Force modeling and gamification for Epidural Anesthesia training

Abstract

This work presents a serious game approach together with a force model for epidural anesthesia training, a blind medical procedure for needle insertion in which correct placement and location is related to the loss of resistance (LOR) from tissues inside epidural lumbar region, in order to avoid the puncture of dura-mater membrane. The training uses a haptic device, controlled by a force and a mechanical model, which provide experiences with sensations and reactions from the bypassed tissues (skin, fat, spinal ligaments, epidural space and dura-mater). The constitutive models for each tissue included in the procedure are approximated in a non-linear homogeneous elastic model, originated from a comparative study of many approaches. The haptic devices are capable to reproduce the resistance to the movements, allowing the feel of reaction to the operator, as if actions were executed in a real world. The simulation prototype also incorporates the gamification elements of points and achievements in order to improve the motivation of the trainee along the learning and practice, stimulating the student for skill level improvement. The haptic touch device is capable of six degrees of freedom (6 DOF), allowing translations and rotations on three axes (x, y, and z). The main objective is to present the force model, and the current development status. The solution is integrated into a virtual simulation environment, for training this medical procedure, preliminary results are shown as well.