Simulation

Simulation is an imitation of a procedure or a process in various fidelities. Simulation can be used for training, testing, assessment, scientific modelling etc.

We are specialized in developing low and high-fidelity simulation for various cardiovascular procedures. We work with various partners in developing products for use in surgical training and planning.

Stand-alone high-fidelity mitral valve simulator

Mitral valve repair is one of the most complex and difficult procedure in cardiac surgery due to the complexity of the mitral valve and diversity of its pathology.

Performing mitral valve repair through minimally invasive techniques (whether endoscopically, through direct vision, or with robotic assistance) is even more difficult. The most critical technical steps are working with long-shafted instruments endoscopically and placing sutures on the mitral valve annulus. Therefore, the learning curve of MIMVR is steep and unfortunately still developed in patients.

The simulator provides a platform to train the endoscopic skills repeatedly and objectively. Additionally, the simulator provides objective assessment and feedback, which is essential in any simulator-based training. Also, the disposable mitral valve is made of special silicone developed by us that provides a true suturing experience. We have developed a disposable 3D-printed pathological silicone replica that can be mounted into the simulator so that one can also be trained in any repair technique on any pathology of the mitral valve. The simulator can be used for training purposes, for preoperative planning of complex cases, and for facilitating the start of a new program.

The simulator can also be used for robotic-assisted mitral valve repair or minimally invasive mitral valve repair with direct vision.

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Characteristics of the simulator

  1. The simulator can be used for the following surgical approaches:
    • Endoscopically
    • Through direct vision
    • With robotic assistance using the available ports
    • Conventional mitral valve repair by opening the thorax
  2. The mitral valve component is disposable and developed from a special material that mimics the tissue characteristics of the mitral valve for a realistic suturing experience.
  3. The simulator gives feedback about the exact depth and length of each suture placed.
  4. The simulator provides a picture of each suture.
  5. The target depth and length of each suture attempt can be pre-set and the simulator will provide feedback about the suture attempt with regard to the pre-set values.
  6. The papillary muscle components used for simulating the suturing of the neochordae are available as an accessory.
  7. The standard disposable mitral valve component can be replaced by a 3D-printed pathological mitral valve component reproduced from an individual patient’s 3D TEE scan allowing for pre-operative planning and practice in the case of a complex mitral valve repair.

Multi-modality cardiovascular and thoracic simulation platform

This new platform has been prepared to accommodate the training of various cardiovascular and thoracic procedures.

The torso is prepared for full sternotomy, mini-sternotomy, mini-thoracotomy, robotic and thoracoscopic approaches from both sides. The platform is integrated in a solid flight case for easy transportation. The monitor is mountable on four corners of the platform and is connected to inside computer and cameras. By opening the torso, the internal module can be exchanged for a low- or high-fidelity module developed for a particular surgical procedure. The module that is available now is the high-fidelity mitral valve module with metric-based feedback system as in the stand-alone high-fidelity mitral valve simulator.

We are currently developing different modules for various operations that can be acquired separately in the near future.

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Tele-simulation Platform for Endoscopic MIMVR

To make the simulation-based training more accessible to surgeons we have developed a tele-simulation platform based on our high-fidelity mitral simulator.

This platform is fully 3D printed, transportable and easily assembled. The simulator can be connected to any smart device and give live connectivity from any corner of the globe to our training centre. The silicone mitral valve and papillary muscles are disposable and provide the possibility to be trained in repairing different mitral valve pathologies.

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