GB2577333A

GB2577333A - Simulated keyhole surgery training kit and app

Info

Publication number: GB2577333A
Application number: GB1815533.3A
Authority: GB
Inventors: Wallace William; Gandhi Maulik
Original assignee: Mavric Ltd
Current assignee: Mavric Ltd
Priority date: 2018-09-24
Filing date: 2018-09-24
Publication date: 2020-03-25
Also published as: WO2020065256A1; GB201815533D0; AR116497A1

Abstract

A simulated keyhole surgery training kit (1) is disclosed comprising training tools (10) for hand manipulation. In use, the tools are passed through openings that simulate the keyholes that are made during a surgical procedure. A structure (16) is also provided and configured to locate the openings above a surface on which the kit is to be placed. The training tools each comprise an optical marker (12) configured to enable motion tracking of the tool by an apparatus (30, 40) via an optical imaging device (34). The structure may also include a storage portion for storing the tools and keyhole openings. A method and computer program for simulating keyhole surgery.

Description

SIMULATED KEYHOLE SURGERY TRAINING KIT AND APP

FIELD OF THE INVENTION

Embodiments of the present invention relate to a simulated minimally invasive surgery training kit and app. In particular, they relate to a simulated keyhole surgery training kit and app, which may be orthopaedic keyhole surgery.

BACKGROUND TO THE INVENTION

Simulated orthopaedic keyhole surgery training kits are known. They help to improve hand-eye coordination for trainee surgeons. However, they are complex and expensive.

The kits may not be affordable for trainee surgeons or their trainers, who lack the resources to procure known kits. For example, in some developing countries, trainee surgeons may have to practice on live patients due to the high cost of simulator kits or cadavers.

Therefore, there is still a potential to further reduce surgical complications in orthopaedic keyhole surgery (e.g. arthroscopic surgery for joints such as knee joints, shoulder joints, ankle joints, elbow joints, spinal joints, or the like).

BRIEF DESCRIPTION OF VARIOUS EMBODIMENTS OF THE INVENTION 25 In view of the above background, the inventors have identified a benefit to producing a simulated keyhole surgery training kit and/or app which has one or more of the following attributes: a low cost of production; a low cost of distribution; reduced specialized training for assembly or use; and an effective means for developing hand-eye coordination for keyhole surgery. The invention is as defined in the claims.

According to various, but not necessarily all, embodiments of the invention there is provided a simulated keyhole surgery training kit, the kit comprising: training tools for hand manipulation, each training tool comprising an optical marker configured to enable motion tracking of the optical marker by an apparatus via optical sensing means; keyholes, wherein the keyholes are dimensioned to enable the training tools to extend through the respective keyholes; and a structure configured to locate the keyholes above a surface on which the kit is to be placed.

An advantage is that the absence of specialized motion tracking tools or proprietary cameras reduces the number of parts in the kit without compromising its effectiveness as a training tool. Most trainee surgeons possess a hand-portable electronic device (apparatus) such as a smartphone, tablet or laptop, having an integrated camera (optical sensing means). In particular, but not exclusively, the camera may be a visible-light camera. The hand-portable electronic device camera may be usable for motion tracking. The camera output can be provided to an app for implementing one or more training exercises for testing hand-eye co-ordination. By utilizing tools the trainee already has access to, the kit is more economical to produce, enabling increased adoption and reduced use of live patients for initial training.

In some examples, the structure is configured to enable, in use, a line of sight from the optical sensing means to the optical markers, while the training tools extend through the keyholes to locate the optical markers between the keyholes, and the optical sensing means is positioned back from the structure. In some examples, the structure comprises supports for locating the keyholes above the surface, enabling the line of sight to the optical markers from the optical sensing means positioned back from the structure.

An advantage is that the kit is more adaptable. This is because the structure presents a reduced obstruction of a line of sight from the user's camera to the optical markers, compared to a dome structure or other enclosure which would conceal the markers. Therefore, the hand-portable electronic device can be placed at a variety of locations and angles, while retaining a line of sight for the camera. Since the hand-portable electronic device may be displaying the training exercises on an integrated display, this adaptability enables the trainee to simulate different display locations in an operating theatre relative to the patient, so the trainee can practice having to look in a direction away from the patient to see the arthroscope display feed.

In some examples, the structure is configured such that an angle and/or position of at least one of the keyholes relative to an angle and/or position at least one other of the keyholes is changeable.

An advantage is that the kit is more adaptable. The kit can be adjusted to simulate surgeries on different joints. For example, a knee surgery may require keyhole incisions at the front of the knee, whereas a shoulder surgery may require keyhole incisions at the front and rear of the patient.

In some examples, the optical markers comprise images for visible-light detection by the optical sensing means. In some examples, the training tools are non-electronic.

An advantage is improved compatibility with trainee equipment. The trainee may already have a smartphone or tablet equipped with a visible-light digital camera, capable of image tracking image-based optical markers.

In some examples, the training tools comprise length axes, and wherein the optical markers are three-dimensional optical markers for enabling continued motion tracking if the training tools are rotated about their length axes.

An advantage is improved freedom of movement.

In some examples, the kit comprises storage means having a depth dimension of less than approximately four centimetres, for storing at least the training tools, the keyholes, and at least a portion of the structure. In some examples, a portion of the structure is configured to act as at least a portion of the storage means. In some examples, the total weight of the kit is less than approximately two kilograms.

An advantage is a lower cost of postage and increased portability, making the kit more accessible to more trainee surgeons and therefore reducing the use of live patients for initial training.

In some examples, the keyholes are elongated, to restrict a range of articulation of the training tools.

An advantage is improved simulation of the conditions of a patient's body.

In some examples, the optical markers are for enabling motion tracking for a training method that causes visual output of a training exercise for developing surgical tool-manipulation skills usable in keyhole surgery, concurrently with visual feedback indicative of at least position information associated with at least one of the training tools.

According to various, but not necessarily all, embodiments of the invention there is provided a simulated keyhole surgery training method, the method 25 comprising: receiving data from optical sensing means, for enabling motion tracking of optical markers of hand-manipulated training tools; causing visual output of a training exercise for developing surgical tool-manipulation skills usable in keyhole surgery; and causing visual feedback indicative of at least position information associated with at least one of the training tools, concurrently with the visual output of the training exercise, wherein the position information is determined in dependence on the motion tracking of the optical markers. The method may be performed, at least in part, by an app or other software on one or more devices.

An advantage is that fewer physical parts need to be supplied to the trainee, without compromising training effectiveness. As a minimum, the trainee could install the software onto their own smartphone or tablet. The trainee could be provided with the optical marker images, which they could print out on their own printer, and attach to their own training tools, which may be real surgical instruments or rudimentary approximations (e.g. sticks). Alternatively, the trainee may order the kit. As above, the kit is more economical to produce, enabling increased adoption and reduced use of live patients for initial training.

According to various, but not necessarily all, embodiments of the invention there is provided computer program instructions for causing at least one apparatus to implement a simulated keyhole surgery training method, the method comprising: receiving data from optical sensing means, for enabling motion tracking of optical markers of hand-manipulated training tools; causing visual output of a training exercise for developing surgical tool-manipulation skills usable in keyhole surgery; and causing visual feedback indicative of at least position information associated with at least one of the training tools, concurrently with the visual output of the training exercise, wherein the position information is determined in dependence on the motion tracking of the optical markers.

In some examples, the visual output and the visual feedback are displayed in an augmented reality environment. Alternatively, they may be displayed in a virtual reality environment.

An advantage is that the conditions of a real surgery are simulated, in which the surgeon must look at a display rather than at the patient, to see where the tips of their surgical instruments are.

In some examples, the image data provides a field of view in which the optical markers of more than one of the training tools are visible.

An advantage is that the integrated camera of the hand-portable electronic device can be used, rather than a tool-mounted camera (e.g. arthroscope or 10 another endoscope) According to various, but not necessarily all, embodiments of the invention there is provided an electronic apparatus configured to execute the simulated keyhole surgery training method.

In some examples, the electronic apparatus is a hand-portable electronic device or one or more modules for a hand-portable electronic device.

In some examples, the electronic apparatus comprises a rear face comprising the optical sensing means, and comprising a front face having a display for displaying the visual output and the visual feedback and/or having an interface for causing an external display to display the visual output and the visual feedback.

According to various, but not necessarily all, embodiments of the invention there is provided a simulated keyhole surgery training system comprising the simulated keyhole surgery training kit, and the electronic apparatus, wherein the optical markers enable the visual feedback to be displayed, for the training exercise.

According to various, but not necessarily all, embodiments of the invention there is provided a simulated keyhole surgery training kit, the kit comprising: training tools for hand manipulation, each training tool comprising a marker configured to enable motion tracking of the marker by an apparatus via sensing means; keyholes, wherein the keyholes are dimensioned to enable the training tools to extend through the respective keyholes; and a structure configured to locate the keyholes above a surface on which the kit is to be placed, wherein the structure is configured to enable, in use, a line of sight from optical sensing means to the optical markers, while the training tools extend through the keyholes to locate the optical markers between the keyholes, and the optical sensing means is positioned back from the structure.

BRIEF DESCRIPTION OF THE DRAWINGS

For a better understanding of various examples of embodiments of the present invention reference will now be made by way of example only to the accompanying drawings in which: Fig 1 illustrates an example of a simulated keyhole surgery training kit; Fig 2 illustrates another example of a simulated keyhole surgery training kit; Fig 3 illustrates an example of an apparatus; Fig 4 illustrates another example of an apparatus; and Fig 5 illustrates an example of a computer-readable storage medium.

DETAILED DESCRIPTION OF VARIOUS EMBODIMENTS OF THE INVENTION

Figs 1 and 2 illustrate a simulated keyhole surgery training kit 1, the kit 1 comprising: training tools 10 for hand manipulation, each training tool comprising an optical marker 12 configured to enable motion tracking of the optical marker by an apparatus 30, 40 via optical sensing means 34; keyholes 14, wherein the keyholes 14 are dimensioned to enable the training tools to extend through the respective keyholes 14; and a structure 16 configured to locate the keyholes 14 above a surface on which the kit 1 is to be placed.

Fig 1 illustrates two training tools 10, of which one is for the left hand and the other is for the right hand. In some examples, the design of the training tools 10 may exhibit no handedness.

The training tools 10 are configured to be hand-held, at least in that they are sufficiently long and narrow to be gripped between the thumb and one or more fingers or by a clenched fist, and to extend beyond the keyholes 14 for a sufficient length that approximates the distance from a patient's surgical keyhole opening to the body part being operated on.

The training tools 10 of Fig 1 are substantially rigid. However, in other examples one or more training tools 10 may be flexible to model a flexible instrument, e.g. a flexible endoscope.

The training tools 10 of Fig 1 are non-electronic. In other examples, they may be provided with one or more sensors or one or more feedback actuators.

One or more dimensions of the training tools 10 may emulate one or more dimensions of instruments for use in keyhole surgery such as orthopaedic keyhole surgery, laparoscopy, spinal microsurgery, or other minimally invasive surgeries. Such instruments include arthroscopes, punches, biters, retrievers, shavers, etc. The one or more dimensions may include length. The lengths of the training tools 10 may be between approximately 10cm and 40cm. The length of one training tool 10 may be the same or different from the length of another training tool 10.

In Fig 1, the training tools 10 are simple tubes, comprising no additional features or formations other than the optical markers 12.

The optical markers 12 are for detection by the optical sensing means 34, to enable motion tracking. The optical markers 12 are located at end regions of the respective training tools 10. In Fig 1, the optical markers 12 are located at the ends of the training tools 10, which is where the workpieces would be located in surgery.

The optical markers 12 may be releasably attached to the training tools 10, or permanently attached (e.g. integrally formed as part of the training tool 10).

The optical markers 12 of Fig 1 comprise images for visible-light detection by the optical sensing means 34. The images are for enabling motion tracking for the augmented or virtual reality app.

The images on the optical markers 12 of different training tools 10 may be the same or different. Different tools can be distinguished from each other using different images.

The optical markers 12 of Fig 1 each comprise a quadrilateral face comprising the image. In other examples, the optical markers 12 may comprise a differently shaped face, or may be continuously curved.

The optical markers 12 may be three-dimensional optical markers 12 for enabling continued motion tracking if the training tools 10 are rotated in a rolling motion about their length axes (longest axis, through tool centroid).

For example, a three-dimensional optical marker 12 may comprise a continuous or repeating image on multiple differently oriented faces (if faceted) or portions of a continuous curve (if round). Different images may be provided at different azimuths/faces, to enable tracking of the held angle of the training tools 10. In Fig 1, the optical markers 12 may be cuboids, with images on a plurality of faces of the cuboids.

Referring now to the keyholes 14, the keyholes 14 are configured to emulate keyhole openings that may be encountered in keyhole surgery. The keyholes 14 may emulate an opening in the skin, or an opening internal to the patient, which may define a narrowest point.

The function of the keyholes 14 is to restrict translational movement of the training tools 10. Therefore, the training tools 10 can only be moved by articulating motions about one or more axes. This would be encountered in keyhole surgery.

The diameter of the keyhole 14 is therefore relevant to the quality of the simulation. The average inside diameter of the keyhole 14 may be from the range approximately lcm to approximately 5cm, similar to that which would be encountered in keyhole surgery. In a particular example, the range is from approximately 1cm to approximately 2.5cm, wherein keyhole incisions are more typically within this narrower range. The cross-sectional area of a keyhole 14 may be only 1.2 to five times greater than the cross-sectional area of a training tool 10, therefore restricting translational motion.

The separation of the keyholes 14 from each other is also relevant to the type of surgery. The separation may be fixed or changeable. The keyhole-to-keyhole separation may be within the range of from approximately 20 centimetres to approximately 50 centimetres, to approximate the width of a knee, shoulder, or other joint between the keyholes 14.

The space between the keyholes 14 may be empty of obstructions to the manipulation of the training tools 10, because the training exercises are virtual rather than physical.

If the optical markers 12 are larger than the apertures defined by the keyholes 14, the training tools 10 may be insertable backwards (handle-first) through the keyholes 14.

The keyholes 14 of Fig 1 are surrounded by a closed ring of material. The material may define an 0-shaped aperture for the keyhole 14. In other examples, the surrounding material may not be fully enclosed. For example, the aperture may be U-shaped or V-shaped. In other words, although a lower boundary and left and right boundaries of the keyhole 14 are useful for preventing slippage of the training tools 10, an upper boundary may not be required as gravity keeps the training tools 10 in place. The lack of an upper boundary may even enable another method of insertion of the training tools 10 through the keyhole 14, in different implementations from those shown in the Figures.

In Fig 1, the keyholes 14 are not elongated. However, they may be elongated such as shown in Fig 2. Elongated means extending in the direction of the training tool 10, i.e. substantially parallel to the length axis of the training tool 10. The elongated keyhole boundary supports the training tools 10 and restricts a range of articulation of the training tools 10. This is what may be encountered in keyhole surgery, especially if the surgery site is deep in the patient's body.

In Fig 2, the 0-shaped keyhole 14 is elongated to form a cylinder of approximately circular cross-section. In a particular implementation, the cylinder may form the horizontal of a T-connector, wherein the vertical of the T-connector may be for enabling coupling of the elongated keyhole 14 to the supporting structure 16.

The structure 16 will now be described in more detail. The function of the structure 16 is at least to locate the keyholes 14 above a surface on which the assembled kit 1 is placed. The keyholes 14 may be high enough that the trainee cannot comfortably rest their elbows on the surface, e.g. at least 20cm.

Fig 1 shows a generic structure 16 which could take any form. However, the structure 16 could be advantageously configured to enable a clear line of sight from an optical sensing means 34 placeable in many different positions, for motion tracking. A clear line of sight would not be possible if the keyholes 14 are provided on a dome or other enclosure.

Fig 2 shows additional detail of how a structure 16 could be implemented, in one, but not necessarily all embodiments of the invention.

The structure 16 of Fig 2 notably comprises a plurality of supports 22 for locating the keyholes 14 above the surface. The keyholes 14 are located at upper portions of the supports 22. Lower portions of the supports 22 are footed to loosely rest or connect to a surface (e.g. desk) on which the kit 1 is placed, to provide stability against toppling.

A first one or more of the keyholes 14 is supported by a first one of the supports 22, and a second one or more of the keyholes 14 is supported by a second one of the supports 22. The first and second supports are distinct, in the manner of legs rather than a single dome supporting all keyholes 14.

The supports 22 may be relatively narrow, for minimizing obstruction to the line of sight. For example, a width dimension of each support 22 may be from 20 approximately 0.5cm to approximately 10cm. The rest of the space around the kit 1 may be substantially un-occluded.

Although Fig 2 illustrates a support 22 as one column-like member, other means could be used, such as multi-membered frames.

The supports 22 may be solid or hollow in cross-section. In some examples, the supports 22 may comprise solid and hollow portions. The supports 22 may be tube-shaped. Although Fig 2 (top down view) illustrates a support 22 being a circular cylinder in cross-section, other cross-section shapes are usable.

The supports 22 may be permanently or reversibly attached to the keyholes 14. In Fig 2, the keyholes 14 are T-connectors as mentioned above, wherein the vertical of the T-connector provides a friction fit over the top of a support 22.

Other connection means are possible, such as interference connections. Permanent attachment techniques include integral forming/moulding, or welding.

The supports 22 may comprise footing means so that the supports 22 stand upright. The footing means may be detachable from the supports 22. Alternatively, the footing means may be permanently attached to the supports 22.

In Fig 2, multiple supports 22 may share a single footing means, and the footing means comprises a base 20. The supports 22 share a common base. If the base 20 or other footing means is detachable from the supports 22, couplers 24 may be provided for reversibly attaching the supports 22 to the base 20. The couplers 24 may comprise a male or female portion for the base 20, that receives a respective female or male portion on a lower portion of the support 22.

In Fig 2, the base 20 comprises a male portion (a boss) to act as a coupler 24, and the support 22 comprises the female portion. The female portion is defined as the support 22 being hollow along at least a portion of its length, required for the connection. As mentioned above, the support 22 may be hollow along its whole length. The connection by the coupler 24 may be a friction fit but it could additionally or alternatively be an interference fit.

The structure 16 is configured such that an angle and/or position of at least one of the keyholes 14 relative to an angle and/or position at least one other of the keyholes 14 is changeable. The movement may be roll, pitch, yaw, translation, or a combination thereof. Angular changes of more than 10 degrees may be possible. Translational movements of more than 5cm may be possible. In a specific example, the supports 22 enable this behaviour by being flexible. Flexibility comprises an ability to withstand substantial bending and/or twisting motions, without plastically deforming. In other examples, the supports 22 may be rigid. The rigid or flexible supports 22 may comprise mechanisms for enabling the angle/position changes.

The flexible supports 22 may be resilient, returning to their un-flexed positions once an external force is no longer applied. Alternatively, the flexible supports 22 may retain their deformed position once flexed, enabled by flexible gooseneck tubing or the like.

The kit 1 may be further optimised for a low cost of production and distribution, as explained below.

In Fig 2, but not necessarily all examples, the kit 1 arrives disassembled in a storage means. At least a portion of the storage means (storage container) of the kit 1 is provided by the base 20 (or other footing) for the supports 22. In other examples, the kit 1 arrives assembled.

Therefore, the longest dimensions of the parts of the kit 1 (e.g. training tool length) to be stored in the base 20 may be shorter than the longest dimension 20 of the base 20.

The base 20 in Fig 2 is tray-shaped, hence the dashed lines in Fig 2 (side view) to show hidden lines behind the upstanding portions of the tray.

In a specific example, the tray may be provided with a removable or attached lid, forming the other portion of the storage means.

The lid may be attached to the base 20 by one or more hinges. When the lid is closed, the total depth from the underside of the tray-shaped base 20 to the top of the lid may be less than approximately four centimetres. This enables the kit 1 to be posted in a smaller category parcel, and to fit through letterboxes. In other examples, the total depth may be less than approximately ten centimetres.

The materials for the kit 1 may be optimised so that the total weight of the kit 1 is less than approximately two kilograms. In some examples, the kit 1 is lighter than one kilogram.

The supports 22 may be reinforced to reduce the material thickness required. The reinforcement may comprise corrugations or in-filled sections in the interior of the supports 22 (if hollow).

Parts of the kit 1 may be lightweight. Lightweight (and inexpensive) material includes non-metallic materials. The structure 16 and/or the training tools 10 may be substantially non-metallic. In a specific example, no metallic material may be used. Substantially non-metallic is defined as greater than 50% by weight of non-metallic components. The training tools 10 and/or structure 16 may comprise or consist of polymeric materials or wood-derived materials (e.g. paper or card). The optical markers 12 may comprise or consist of polymeric or wood-derived materials (e.g. paper or card).

Fig 3 illustrates an example of optical sensing means 34 and an apparatus 30. The apparatus 30 is a hand-portable electronic apparatus. The hand-portable electronic apparatus 30 may be configured for telecommunications (e.g. smartphone), and may comprise a subscriber identity module. The hand-portable electronic apparatus 30 may fit into a pocket (smartphone or tablet). In other examples, the apparatus may be a laptop, desktop or other computer.

The apparatus 30 as illustrated comprises an integrated optical sensing means 34 and an integrated display 32. The optical sensing means 34 is on the rear face and the display 32 is on the front face.

Although the apparatus 30 may belong to the trainee, in other examples the apparatus 30 may be supplied with the kit 1 to form a system.

The integrated optical sensing means 34 is a visible-light analog or digital 5 camera. The camera may be for other wavelengths in other examples. The camera may be capable of a video feed, for motion tracking.

When the kit 1 is in use, the apparatus 30 may be positionable sufficiently far back that all of the optical markers 12 of all of the training tools 10 are in the unobstructed field of view of the optical sensing means 34.

The integrated display 32 may be capable of displaying an optical marker position 38 and any training exercises 36. The apparatus 30 may additionally or alternatively comprise an interface for causing an external display to display an optical marker position 38 and training exercises 36. For example, the external display may be a wireless display. The external display may be a virtual reality headset display.

The apparatus 30 may comprise a man-machine interface such as a touch-screen, for control of the app.

The functionality of the app/instructions with the kit 1 may define at least the following method: receiving data from optical sensing means 34, for enabling motion tracking of optical markers 12 of hand-manipulated training tools 10; causing visual output of a training exercise 36 for developing surgical tool-manipulation skills usable in keyhole surgery; and causing visual feedback indicative of at least position information 38 associated with at least one of the training tools 10, concurrently with the visual output of the training exercise 36, wherein the position information 38 is determined in dependence on the motion tracking of the optical markers 12.

The visual output and the visual feedback may be rendered in a virtual environment. The virtual environment may be an augmented reality environment or a full virtual reality environment. Some, all or none of the raw camera footage may be displayed in the virtual environment.

The rendered virtual environment may comprise a virtual surgery site. For example, the glenoid cavity may be displayed, to simulate shoulder arthroscopy. For the knee joint, the femoral condyle and meniscus may be displayed. The rendered position information 38 and training exercise 36 may be overlaid or located within the virtual surgery site in the rendered virtual environment.

Position information associated with one of the training tools 10 may be used to render a point of view in the virtual environment, to simulate the camera feed from an arthroscope or other endoscope. Therefore, the point of view of the optical sensing means 34 may be translated to a point of view from one of the optical markers 12. The trainee will see the surgery site from the point of view of one of the optical markers 12. Movement of that training tool 10 will change the apparent location of the point of view on the display 32, to enable focused exploration of the surgery site.

The position information associated with the other of the training tools 10 may be used to plot a location 38 in the virtual environment of the other training tool 10 or tools. The location may be known in two or three dimensions. The rendered location may be from the point of view of the optical sensing means 34 or the point of view of the other optical marker 12. A cross-hair is shown in Fig 3 to represent the location 38.

The training exercise 36 may comprise a line which may follow a straight or curved path. Alternatively, the training exercise 36 may comprise one or more points. The path or point may be plotted in two-dimensional or three-dimensional space.

The user may need to complete the training exercise 36 by moving at least one of the training tools to follow the required path or reach the required point, with minimal deviation in two or three dimensions. The points or path may represent movements expected in a particular type of surgery. The user may be displayed a target time or time limit within which to complete the training exercise 36.

Various metrics such as positional deviation, time taken, higher-order motions (e.g. accelerations or jerks), or a combination thereof, may be computed in order to determine whether the training exercise 36 is successfully completed, and/or to quantify the user's performance. Completion of a training exercise 36 enables a more difficult training exercise to be rendered.

The metrics, ranking and/or list of completed training exercises all define potentially useful performance indicators. Performance indicators may be stored in permanent non-volatile memory either on-board the apparatus 30 or on an external server, or both, to enable comparison of the performance of different trainees. This helps trainers to identify trainees who need more help. If trainees can compare data with other trainees, the gaming/competition aspect has a link to improved engagement with training, and therefore improved training outcomes.

The virtual environment may comprise a collision model. Collisions of training tools 10 with simulated body parts may be determined. Collisions may define another metric for use as a performance indicator.

Poor performance may or may not be fed back to the user during completion of the training exercise 36. For example, collisions may be fed back. Audible, visual or haptic feedback may be provided, or a combination thereof. Haptic feedback may be provided by an integrated vibration module of the hand-portable electronic device, that is also associated with making calls.

Alternatively, the training tools 10 or another device may be configured for haptic feedback, which may be vibratory feedback or other haptic feedback.

The app may comprise various user interfaces in addition to the training exercises 36, for one or more of: presenting metrics; presenting performance indicators; enabling an in-app purchase for ordering the kit 1; presenting instructions for a DIY kit 1 including for printing their own markers 12; etc. Fig 4 illustrates another example of an electronic apparatus 40. The electronic apparatus 40 may be implemented as at least one module or system to enable the hand-portable electronic device of Fig 3 to perform the functionality disclosed herein. Alternatively, the apparatus 40 may be a module for another device.

The electronic apparatus 40 of Fig 4 comprises at least one processor 42; and at least one memory device 44 coupled to the processor, the at least one memory device having instructions 46 (e.g. computer program instructions) stored therein, the at least one memory device 44 and the instructions 46 configured to, with the at least one processor 42, cause any one or more of the methods described herein to be performed.

Fig 5 illustrates a non-transitory computer-readable storage medium 50 comprising the instructions 46. Examples of such a medium include a magnetic storage medium (e.g. floppy disk), an optical storage medium (e.g. compact disc), a magneto-optical storage medium, read only memory, random access memory, flash memory, erasable programmable memory, or other types of medium for storing such instructions. In other aspects, there is provided a data carrier signal carrying the instructions.

As used here 'module' refers to a unit or apparatus that excludes certain parts/components that would be added by an end manufacturer or a user.

Although embodiments of the present invention have been described in the preceding paragraphs with reference to various examples, it should be appreciated that modifications to the examples given can be made without departing from the scope of the invention as claimed. For example, the kit 1 and/or app may be adapted for other forms of minimally invasive surgery training than orthopaedic keyhole surgery. For instance, it may be adapted for soft tissue keyhole surgery such as laparoscopy. The keyhole spacing and/or relative positions of the keyholes 14 may be changed to reflect different entry point locations on the patient's body. The keyholes 14 may be replaced by other larger/differently shaped means for emulating a minimally invasive surgical opening, through which the training tools 10 must extend. The virtual environment and training exercises 36 may be adapted accordingly. The training tools may be lengthened and/or made flexible if required.

As a further extension, the kit/app may be adapted for non-keyhole surgical training, with similar modifications. The keyholes 14 may be replaced by larger/differently shaped means for emulating an invasive (large) surgical opening. The virtual environment and training exercises 36 may be adapted accordingly. The training tools may be lengthened and/or made flexible if required.

Features described in the preceding description may be used in combinations other than the combinations explicitly described.

Although functions have been described with reference to certain features, those functions may be performable by other features whether described or not.

Although features have been described with reference to certain embodiments, those features may also be present in other embodiments whether described or not.

Whilst endeavoring in the foregoing specification to draw attention to those features of the invention believed to be of particular importance it should be understood that the Applicant claims protection in respect of any patentable feature or combination of features hereinbefore referred to and/or shown in the drawings whether or not particular emphasis has been placed thereon. For example, the optical markers can be replaced with another form of motion tracking marker, should another feature be deemed patentable.

Claims

CLAIMS1. A simulated keyhole surgery training kit (1), the kit comprising: training tools (10) for hand manipulation, each training tool comprising an optical marker (12) configured to enable motion tracking of the optical marker by an apparatus (30, 40) via optical sensing means (34); keyholes (14), wherein the keyholes are dimensioned to enable the training tools to extend through the respective keyholes; and a structure (16) configured to locate the keyholes above a surface on which the kit is to be placed.
2. The kit as claimed in claim 1, wherein the structure is configured to enable, in use, a line of sight from the optical sensing means to the optical markers, while the training tools extend through the keyholes to locate the optical markers between the keyholes, and the optical sensing means is positioned back from the structure.
3. The kit as claimed in claim 2, wherein the structure comprises supports (22) for locating the keyholes above the surface, enabling the line of sight to the 20 optical markers from the optical sensing means positioned back from the structure.
4. The kit as claimed in claim 1, 2 or 3, wherein the structure is configured such that an angle and/or position of at least one of the keyholes relative to an angle and/or position at least one other of the keyholes is changeable.
5. The kit as claimed in any preceding claim, wherein the optical markers comprise images for visible-light detection by the optical sensing means.
6. The kit as claimed in any preceding claim, wherein the training tools comprise length axes, and wherein the optical markers are three-dimensional optical markers for enabling continued motion tracking if the training tools are rotated about their length axes.
7. The kit as claimed in any preceding claim, comprising storage means (20) having a depth dimension of less than approximately four centimetres, for storing at least the training tools, the keyholes, and at least a portion of the structure.
8. The kit as claimed in claim 7, wherein a portion (20) of the structure is configured to act as at least a portion of the storage means.
9. The kit as claimed in any preceding claim, wherein the total weight of the kit is less than approximately two kilograms.
10. The kit as claimed in any preceding claim, wherein the keyholes are elongated, to restrict a range of articulation of the training tools.
11. The kit as claimed in any preceding claim, wherein the training tools are non-electronic. 20
12. A simulated keyhole surgery training method, the method comprising: receiving data from optical sensing means (34), for enabling motion tracking of optical markers (12) of hand-manipulated training tools (10); causing visual output (36) of a training exercise for developing surgical tool-manipulation skills usable in keyhole surgery; and causing visual feedback (38) indicative of at least position information associated with at least one of the training tools, concurrently with the visual output of the training exercise, wherein the position information is determined in dependence on the motion tracking of the optical markers.
13. Computer program instructions (46) for causing at least one apparatus (30, 40) to implement a simulated keyhole surgery training method, the method comprising: receiving data from optical sensing means (34), for enabling motion tracking of optical markers (12) of hand-manipulated training tools (10); causing visual output (36) of a training exercise for developing surgical tool-manipulation skills usable in keyhole surgery; and causing visual feedback (38) indicative of at least position information associated with at least one of the training tools, concurrently with the visual output of the training exercise, wherein the position information is determined in dependence on the motion tracking of the optical markers.
14. The computer program instructions of claim 13, wherein the visual output and the visual feedback are displayed in an augmented reality environment.
15. The computer program instructions of claim 13 or 14, wherein the image data provides a field of view in which the optical markers of more than one of the training tools are visible.
16. An electronic apparatus (30) configured to execute the simulated keyhole surgery training method of claim 12.
17. The electronic apparatus of claim 16, wherein the electronic apparatus is a hand-portable electronic device or one or more modules for a hand-portable electronic device.
18. The electronic apparatus of claim 16 or 17, comprising a rear face comprising the optical sensing means (34), and comprising a front face having a display (32) for displaying the visual output (36) and the visual feedback (38) and/or having an interface for causing an external display to display the visual output and the visual feedback.
19. A simulated keyhole surgery training system comprising the simulated keyhole surgery training kit of any one or more of claims 1 to 11, and the electronic apparatus of any one or more of claims 16 to 18, wherein the optical markers enable the visual feedback (38) to be displayed, for the training 5 exercise.