In recent years advanced robotic technology has seen more use in the medical field to assist in the development of efficient training systems. Such training systems must fulfill the following criteria: they must provide quantitative information, must simulate the real-world conditions of the task, and assure training effectiveness. We developed Waseda Kyotokagaku Airway series to fulfill all of those requirements. The WKA series we had developed does not consider external appearance such as patient skin, or internal appearance such as the pharynx, larynx, and esophagus. Moreover, the tongue mechanism of the previous system can not precisely measure the force applied by medical devices and cannot simulate muscle stiffness. In addition, the mandible mechanism of the previous system could not adequately reproduce various airway difficulties or apply force control. For these reasons, we propose the WKA-4, which has high-fidelity simulated human anatomy, and we have improved the mechanism over the previous system. We have also attached a lung to the proposed system to improve simulation of the real-world conditions of the task. In this paper, we present how to design several organs with various embedded sensors and actuators, for a conventional patient model with high-fidelity simulated human anatomy. We also present the control system for the WKA-4. Finally, we present a set of experiments carried out using doctors as subjects, and they gave their valuable opinions about our system.

Many patients suffer from swallowing disorders (dysphagia). There are many treatments for these disorders, such as swallowing therapy, surgery, and dietary modification. In our study, we focuse on dietary modification, a common approach. Normally, the swallowing is affected by food bolus properties such as hardness, stickiness and rheological characteristics, and dietary modifications can prevent swallowing disorder patients from suffering dysphagia (aspiration), as well as promote good nutrition. Based on these facts, our goal is to find foods which do not cause dysphagia, and develop food for swallowing disorder patients accordingly. Therefore, we are proposing an in-vitro Dynamic VFSS (Video Fluorographic Swallowing Study) simulation system which uses advanced robotics technology to mimic the dynamic process of swallowing and monitors the status and movement of the food bolus inside the system, for objective evaluation of the swallowing process. The dynamic VFSS simulation system consists of a head, mandible, neck, tongue, pharynx, and larynx which reproduce human anatomy. It is driven by 16 actuators with wire driving mechanisms. In this paper, we will present the dynamic VFSS simulation unit in detail. In addition, we will detail a set of the experiments carried out to determine whether food bolus properties can affect dysphagia or not. To observe the movement of the food bolus, we use a Video Fluoroscopy (VF) unit. The results of the experiments show that thickened boluses have a tendency to leave residue in the epiglottic vallecula. In contrast, liquids cause less residue, and increase the risk of dysphagia (aspiration). Moreover, this study shows that the frontal image, as well as the lateral image, is important for evaluating residual food in the oral- pharyngeal space.

Recently, in medical field, different training methods for medical staff have been proposed. However, the lack of knowledge on the real improvements of trainees makes difficult the real effectiveness of those proposed methods. Therefore, we are proposing an Active Training system for the effective medical training. The Active training system is characterized by providing quantitative information of the trainee's performance of the task to the trainee, simulating real-world conditions of the task, and assuring training effectiveness. In order to fulfill each of these characteristics, we have developed Waseda Kyotokagaku Airway No.3 (WKA-3) which makes it possible to obtain quantitative information for the trainee's performance and reproduce the various cases, individual differences for the airway difficulties for the simulating real-world conditions of the task. In this paper, we are proposing a patient scenario generation which can reproduce the characteristics of the patient simulating real-world conditions of the task for WKA-3. In emergent situation or surgical operation, the characteristics of patients are presented in the three parameters such as: patient initial conditions, time variant status change, and reflex action. By adjusting, and combining each of the three parameters, we can reproduce the various patient scenarios. In this paper, we also state how to generate the Patient Scenario Generation using the position control and virtual compliance control. Finally, a set of experiments has been carried out to the doctor subjects in order to verify effectiveness of the proposed Patient Scenario Generation, and discuss the doctors about the result of the experiments.

An active training system is characterized by providing quantitative information of the trainee's performance of the task to the trainee, simulating real-world conditions of the task, and assuring training effectiveness. For this purpose, the authors have been developing an Airway management training system. In particular, we have previously presented an evaluation model system to acquire quantitative information for the trainee's performance, and an actuated model system for real-world conditions of the task. In order to fulfill all of the characteristics of the active training system; in this paper, we would like to propose an integrated system, Waseda Kyotokagaku Airway No.3 (WKA-3) which integrates the function of both system models. For this reason, we have focused on embedding sensors and actuators with the link drive mechanism and the wire drive mechanism to a conventional patient model towards the development of a patient robot. In this paper, we present WKA-3 how to design the mechanism and how to redesign several organs to embed the sensors for the measurement of the trainee's performance. A set of experiment have been carried out to doctor subjects using the WKA-3 to verify the effectiveness of the proposed system by asking doctors to evaluate the proposed system.

The emerging field of medical robotics aims to introduce intelligent tools to assist a physician. The main challenges for developing efficient medical robotic training systems are simulating real-world conditions of the task and assuring training effectiveness. High anatomic fidelity has been achieved in current systems. However, those training systems are designed to reproduce specific conditions of the task (passive training). In this research, we are focusing in developing an airway management training systems designed to reproduce various cases of difficult airway. Such difficulties (i.e. restricted mouth opening, various shapes of oral cavity including tongue swallowing, etc) may provoke traumas on different organs of the patient during an emergency situation. For this purpose, the authors have proposed the development of more advanced training tools. For this purpose, we have focused in embedding sensors and actuators to a conventional patient model towards the development of a patient robot (in previous research, authors have presented the evaluation model which embeds sensors). In this paper, we present an airway training system which embeds actuators into a mannequin. In particular, the mechanism design of the Waseda Kyotokagaku Airway No.2 (WKA-2) is detailed. The WKA-2 is composed of twelve active and one passive degrees of freedom; which are designed to reproduce the various cases of difficult airway. For this purpose, the WKA-2 reproduces the human muscles around the upper airway based on a wire driving mechanisms (a total of sixteen wires are used). In particular, the head of the model is composed of a tongue and mandible with translational and rotational movements around kinematic axis. In addition, we present the details of the kinematic model of WKA-2 which enable the robot to reproduce the airway difficulties. Finally, we presented the design of a tension sensor designed to measure the applied tension on each of the wire driving mechanism of WKA-2. As preliminary experiments, we reproduce several cases of difficult airways using WKA-2.