluation of an epidural injection simulator with force feedback for medical training

Performing epidural injections is a complex task that demands a high level of skill and precision from the physician, since an improperly performed procedure can result in serious complications for the patient. The objective of our project is to create an epidural injection simulator for medical training and education that provides the user with realistic feel encountered during an actual procedure. We have used a Phantom haptic interface by SensAble Technologies, which is capable of three-dimensional force feedback, to simulate interactions between the needle and bones or tissues. An additional degree-of-freedom through an actual syringe was incorporated to simulate the "loss of resistance" effect, commonly considered to be the most reliable method for identifying the epidural space during an injection procedure. The simulator also includes a new training feature called "Haptic Guidance" that allows the user to follow a previously recorded expert procedure and feel the encountered forces. Evaluations of the simulator by experienced professionals indicate that the simulation system has considerable potential to become a useful aid in medical training.