An In-Office Hysteroscopy VR/Haptic Simulation Platform for Training in Spatial Navigation and Passage of the Cervical Canal

Hysteroscopy is a type of gynecological procedure that enables diagnosis and treatment of intrauterine pathologies using a minimally-invasive approach. Recent advancements, especially in optics, made it possible to perform this procedure in an ambulatory, outpatient setting without anaesthesia. Yet, such approach introduces additional challenges to gynecologists, as the surgical instruments have to pass through the cervix, a narrow curved canal. This process can be traumatic and even cause tissue damage or rupture. Current training curricula mainly focus on general minimally-invasive surgical skills or on inpatient hysteroscopy. This paper describes the first virtual reality training system designed purposely for in-office hysteroscopy training featuring both passive and active haptic feedback. Design requirements were defined through a literature review and a survey of clinical experts. A dedicated platform was developed and tested with clinicians and medical students. The results of the conducted experiments verified the skill acquisition capabilities of the platform showing a.o. shorter execution time and path length, lower integral forces in most of non-expert participants. The results also demonstrated the capability of the system to differentiate between experts and non-expert groups. Reported findings suggest that the platform has the potential to evolve into an effective solution for in-office hysteroscopy training.