Novel Simulation Device for Targeting Tumors in Laparoscopic Ablation: A Learning Curve Study

Area of Science:

• Medical Technology
• Surgical Navigation
• Interventional Radiology

Background:

• A novel 3-dimensional (3D) guidance system was developed to improve needle accuracy in ablation procedures.
• Accurate needle placement is critical for effective and safe ablation therapies.

Purpose of the Study:

• To evaluate the efficacy of a new 3D guidance system compared to traditional ultrasound for needle placement in ablation.
• To assess the impact of 3D guidance on procedure time, needle withdrawals, and surgeon workload.

Main Methods:

• Five novices and five experienced surgeons performed simulated tumor targeting under four conditions: ultrasound (in-line and off-axis) and 3D guidance (in-line and off-axis).
• Key metrics collected included time to target, number of needle withdrawals, and surgeon mental workload using the NASA-Task Load Index.
• Statistical analysis involved within-subjects paired t-tests to compare performance across conditions.

Main Results:

• The 3D guidance system significantly reduced the number of needle withdrawals in both in-line and off-axis targeting compared to ultrasound.
• Surgeon mental workload was significantly lower with 3D guidance for both novice and experienced surgeons (P < .001).
• Novice surgeons demonstrated a significant improvement in targeting time with 3D guidance during off-axis attempts (P = .03).

Conclusions:

• Three-dimensional guidance effectively reduces needle withdrawals, potentially lowering complication rates during ablation.
• The system significantly decreases mental workload, especially after achieving proficiency.
• Novices demonstrated a faster learning curve with 3D guidance compared to ultrasound alone, suggesting improved accessibility for less experienced practitioners.