title: PsT1: A Low-Cost Optical Simulator for Psychomotor Skills Training in Neuroendoscopy.
abstract: BACKGROUND
  Well-developed psychomotor skills are important for competence in minimally invasive surgery. Neuroendoscopy is no exception, and adaptation to different visual perspectives and careful handling of the surgical instruments are mandatory. Few training systems, however, focus on developing psychomotor skills for neuroendoscopy. Here, we introduce a new training system called PsT1 that provides visual feedback via the use of simple optics that emulate the endoscope at 0° and 30°. Time and error metrics are generated automatically with integrated software to ensure objective assessment.
  
  
  METHODS
  Neuroendoscopic optics were emulated with a low-cost, commercially available universal serial bus 2.0 camera and a light-emitting diode light source. Visual feedback of 30° was obtained by displacing the optical axis of the universal serial bus camera by 30°, and metrics (time, precision, and errors) were generated automatically by the software. Three evaluation modules were developed (spatial adaptation, depth adaptation, and dissection), and 35 expert and nonexpert neurosurgeons performed an initial evaluation of the system.
  
  
  RESULTS
  A total of 81% and 90% of surgeons agreed that the visuals were satisfactory and movement and control were accurately replicated, respectively. The advantages and disadvantages of the system were compared.
  
  
  CONCLUSIONS
  Here, we present a novel, low-cost, and easy-to-implement training system for developing basic neuroendoscopic psychomotor skills. The use of objective metrics, surgical instruments, and emulation of the neuroendoscope at 0° and 30° are competitive advantages of the current system.
authors.affiliation: Research and Advanced Studies Center of the National Polytechnic Institute of Mexico (Cinvestav - IPN), Electrical Department, Col San Pedro Zacatenco, México DF. Electronic address: dlorias@cinvestv.mx.
authors.forename: Daniel Lorias
authors.initials: DL
authors.lastname: Espinoza
authors.affiliation: Department of Neurosurgery, Hospital Infantil de México Federico Gómez, Delegación Cuauhtémoc, México DF.
authors.forename: Vicente
authors.initials: V
authors.lastname: González Carranza
authors.affiliation: Department of Neurosurgery, Hospital Infantil de México Federico Gómez, Delegación Cuauhtémoc, México DF.
authors.forename: Fernando
authors.initials: F
authors.lastname: Chico-Ponce de León
authors.affiliation: Research and Advanced Studies Center of the National Polytechnic Institute of Mexico (Cinvestav - IPN), Electrical Department, Col San Pedro Zacatenco, México DF.
authors.forename: Arturo Minor
authors.initials: AM
authors.lastname: Martinez
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation / Q000191:economics; D003362:Cost-Benefit Analysis; D003867:Depth Perception; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000193:education; D008297:Male; D009048:Motor Skills; D044583:Neuroendoscopy / Q000193:education* / Q000592:standards; D055620:Optical Phenomena; D011597:Psychomotor Performance; D012984:Software; D013028:Space Perception
keywords: Angled optics; Box trainer; Degrees of freedom; Metrics; Neuroendoscopy