virtX - a computer based system for training the intrasurgical use of mobile image intensifier systems

• Main Authors: Pretschner, Dietrich Peter, Stürmer, Klaus Michael, Raab, Björn, Lörchner, Andre, Kimmel, Robert, Grobe, Jan-Henrik, Ahrens, Christoph Alexander, Teistler, Michael, Duwenkamp, Christopher, Wagner, Markus, Bott, Oliver Johannes, Dresing, Klaus
• Format: Article
• Language: deu
• Published: German Medical Science GMS Publishing House 2006-11-01
• Series: GMS Medizinische Informatik, Biometrie und Epidemiologie
• Subjects: virtual radiography; C-arm; computer based training; orthopaedic surgery; trauma surgery
• Online Access: http://www.egms.de/en/journals/mibe/2006-2/mibe000035.shtml

Background and objectives: Currently the correct intrasurgical positioning and adjustment of mobile X-ray image intensifiers (C-arm) can be learned theoretically through the use of textbooks, the practical training with the device itself suffers from the lack of visual feedback, i.e. radiographs corresponding to the adjustment of the C-arm. This leads to the question, whether the training of correct operation and adjustment of a C-arm in different operation scenarios can be supported by a C-arm simulation system being part of a CBT system (Computer Based Training). Methods: In co-operation with physicians from accident surgery and radiology the computer-based training system virtX was developed. virtX confronts the user with different exercises of C-arm adjustment and evaluates their execution and the results. These tasks can be created with the help of an authoring tool and can be accomplished by the trainee in different modes: a pure virtual mode and a combined virtual-real mode. In the pure virtual mode the user controls the virtual C-arm in a virtual operating theatre via the graphic-interactive virtX user interface. In the virtual-real mode however the position and orientation of a real C-arm are detected and mapped onto the virtual C-arm. At any time during the completion of an exercise the user can produce a close-to-reality, virtual radiograph and can control all parameters, like the positions of the apertures, X-ray intensity, etc. virtX was used on a three-day course for OR personnel with 120 participants and evaluated using questionnaires.Results: 79 of the participants returned a questionnaire. The average age of the 62 female and 15 male participants (two n.s.) was 34 ± 9 years, their professional experience was 8.3 ± 7.6 years. 18 persons (23%) indicated to work occasionally with a C-arm, 61 (77%) worked regularly with it. Over 83% of the interviewed participants considered virtX a useful addition to the conventional C-arm training. With an acceptance of 91% of the participants the virtual radiography was judged particularly important for understanding C-arm functioning. With 84% acceptance the combined virtual-real mode also got a comparatively high rating. Conclusion: The evaluation results show a high degree of acceptance of the virtX system as a substantial enhancement of conventional C-arm training.