Neuroendoscope box trainer

Abstract

An electromechanical box trainer for neurosurgery has the following features: (i) a base part comprising a rubberized working opening (11) on a front wall (1) for the insertion of an endoscope (26) and manipulation tool (25), a motorized pinboard (14) programmed by a microcontroller and positioned at a 45-degree inclination to define a training volume in accordance with neuroendoscopy, a membrane keypad for changing the rotation angle of the pinboard (14) along the vertical axis, a liquid crystal display (LED) array to illuminate the interior of the box, and a removable base plate (6) to house the microcontroller and part of the other components mentioned; wherein a section of the lower two-thirds of the front wall (1) has a slot (9) for mounting the liquid crystal display (LED) array and a slot (29) for mounting the membrane keypad, wherein furthermore, a stand (28) and a servo motor (13) are provided, wherein the stand (28) serves to attach the servo motor (13) to a base of the base part, wherein the pin plate (14) is attached to the servo motor using the stand (28), wherein by means of user input via the membrane keyboard, the angle of the pinboard (14) can be adjusted from 45° to +45° to increase or decrease the difficulty of the task, and (ii) a detachable part surrounded by five walls, for example a front wall (18), two side walls (17 and 19), a rear wall (20) and a top wall (23), has a housing for attaching an auxiliary camera (32) to record all tasks for evaluation and a slider on the rear for adjusting the camera focus, wherein the detachable part has at a lower end an extrusion (31) of 10 mm for the purpose of attaching the detachable part to the base part.

Description

FIELD OF THE INVENTION:

[0001] The present invention relates to a minimally invasive neurosurgery training device, and more particularly to a neuroendoscopic box trainer for improving eye-hand coordination, dexterity, movement efficiency, instrument-tissue manipulation, and endoscope manipulation. The present invention further provides a neuroendoscopic box trainer that also includes an auxiliary camera for recording and offline analysis of the activity performed by the user. BACKGROUND AND STATE OF THE INVENTION:

[0002] Neurosurgical procedures are highly complex, and the margin for error is very small. Even a small error made by a surgeon can lead to serious consequences such as paralysis and even death. Neurosurgical techniques are currently shifting toward minimally invasive procedures. Technological advances in minimally invasive techniques are challenging neurosurgeons to improve their skills.

[0003] Neuroendoscopy is a minimally invasive procedure in which an endoscope is used to penetrate the deep structures of the brain. The endoscopic camera is used to navigate through the brain, and an image is displayed on a monitor. Depth information can be interpreted through the movement of the endoscopic camera. The learning process for such surgical procedures is lengthy, and learning based on a training model is not appropriate. Physician-caused errors are increasingly drawing attention to the skill of surgeons, requiring careful and effective training.

[0004] Due to the limitations of extremely fine movements and the size of the eloquent structures involved in neurosurgery, skills training and evaluation tools are not very well developed. Training can be provided either via evaluation systems such as chest trainers or via virtual training platforms. Due to multidisciplinary technological hurdles, virtual simulators do not provide the level of realism that corresponds to the surgical environment expected by the surgeon. Rather, refining surgical skills by performing simple tasks on training devices would help surgeons specifically improve each component. Preliminary training of these minimally invasive surgical skills regarding eye-hand coordination on cadavers and animals is not feasible due to a lack of sufficient resources.Training based on cadavers and animals should only be practiced after a certain level of psychomotor skills has been acquired on crate trainers.

[0005] CN 102208151 A discloses a neuroendoscopy operation teaching box, which relates to a neuroendoscopy operation teaching box, and the operation teaching box comprises a box lid, a box body, and a box bottom; at least one operation training hole is arranged on the box lid, and an operation training tube is arranged below the operation training hole; a head end of the operation training tube is fixedly connected to an inner wall of the operation training hole, a tail end of the operation training tube is suspended above the box bottom; a groove is formed above the box bottom and below the operation training tube; a vertical box body position fixing plate is arranged on the edge of the box bottom; the neuroendoscopy and related surgical instruments are arranged in the box through the operation training tube.A trainee can conduct surgical training by grasping surgical instruments outside the operating box. The neuroendoscopy surgical training box resembles the environment and important conditions of neuroendoscopy surgery, has a simple structure and low manufacturing cost, is practical for training purposes, and is suitable for repeated operations and re-equipment. The neuroendoscopy surgical training box can be used for skill training among professionals and is convenient in use.

[0006] CN 101589416B provided an endo-trainer relating to a device for general practitioners to practice techniques used in endoscopic surgery. A portable endo-trainer in the style of a folding laptop, the endo-trainer comprising: a base defining a workspace for endo-training; a camera for viewing the workspace; either i) a display screen for displaying an image from the camera, the display screen being attached to the base; and / or ii) a wireless or wired connection coupled to the camera for connecting the camera to a display screen; and a foldable endo-training instrument panel, the endo-training instrument panel comprising at least one access to allow access of a surgical instrument to the workspace.and wherein the endo trainer has two configurations, a first, folded configuration in which the endo trainer is folded substantially flat, and a second, operational configuration in which the display screen, if present, is unfolded into a viewing position for an operator of the endo trainer and in which the endo training instrument panel is unfolded such that it is at a certain distance from the endo training base.;

[0007] WO 2013028847A1 disclosed an application and method for surgical skills training, relating to a surgical skills training system, comprising: a trainer platform assembly comprising a training platform; a base, the base configured to receive at least one target array; the target array comprising a planar surface on which a plurality of projecting targets are arranged, aligned at a plurality of angles on the base; a left-side support for supporting the training platform on the base; and a right-side support for supporting the training platform on the base.

[0008] US 6488507 B1 provided a portable surgical trainer, which discloses a wearable enclosure for simulating surgical conditions using endoscopic instruments. The enclosure contains a pump and a fluid reservoir, and a canister into which an animal or synthetic tissue sample is placed within an adjustable cavity. The pump circulates a fluid to an endoscopic instrument located outside the enclosure, enabling a person to practice either monopolar or bipolar instrument techniques within the cavity under conditions simulating real-life surgical conditions.

[0009] US 7837473B2 disclosed a surgical training device and a surgical training method relating to a surgical training device and a surgical training method. The surgical training device may comprise a portable housing including a base and a lid. The surgical training device may comprise a carrier coupled to the base, and the carrier may be movable from a first position stored in the base to a second position coupled to the lid. The carrier may comprise a plurality of openings positioned such that, when the carrier is in the second position, the surgical instruments inserted into the plurality of openings are substantially horizontal and parallel to the base. The surgical training device may comprise a camera and a video monitor connected to the camera.The video monitor can display output from the camera including the surgical instruments and / or simulated tissue.

[0010] US 6790043 B2 provided a method and apparatus for surgical training, highlighting an apparatus and method for microsurgical training using cadaveric anatomy, wherein the vascular system is filled with pressurized fluids to simulate the appearance and function of surgery on a living organism. One or more arteries on the cadaveric anatomy specimen are cannulated and connected to an arterial reservoir having a flexible container containing an arterial fluid simulating the appearance of blood circulating in the arteries of the living organism from which the cadaveric anatomy was obtained. A suitable static pressure simulating the arterial pressure appropriate to that of the living organism is applied to the air in an airtight space surrounding the flexible container in the arterial reservoir.A pulsating machine causes air pulsations in the space surrounding the flexible fluid container to simulate the normal pulsations of the arterial system. One or more veins on the specimen are also cannulated and connected to a venous reservoir having a flexible container containing a venous fluid that simulates the appearance of blood circulating in the veins of the living organism. A suitable static pressure simulating the venous pressure appropriate to that of the living organism is applied to the air in an airtight space surrounding the flexible container in the venous reservoir. If the specimen comprises at least part of a spinal canal, a reservoir of a clear fluid may be connected to the specimen through the spinal canal to simulate cerebrospinal fluid.

[0011] US 6517354B1 disclosed a medical simulation device and a related method, which discloses a medical simulation device that may comprise a housing, a tube guided by the housing that simulates a vessel, a fluid reservoir guided by the housing, a pump guided by the housing for circulating fluid from the fluid reservoir through the tube simulating a vessel, and an access port in fluid communication with the tube simulating a vessel for receiving an instrument therein. The pump may be a pulsatile pump for providing a pulsed circulation of fluid that simulates blood flow. Furthermore, the tube simulating a vessel may comprise an elastic material (e.g., silicone) that is expandable with the pulsed circulation of fluid.Additionally, the vessel-simulating tube may include a section with an enlarged diameter, simulating an aneurysm, or a section with a narrowing, simulating a stenosis. Alternatively, the vessel-simulating tube may include a section simulating arteriovenous dysfunction or a tumor.

[0012] US 7850456 B2 provided a surgical simulation device, system, and method relating to a device system and method for simulating laparoscopic procedures, particularly for teaching and / or demonstration purposes. The system comprises one or more virtual organs to be operated on. The organ comprises a plurality of elements, each element having adjacent elements; and a plurality of tensile connections connecting adjacent elements across said organ, such that a force applied to one of the elements propagates across respective adjacent elements, thus providing a distributed response across the organ.Additionally, a physical manipulation device for manipulation by a user and a tracking arrangement for tracking the physical manipulation device and translating movement of the physical manipulation device into the application of forces to the virtual organ are provided. The system is capable of simulating the movement, cutting and suturing of organs, coagulation, and other surgical and operation-related procedures.

[0013] US 8764452 B2 disclosed a portable laparoscopic trainer illustrating a portable surgical training device. The trainer includes a top cover spaced from a base to form a simulated body cavity for locating model organs located substantially outside the user's field of vision. The top cover includes a video display, fixed insertion ports, and interchangeable inserts containing simulated tissue layers. The training device has open sides for demonstrating and practicing lateral surgical techniques, including simulated or living intestinal tissue attached to a support leg to simulate transanal minimally invasive surgery. A training endoscope with an adjustable focal length for use with the trainer, and in particular with optical trocars, is disclosed.The surgical trainer can be angled and is well suited for training laparoscopic surgical techniques and demonstrating surgical instruments.

[0014] US 7866983B2 disclosed a surgical simulator system relating to a surgical simulator for teaching, practicing, and evaluating surgical techniques. Such a simulator may include a cassette of organs, blood vessels, and tissues, which may be disposable. The simulator also includes a hemodynamic simulator and a frame assembly, the frame assembly providing support for the cassette of organs and a fluid conduit through which simulated blood flow from the hemodynamic simulator may be connected to the blood vessels of the organs and related tissues. The hemodynamic simulator provides adjustable and variable pressure to the arteries and veins, as well as variable pulse rates that can be programmed at settings selected by an instructor or user.

[0015] US 7931470B2 relates to an interface device and a method for interfacing instruments with medical procedure simulation systems, which explains an interface device and a method for interfacing instruments with a medical procedure simulation system, which serve to interface peripheral devices in the form of pseudo-medical instruments with the computer of the medical procedure simulation system to enable medical procedure simulation. The interface device comprises a housing having a simulated body region of interest to enable insertion of a dummy instrument, such as an endoscope tube, into the interface device. The simulated body region of interest can be pivotable to simulate various patient orientations.The instrument is engaged by a retaining mechanism to measure rotational and translational movement of the instrument. An actuator is disposed within the interface device to provide force feedback to the instrument. The measured movement is provided to the computer system to represent instrument movement on the display during simulation. Alternatively, the interface device may be configured to accommodate instrument assemblies comprising a plurality of nested instruments (e.g., sheath, catheter, and wire), whereby the interface device individually encompasses and measures manipulation of the nested instruments and provides force feedback thereto. Furthermore, the interface device may be configured to simultaneously accommodate a plurality of independently inserted instruments.

[0016] US 7931471B2 disclosed a surgical training aid device relating to a surgical training aid device for enabling the training of medical procedures, comprising a housing and an anatomical replication assembly. The housing includes a shell having a lower surface and an upper surface opposite the lower surface. The anatomical replication assembly is positioned on the upper surface of the shell of the housing and includes a base layer and at least one body component. The base layer has a lower surface and an upper surface and overlaps a portion of the upper surface of the shell of the housing. The base layer further has adhesive. The body component is positioned between the upper surface of the housing and the lower surface of the base layer or on the base layer. The body component also has adhesive.The body component is releasably coupled to the base layer due to the adhesiveness of the two components, wherein the adhesiveness is overcome to separate the at least one body component relative to the base layer.

[0017] US 8105089 B2, which relates to a model for training medical procedures, highlights a training model for use in training to perform a medical procedure involving an intervention in a skull, for example, the insertion of an external ventricular drain or the removal of a subdural hematoma. The training model may comprise a base component defining a training component container and a training component for attachment within the training component container, and comprising a skull portion. Alternatively, the training model may comprise the skull portion or the training component in isolation. The skull portion comprises an outer skull layer, a middle skull layer, and an inner skull layer. The outer skull layer is constructed of an outer skull material that simulates bone tissue upon penetration therein.The middle layer of the skull is constructed from a medium-sized cranial material that, when penetrated, simulates marrow tissue. The inner layer of the skull is constructed from an inner cranial material that, when penetrated, simulates bone tissue.

[0018] CN 1226707 C, which discloses a method and system for simulating surgical procedures, explains that it is provided by the computer unit used in a virtual environment, the target in the body, for example, the organs, during a surgery simulation method and system. The target of the virtual environment includes the physical description of the three-dimensional mathematical model reflecting the physical and mechanical properties of the target geometry, as well as virtual instruments controlled by the physical delivery device, thereby enabling manipulation of the model. The method comprises the following steps: a video sequence of the two-dimensional projection of the model, wherein the real body of the video sequence includes the recorded target view and interacts only with the virtual instrument of a model intervention.Furthermore, the present invention also relates to the process simulation containing several surgical procedures.

[0019] CN 2751372 Y provides a laparoscope-simulated training table, which relates to a laparoscope-simulated training table comprising an abdominal molding box, a camera, and a monitor. The utility model is characterized in that the abdominal molding box simulates the artificial presence of a pneumoperitoneum in a laparoscopic operation; the camera is arranged inside the abdominal molding box and is connected to the monitor located outside the box by a lead wire; the surface of the abdominal molding box is provided with connecting holes in which laparoscope surgical instruments are arranged; simulated connecting parts of the human body are arranged inside the abdominal molding box. The laparoscope-simulated training table of the utility model can help trainees practice the technical operations of dissection, clamping with forceps, stopping bleeding, anastomosis, suturing, ligation, etc.to train for laparoscopic surgery. The utility model is not limited in time or space, allowing trainees to quickly familiarize themselves with and master the basic procedures of laparoscopic surgery. The utility model offers the advantages of a simple structure and convenient operation.

[0020] US 5403191 A disclosed a laparoscopic surgery simulator and a method of use relating to a device used in simulating the cavity of a human body, allowing an individual user to practice endoscopic surgical procedures by imitating the surgical steps performed under actual lifelike conditions, thereby learning the technique and continually improving eye-hand coordination skills and manual dexterity. The simulator is provided with open sides to access the cavity for the purpose of placing objects simulating human organs, which are then mounted and anchored within the cavity for the purpose of practical simulation of instrument handling.Surgical instruments are inserted into the cavity through the predetermined apertures on the transparent plastic screen, and the instruments are handled during the training procedure without a binocular view of the object simulations; instead, the trainee imitates and performs the activities in the cavity using a view using the endoscopic video monitor system or a similar method of indirect viewing provided by the reflective mirrors of the two-mirror concept, thus simulating lifelike surgical conditions.

[0021] US 20040033476 A1 provides a laparoscopic trainer, highlighting a surgical training device for practicing surgical techniques. The device includes a surgical area arranged to receive an operable structure and a shielding wall with an aperture. The wall is positioned relative to the surgical area such that the wall prevents a direct view of the surgical area from at least one position external to the wall. The device further comprises an optical system including a first mirror and a second mirror. The first mirror is arranged to reflect a primary image of the surgical area onto the second mirror, which in turn is arranged to reflect a secondary image of the surgical area visible from the external position.The position and orientation of the mirrors and aperture is such that only the secondary image of the surgical area is visible from the external position.

[0022] BE1020673 A3, Tian, ​​Q. et al.: Enhancing Fundamentals of Laproscopic Surgery Trainer Box via designing a Multi-Sensor Feedback System. In: Medicine meets virtual reality conference. 2013. Document pages 1-3, US 2007 / 0 166 682 A1, US 7, 594,815 B2 and US 5,873,732 A each disclose further box trainers.

[0023] However, the prior art does not disclose trainers for neuroendoscopy training, and most prior art documents disclose laparoscopic simulators and trainers. The present invention discloses a novel chest trainer designed to provide the enclosed, confined environment required for training in the field of endoscopic neurosurgery. The neuroendo chest trainer includes a pin plate positioned at 45 degrees to provide an incline parallel to the endoscope insertion wall. Furthermore, the pin plate includes a 10 mm trough to provide variable depths for manipulation in all three axes. Furthermore, the motorized movement of the pin plate along the Z-axis is intended to increase the difficulty of the task and familiarize the trainee with variable angular ranges.

[0024] Furthermore, the neuroendoscope box trainer as disclosed by the present invention includes an auxiliary camera to record the activity of the performed task and to analyze parameters such as hitting the plate, dropping the rings, smoothness of movement of the instrument, and reach. OBJECTS OF THE INVENTION:

[0025] Therefore, it is an object of the present invention to provide a cost-effective box trainer for minimally invasive neuroendoscopy.

[0026] Another object of the present invention is to provide a confined environment resembling a neurosurgical workspace and to evaluate their skills using an auxiliary camera.

[0027] Yet another object of the present invention is to provide different levels of difficulty with respect to performing elementary tasks such as pick and place while simultaneously handling objects having tissue-like properties with the aid of an endoscopic display. SUMMARY OF THE INVENTION:

[0028] According to this present invention, an electromechanical box trainer for neurosurgery is provided, comprising: (i) a base part having a rubberized working opening (11) on a front wall (1) for the introduction of an endoscope (26) and tools (25) for manipulation, a motorized pin plate (14) programmed by a microcontroller and placed at an inclination of 45 degrees to define a training volume according to neuroendoscopy, a membrane keyboard for changing the angle of rotation of the pin plate (14) along the vertical axis, a liquid crystal display (LED) array for illuminating the interior of the box, and a removable base plate (6) for accommodating the microcontroller and some of the other aforementioned components;wherein a portion of the lower two-thirds of the front wall (1) has a slot (9) for attaching the liquid crystal display (LED) array and a slot (29) for attaching the membrane keyboard, wherein a stand (28) and a servo motor (13) are further provided, wherein the stand (28) serves to attach the servo motor (13) to a bottom of the base part, wherein the pin plate (14) is attached to the servo motor using the stand (28), wherein by means of a user input via the membrane keyboard an angle of the pin plate (14) is adjustable from 45 ° to +45 ° in order to increase or decrease the difficulty of the task; and (ii) a removable part surrounded by five walls, for example a front wall (18), two side walls (17 and 19), a rear wall (20) and a top wall (23), has a housing for attaching an auxiliary camera (32) to record all tasks for evaluation purposes, and a slider on the back to adjust the camera focus, wherein the removable part has an extrusion (31) of 10 mm at a lower end for the purpose of attaching the removable part to the base part. Furthermore, the crate trainer has the feature that - the working opening (11) leads to an activity area to carry out a placement task by manipulating rubber rings placed on the pins; - the motorized pin plate (14) has a manipulation area of ​​60x40 mm, a 10 mm recess in the center to provide a variable manipulation depth; - four columns and three rows of 4 mm in diameter and 15 mm in height, of which the lateral columns are located in the flat region and the middle columns are located in the trough region; - the rubberized surface, rubber rings for carrying out the activity of assembly, twelve pins made of ABS plastic; - the removable base plate is fixed to the lower wall (5) of the base part and has a screw fixing device (7) and a circuit board fixing device (8); - the removable base plate is attached to the servo motor (13), with slots providing space for electronic components; - the auxiliary camera is attached to the stand, focuses the inner pin plate (14) and records the user's activity using a wide-angle lens and is thus suitable for effectively capturing endoscope and instrument movement; - The LED array is placed on the upper third section of the base to illuminate the interior of the trainer. BRIEF DESCRIPTION OF THE ENCLOSED DRAWINGS: Fig. Figure 1 is a sectional view of the Neuroendo-Trainer together with the instrument and endoscope in their respective functional positions, entering the base part through the predefined aperture on the box; Fig. 2 is the isometric view of the base part. Fig. 3 is the isometric view of the rubberized working opening. Fig. 4 is the top view of the base part. Fig. 5 is the isometric view of the bottom wall of the base part. Fig. 6 is the isometric view of the pin plate. Fig. Figure 7 is the isometric view of the removable upper part. Fig. 8 is the front view of the slider. Fig. 9 is the rear view of the removable upper part. Fig. 10 is the isometric view of the camera mount. Fig. 11 is the neuroendo box trainer. DETAILED DESCRIPTION OF THE INVENTION:

[0029] According to this present invention, a crate trainer for neuroendoscopy is provided, comprising a base and a removable upper part. The base consists of a rubberized opening on the front for inserting the endoscope and manipulation tools, a motorized pin plate programmed by a microcontroller that defines a training volume according to the neuroendoscopy work environment for placement tasks, a rubber layer for covering the pin plate and rubber rings for manipulation, a membrane keyboard for changing the rotation angle of the pin plate along the vertical axis, a liquid crystal display on the front for displaying the corresponding angle of the pin plate, a stand for attaching the servo motor to the bottom of the base, a removable base plate for housing the circuitry and other components, and an LED array for illuminating the interior of the crate.The upper part of the box consists of a housing for attaching the auxiliary camera to record the task for evaluation purposes, as well as a slider on the back to adjust the camera focus.

[0030] Fig. Figure 1 shows an electromechanical box trainer for neurosurgery education and training, especially for training in neuroendoscopic endonasal surgery. The base, made of opaque ABS plastic, has five walls to provide an enclosed area.

[0031] The Fig. The base part shown in Figure 2 comprises a rubberized working opening 11 on the front wall 1, in which the section of the upper third is inclined at 45 degrees 10 and has a 20 mm aperture, as in Fig. 3, with a rubber opening in the center 11 for inserting an endoscope 26 and tool 25. The lateral walls are 2 and 4, and the rear wall is 3. The bottom wall is 5, to which the removable base plate is attached. The lower two-thirds section of the front wall 1 has a slot 9 for attaching the liquid crystal display and a slot 29 for a membrane keypad. The membrane keypad determines the angle of the pin plate, which can be varied from -45 degrees to +45 degrees to increase the difficulty of the task.

[0032] The interior of the base part contains a removable base plate 6, as shown in Fig. 4, with a slot 12 for mounting the servo motor 13, and has a slot 27 to provide space for electronic components.

[0033] The removable base plate 6 is attached to the bottom wall 5 of the base part, which contains screw fastening devices 7 and circuit board fastening devices 8, as shown in Fig. 5, discloses an LED array placed on the upper third portion of the base to illuminate the interior of the trainer. A 10 mm groove 30 was created on top of the inner wall of the base for the purpose of securely securing the removable upper section. A circular opening is provided on the rear wall of the base to provide power to the circuitry.

[0034] The box trainer for neuroendoscopic surgery training essentially features an enclosed work area to block the trainee's direct line of sight to the activity area. Furthermore, the Brand X endoscope and Brand Y tool are inserted through a rubberized work opening. The work opening leads to an activity area for performing a placement task by manipulating rubber rings placed on the pins. Furthermore, another rubberized platform is placed on the activity area.

[0035] In one aspect, a method for training psychomotor skills is provided. One embodiment consists of providing a variable depth perception activity using an uneven and sloped manipulation area. In another aspect, the axial rotation of the activity area further increases the difficulty of the depth manipulation. Dimensional constraints of the activity area are provided to mimic the real surgical scenario of an endonasal neuroendoscopic surgery. Angular constraints on axial rotations of the activity area are decided to familiarize the trainee with the use of endoscopes oriented at different angles.

[0036] From the Fig. Figure 6 clearly shows a motorized pin plate 14 with twelve pins 16 made of ABS plastic, and the plate 14 is attached to the servo motor 13 using a stand 28. It has a rubberized surface 15 and rubber rings around the pins to perform the insertion activity. The pin plate 14 has a manipulation area of ​​60x40 mm, a 10 mm trough in the center to provide variable manipulation depth, four columns and three rows of pins 16 with a diameter of 4 mm and a height of 15 mm, of which the lateral columns are located in the flat region and the central columns are located in the trough region. The height of the pins was designed to provide a medium level of difficulty during the placement of the rings of variable diameter (8, 9, 10 mm). A rubber layer 15 is placed on the pin plate 14 to provide a fabric feel.

[0037] Fig. Figure 7 discloses an upper removable part enclosed by five walls. It comprises a front wall 18, two side walls 17 and 19, a rear wall 20 with a rectangular slider 21, as shown in Fig. 8, for adjusting the camera's focus, an upper wall 23 having a post 24 inwardly extending for mounting the auxiliary camera 32, and a slot 22 for the camera wiring. The lower end of the upper part has a 10 mm extrusion 31 for its attachment to the base part.

[0038] Fig. Figure 9 shows how the auxiliary camera 32 attached to the stand 24 focuses the inner pin plate 14 and records the user's activity using a wide-angle lens 33.

[0039] Fig.Figure 10 shows an isometric view of the camera setup. Videos are recorded via Ethernet to the desktop or laptop and saved to the hard drive. The camera placement is appropriately chosen to effectively capture endoscope and instrument movement. The video recordings are used for offline analysis of the trainee's psychomotor skills.

[0040] According to another embodiment of the invention, a Brand Z camera was placed on top to capture all activity taking place inside the box. This allows the captured video data to be analyzed offline to assess the effectiveness of the practitioner's activity. Yet another embodiment of the invention relates to recording the activity using the Brand X endoscopic camera for further skill analysis.

[0041] The trainee performs the activity of placing rings on the ring row by row from the right object area to the left target area. After completing the rows, the trainee places the rings diagonally again in the object area.

Claims

[1] An electromechanical box trainer for neurosurgery has the following features: (i) a base part having a rubberized working opening (11) on a front wall (1) for introducing an endoscope (26) and tool (25) for manipulation, a motorized pin plate (14) programmed by a microcontroller and placed at an inclination of 45 degrees to define a training volume according to neuroendoscopy, a membrane keyboard for changing the angle of rotation of the pin plate (14) along the vertical axis, a liquid crystal display (LED) array for illuminating the interior of the box, and a removable base plate (6) for accommodating the microcontroller and part of the other mentioned component; wherein a portion of the lower two-thirds of the front wall (1) has a slot (9) for attaching the liquid crystal display (LED) array and a slot (29) for attaching the membrane keyboard, wherein further comprising a stand (28) and a servo motor (13), wherein the stand (28) serves to mount the servo motor (13) on a bottom of the base part, wherein the pin plate (14) is mounted on the servo motor using the stand (28), wherein by means of a user input via the membrane keyboard, an angle of the pin plate (14) can be adjusted from 45 ° to +45 ° in order to increase or decrease the difficulty of the task, and (ii) a removable part surrounded by five walls, for example a front wall (18), two side walls (17 and 19), a rear wall (20) and a top wall (23), having a housing for attaching an auxiliary camera (32) to record all tasks for evaluation and a slider on the back to adjust the camera focus, the removable part having at a lower end an extrusion (31) of 10 mm for the purpose of attaching the removable part to the base part. [2] An electromechanical box trainer for neurosurgery according to claim 1, wherein the working opening (11) leads to an activity area for performing a loading task by manipulating rubber rings placed on the pins. [3] Electromechanical box trainer for neurosurgery according to claim 1, wherein the motorized pin plate (14) has a manipulation area of ​​60x40 mm, a trough of 10 mm in the center for providing a variable manipulation depth. [4] An electromechanical box trainer for neurosurgery according to claim 3, wherein the motorized pin plate (14) further comprises four columns and three rows of 4 mm in diameter and 15 mm in height, of which the lateral columns are located in the flat region and the middle columns are located in the trough region. [5] An electromechanical box trainer for neurosurgery according to claim 3 or 4, wherein the motorized pin plate (14) has a rubberized surface, rubber rings for performing the loading activity, twelve pins made of ABS plastic. [6] An electromechanical box trainer for neurosurgery according to claim 1, wherein the detachable base plate (6) fixed to the bottom wall (5) of the base member has a screw fixing device (7) and a circuit board fixing device (8). [7] An electromechanical chest trainer for neurosurgery according to claim 6, wherein the removable base plate (6) is attached to the servo motor (13), with slots providing space for electronic components. [8] An electromechanical box trainer for neurosurgery according to claim 1, wherein the auxiliary camera (32) attached to the stand focuses the inner pin plate (14) and records the user's activity using a wide-angle lens and is thus capable of effectively capturing endoscope and instrument movement. [9] An electromechanical box trainer for neurosurgery according to claim 1, wherein the LED array is placed at the upper third portion of the base member to illuminate the interior of the trainer.

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