Haptic simulators can help medical students to train and improve their skills before practicing with a real patient. However, the vast majority of needle insertion haptic simulators are based on sophisticated models that are accurate but highly demanding in computing resources. Most of them do not provide haptic feedback and/or are not suitable for haptic control due to their computing time. In this paper, we presented a new low computing consuming method that aims to provide a realistic needle insertion experience to the student. A description of the proposed solution is provided, and it is illustrated by experimental results to highlight its performance.

Epidural anesthesia, despite being a relatively common medical procedure, remains quite demanding in terms of skills as it is mostly blind and thus heavily reliant on the haptic sensations. Although some training support solutions exist, anesthetists consider them mostly inefficient or impractical. A few attempts at creating a simulator for this particular procedure exist but each one lacks one of the important requirements of the procedure. This article introduces a haptic simulator featuring a more complete and realistic simulation of the procedure than we could observe in existing simulators. The simulator is composed of a generic electrical haptic interface coupled with a pneumatic cylinder.

Epidural anaesthesia is a medical gesture commonly performed by an anaesthesiologist. However, it remains one of the most difficult gestures to master for medical students. Given the lack of sufficiently realistic training devices available for future physicians, we propose a new haptic simulator which reproduces the haptic sensations felt by anaesthesiologists when performing this kind of operation. The originality of this simulator is the coupling of a Geomagic Touch®device with a pneumatic cylinder to reproduce the “Loss of Resistance” phenomenon which helps the physician to control the needle depth. In this paper, we introduce the parametric 3D model of the region of interest and the control laws used jointly. Even though this device could not reproduce the right level of forces required in this type of anaesthesia, an anaesthesiologist involved in the project gave positive feedback about its haptic tissue rendering.

This paper presents the BirthSIM model, a haptic interface of a childbirth simulator. The aim of this haptic interface is to improve haptic rendering and increase the biofidelity of the movements and forces which occur during the fetal descent. Thus the model of this 2 degrees of freedom pneumatic actuated interface is presented in this article, in order to synthesize a control law based on the backstepping method. The control law obtained allows targeted trajectories of positions and pneumatic stiffness to be tracked but also allows the equivalent stiffness of the end effector in Cartesian coordinates to be adapted in real time. The difference between pneumatic stiffness and closed loop stiffness is explained. Finally, some simulation results are presented to validate the control law behavior.

This paper presents a novel bilateral control scheme for pneumatic teleoperation systems that are actuated by low cost solenoid valves. A sliding mode control is incorporated into a two-channel, bilateral teleoperation architecture involving position-position, force-force, or force-position schemes. An analysis of stability and transparency of the closed-loop teleoperation system is carried out. The proposed control design is verified on a single-degree-of-freedom pneumatic teleoperation system with four on/off solenoid valves. Moreover, simulation results demonstrate high accuracies in terms of position and force tracking in the teleoperation system.

This paper presents an enhanced sliding mode control for pneumatic master-slave teleoperation systems that are actuated by low-cost solenoid valves. A five-mode sliding control is incorporated into position-position, force-force, and force-position teleoperation architectures. While on/off valve pneumatic actuators have previously been modeled as having three discrete operating modes, an extension to five discrete control levels as proposed here helps to improve the actuator dynamic performance and reduce the switching activities of the valves. Stability and transparency analyses of the closed-loop teleoperation system are carried out. The proposed control design is experimentally tested on a single-degree-of-freedom pneumatic teleoperation system. Experimental results demonstrate high accuracies in terms of position and force tracking in the teleoperation system.

This paper presents the control algorithm implanted on the childbirth simulator BirthSIM in order to provide training to novice obstetricians. The forceps extraction is an obstetric manipulation learned by experience. However, nowadays the training is mainly provided during real childbirths. This kind of training could lead to dramatic consequences due to the lack of experience of some operators. This paper explains the approach that has been used to simulate the dynamic process of a childbirth on the BirthSIM simulator. We especially focus on one procedure that reproduces a difficult instrumental delivery. The recorded tractive force to extract the fetus corresponds to the literature results that confirm the realism of the simulator. The novice results emphasize the need of a childbirth simulator in order to gain initial experience without any risks.

This paper presents a new predictive hybrid control law for a pneumatic teleoperation system using solenoid valves. Based on a predictive model of the mass flow rate of the valves, this method is used within a four-channel (4CH) bilateral control architecture for haptic teleoperation. An analysis of the controller parameters is carried out in order to achieve acceptable performances. The results show that a good accuracy in position and force tracking of the teleoperation system is obtained.

This paper presents a new predictive hybrid control law for a pneumatic teleoperation system using solenoid valves. Based on a predictive model of the mass flow rate of the valves, this method is used within a four-channel (4CH) bilateral control architecture for haptic teleoperation. An analysis of the controller parameters is carried out in order to achieve acceptable performances. To evaluate the new strategy, a comparison study has been performed with a classical PWM control of a teleoperation system. The results show that the accuracy in position and force tracking in steady state but also the dynamic behavior of the pressures are better in the case of hybrid control than PWM control.

This paper presents a new available feature on the childbirth simulator BirthSIM. This feature offers a risk- free training for novice obstetricians to proceed to forceps extractions. The different forces involved during deliveries are described and modeled. The choice of a control strategy in order to reproduce all these forces is explained and argued. This paper also introduces the concepts of simple and double synchronization during deliveries. Its application allows to minimize the amount of forces exerted with forceps during an instrumental delivery to make it as safe as possible. Simulations of forceps extraction carried out by two junior obstetricians are provided and analyzed. The corresponding results are compared to the literature and to the results obtained by an expert.

Today, medical simulators are increasingly gaining attraction in clinical settings. These tools allow physicians to visualize the positions of organs, plan surgical interventions, and carry out more comprehensive post operative monitoring. A childbirth simulator provides a risk-free training and research tool for comparing various techniques that use obstetrical instruments or validating new methods. This paper presents a new teaching method to place forceps blades for obstetricians using an instrumented childbirth simulator. The proposed method is based on a physical simulator coupled with a computer graphics interface. Another aspect of this paper is to provide understanding marks to quantify the progression during a training. A first one allows to study the path in space and to quantify their repeatability, a second one allows to compute the error to a reference gesture defined by an expert. Both marks are complementary. Two novices were trained and they manage to have a more repeatable gesture and above all to become closer to a reference gesture, i.e. to reduce the injury linked to the use of forceps during instrumental deliveries.

Birth represents for each human being one the most wonderful days of his life but also one of the most dangerous. Being born in safe conditions requires to be surrounded by professionals who acquire a rigorous knowledge of diagnostic and therapeutic procedures. Nowadays, midwives and obstetricians learn mainly in delivery ward during real childbirths. For difficult childbirths, the use of obstetrical instruments (forceps, spatulas or vacuum extractors) is unavoidable. However, the use of such instruments increases the risks of lesions for the mother and the fetus. In practical, only clinical experience acquired in the delivery ward enables these risks to be reduced. Nowadays, simulators in medicine have a real appeal in the medical environment. These tools enable doctors to visualize the position of the organs in the human body, to plan their movements or to carry out a more complete post operational control. A birth simulator provides a training tool and a research tool to compare various techniques for the use of obstetrical instruments or to validate new methods. It is in this context that we have developed, in collaboration with researchers and medical doctors, a new type of instrumented forceps to offer new solutions for training obstetricians for the safe use of obstetrical forceps delivery. The main contributions of this paper are the design of instrumented forceps coupled with the BirthSIM simulator and the path analysis during the forceps blades placement. This analysis leads to the comparison of the repeatability of the movement between novice obstetricians and expert obstetricians. The results highlight the lack of teaching tool to correctly train the novice obstetricians

This paper presents some new automatic procedures for the BirthSIM childbirth simulator. BirthSIM is able to simulate the uterine contractions and the mother's voluntary efforts, this enables the operator to synchronize these two types of efforts during a normal childbirth, or to synchronize these two efforts with the operator's tractive instrumental effort during childbirth using obstetric instruments. One originality of the BirthSIM simulator is to allow the medical team to acquire a better understanding of the application of these two synchronization concepts. With the aim of implanting various childbirth procedures, four control algorithms and switching algorithms are used to control successively: force, position, force-velocity or force-position. These control algorithms are important to produce the movement of the head, the mother's natural contractions and the mother's pushing action. Different childbirth cases are simulated using an electropneumatic system. The validity of the proposed control method for simulating childbirth modes has been evaluated by an expert obstetrician