Training in urology: The development of a tracking feedback system for flexible scopes

During the training of new doctors in cystoscopy a problem could occur. When the trainee controls the cystoscope, the supervising doctor is focussed on the scope images on a monitor. Because the supervising doctor is not holding the scope, location feedback is absent. This makes it difficult to determine whether the entire inner surface of the bladder has been inspected. This problem of missing critical parts of the surface during a cystoscopy is not described in literature, thus the prevalence of this problem is explored using a questionnaire. A possible solution has been developed, using an assistive tracking system that provides qualitative feedback on inspection performance. The result is an external tracking device consisting of sensors and a computer display that provides real-time bladder location feedback. In an experiment, participants were asked to inspect a bladder model with a cystoscope equipped with and without the system. This proved position feedback significantly increased the inspected area size during the procedure. The improvement in inspected area size was 5%. In a second study, focused on the effect of training, participants were divided into two groups, with and without the system. Participants had to perform a task six times to see the effect the system had on training. These results were inconclusive. The questionnaire that was sent and answered by 100 urologists in the Netherlands indicates that urologists find the system promising. Subsequent steps are general improvement of the system, integration with existing technology, expanding to other scope types and repeating experiments with more participants and in a clinical setting.Medical Instruments and Medical SafetyBiomedical EngineeringMechanical, Maritime and Materials Engineerin