Introduction to LAP-X Gen2+ simulator. Surgical training simulator.

1. An educational platform
By Epona Medical B.V.
Rotterdam, Netherlands

2. Dervis Demirtas, CEO Epona Medical
aerospace engineering,
specialist in control & simulation

3. INTRODUCTION

5. The LAP-X offers residents the opportunity
to train in a safe and controlled
environment, where mistakes can be
made without harming actual patients.
“From mistakes we learn”

7. 2nd generation controller
hardware design
Goal: “Mimic the exact
instrument movements”
Specially designed simulator for
laparoscopy

8. New Controller Gen2+
“Training becomes even more realistic”
Available in January 2012

9. Advantages of LAP-X: LAP-X Hardware Gen2+
Real surgical instruments inserted through an incision point.
The controller mimics reality closely. The touch and feel are
similar to a real surgery.
The training starts with the same instruments used on real
surgeries; narrowing the gap between training and real
surgeries.
Footpedals for cauterization and coagulation

10. Advantages of LAP-X: organized training
With LAP-X simulator, it is now possible to organize the training
Simulator will accelerate the learning curve for skills acquistion.
The shape of the learning curve is likely to be different for every
student; however, the outcome should be identical. “Proficient
skills level” , standardizing training
The best way and the fastest method of skills training is to
break down the training in smaller segments and
focus one by one before combining to one later.

12. Advantages of LAP-X: Better skilled surgeons
Shorten the surgery time, increase the number of surgeries
Lessen the failures/mistakes made by unskilled
residents/students
Shorten recovery time of patients

13. Advantages of LAP-X: Better skilled surgery assistants
During a surgery, it is very common that surgery assistants need to assist
surgeons by holding camera/endoscope or an instrument.
With the LAP-X, surgery assistants will understand the difficulties of scope
assisting and reducing “learning time” during real surgeries.
Possibility to add E-learning content to help surgery assistants understand
different surgery instruments used in a surgery.
Better skilled assistants will increase the efficiency of a surgery.

14. Advantages of LAP-X: Reviewing the results local and online
All the results are stored on a personal profile.
Review the results behind your own desk and computer.
Receive a certificate of proof after finishing a curriculum.
This cirtificate is ony valid for 6 months.

15. Advantages of LAP-X: Administration modus
Overview of all the students in one page.
Review the scores behind your own desk on your own computer.
Monitor when, how long the students train and their progresses over
time.
Add E-learning content.
Add exam questions.
Create and name your own curriculum. This will be available for a
selected students or for all of the students.

16. + Personal portfolio
LAP-X skills + curriculum platform for education
+ E-learning

17. Advantages of LAP-X: Measured parameters
Number of mistakes
Pathlength of the left and right controllers
Time
Dropped objects
In development: Motion signature: every user have an unique 3D
signature.

18. Advantages of LAP-X: Increased training effect
Motivate students with challenging exercises
Serious gaming elements added to motivate and challenge the
residents
Compete with other residents worldwide
Create mandatory training schedules
Deliver a variation in training to increase training effect

19. In our opinion the most important one to start with is
that the training must be a mandatory part of the
curriculum to obtain the expected result.
Also;
Interval and repetition of the training is necessary. We
would advise to pass the curriculum every 6 months
to maintain the certificate.

20. The LAP-X trainer delivers the professor tools to organize
mandatory training:
Monitoring the progress of the students remotely
Creating his own curricula
Insert E-learning content
Insert exam questions
Set up a deadline for residents to finish a curriculum
Automatic warnings supported (in development)
Set up a minimal requirement for a weekly training (in development)

21. Advantages of LAP-X: Support and service
Replacement program of the hardware: always up-to-date with the latest
innovation of the LAP-X controller in the same generation line (*)
Support and service on site, by phone and by email
Support in Dutch, German, English, Japanese,
Chinese, Vietnamese, French, Spanish, Portuguese,
Korean, Indonesian, Thai and Arabic
*During the license period. First year license is included in the package

22. Advantages of LAP-X: Software updates, license
During the license period, module extension and new exercises are
regularly and automatically updated at no extra cost (internet
connection is necessary)
Still able to train with LAP-X after the license expires
Unlimited user registration

23. Advantages of LAP-X: Updates, license
Most realistic hardware interface in the market (the only
simulator with real surgical instruments)
Hardware and software is always up-to-date with a license
First year license is included

24. Epona Medical provides training and simulation
for all minimal invasive disciplines
General Surgery Orthopedics
Gynaecology
Urology
Surgery assistants
Medical students
Etc...

25. Positioning the LAP-X in the training curriculum
CERTIFICATION I CERTIFICATION II
Basic skills Courses and lectures Novice skills
LAP-X Basic curriculum Learn procedures from lectures LAP-X novice I
Basic exercises with the box and books LAP-X novice II
Books Multimedia medium to obtain FLS box task
procedural knowledge
 LAP-X E-learning and exams
CERTIFICATION IV CERTIFICATION III
Practical courses Intermediate skills
Training on a life animal LAP-X intermediate I
Training on a cadaver LAP-X intermediate II
 Novice III
Suturing task and techniques in
a box
Surgery
Assist and/or operate on real patient

26. Free update from gen2 to gen2+
controllers.

27. LAP-X available now in
Netherlands
United States
Brasil
Germany
France
Belgium
United Kingdom
Japan
South Korea
Malaysia
Indonesia
Vietnam
Mexico
Thailand
China
Oman
UAE
Qatar
Kuwait
Bahrain
Saudi Arabia
Iran
Soon available in:
Italy
Russia
Argentia
Chile
Peru
India
Canada
Etc...

28. QUESTIONS?

29. Basics of MIS
(Minimal Invasive Surgery)

30. Training
1. Fulcrum effect
Explanation:
 The instrument tip moves in the opposite direction of the handle.

31. Training
2. Converting 3D movements to 2D screen
Explanation:
 Training for the decreased depth-perception on screen.

32. Training
3. Brain training of converting X,Y,Z movements
to radial coordinates.
Explanation:
 A human is used to thinking in x,y,z displacements with six Degrees Of Freedom
(DOF). During MIS the brain has to convert this to radial coordinates with 4 DOF,
that means thinking in a radius and angle of the instrument.

33. Training
4. Camera misalignment.
Explanation:
 Repositioning the camera may influence the instrument movements on the screen
dramatically, this effect is well known by experienced surgeons and its training
should be paid more adequate attention.

34. Training
5. Working with both hands simultaneously
Explanation:
 LAP-X provides exercises to train the residents to operate with the dominant as
well the non-dominant hand.

35. Training
6. Panic situation
Explanation:
 The resident will be trained to stay calm during a panic situation and given the
chance to correct the mistake within a time limitation.

36. Training
7. Move gently and precisely with your
instruments
Explanation:
 Working gently and precisely has better outcomes than handling the movements
uncontrolledly and fast. This will lessen the mistakes and tissue damages caused by
fast and uncontrolled movements.