Simulation for training with the Autosuture Endo Stitch device.

The rapid development and deployment of novel laparoscopic instruments present the surgical educator and trainee with a significant challenge. Several useful instruments have been particularly difficult to teach the novice. We have developed a platform that allows the combination of the actual instrument handle with a virtual re-creation of the instrument tip. We chose the Autosuture Endo Stitch device as the prototypical instrument because it satisfies our subjective experience of "useful, but hard to teach." A software package was developed to support the re-creation of the needle and suture that accompany the device. The apparatus has haptic capabilities and collision detection so that the needle driver is "aware" of suture and instrument contact. The developed virtual environment allows re-creation of the necessary motion to simulate the instrument, the trainee can use the actual instrument handle, and the system can be altered to accommodate other instruments.