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Mediseus Epidural
by Ross Horley

Inspiration How does it work?
The Mediseus Epidural is a unit that combines software feedback with an epidural simulator, to assist with training clinicians and students in their epidural analgesia skills on virtual patients.


Inspiration
Ross identified that epidurals were high risk procedures, albeit quite common, and that most learning happened on patients.

The idea was to create a simulator that produced the correct feel of delivering an epidural , and use multimedia tools to embed a fully validated curriculum.

Using the Mediseus, clinicians could train on a simulator to a measurable level of proficiency before carrying out the procedure on a patient.


How does it work?
Epidurals are usually delvered to women in labour. Local anaesthetic is injected through the lower back into the epidural space, around the spinal cord. Correct training is important because of the risks involved when dealing with the spinal cord. The standard training methods make it diffuclt to gauge when the epidural needle has entered into the epidural cavity.

The Mediseus Epidural allows students to practice the needle insertion component of the procedure, but also gives the students the academic content of epidural analgesia.

The Mediseus Epidural has a “Sensable Phantom Desktop” which is bolted to a base plate.

The Phantom is fitted with a standard Stylus adapter kit, which is connected to a hollow cylindrical shaft that is constrained in pitch and yaw by a gimbal (take-up) bearing.

The shaft is able to slide longitudinally in and out of the gimbal bearing. The length of the motion in the needle penetration axis is constrained by a stop at the end of the stylus, and a syringe flange at the other end.

At the stylus end, the hollow shaft is connected to rubber tubing that runs through a solenoid valve. The solenoid is connected to the PC via USB, which controls the opening and closing of the solenoid for the loss of resistance.
The software controls the haptics and the loss of resistance.

The Mediseus includes an anatomically correct 3D model of a pregnant woman, including all major anatomy in the lumbar region (relative to the epidural procedure). The model is partitioned into a BSP (Binary Space Partition) tree and raytrace along the direction of the needle.

This produces a set of layers and depth through which the needle passes, each layer having a different set of haptic/touch attributes that are used in calculating the final force to be rendered by the Phantom.

As the needle penetrates the skin, it starts to create a tunnel through the tissue layers that simulates stiffness against the needle. This means it becomes increasingly more difficult to deviate from a straight line.

A software program is operated in conjunction with the phantom unit via the Haptic/Force Feedback. If the student forgets to administer cyber anaesthetic or inserts the needle incorrectly, the computer will give a voice activated response: “Ouch that hurts!!”


Contact Mediseus Epidural
For more information about the Mediseus Epidural, contact the following:
CONTACT DETAILS:
www.medicvision.com.au

About Ross Horley
Ross Horley is the founder of Medic Vision, a company that develops medical simulation technology. He is an electrical engineer by trade.

Although he doesn’t have much time for relaxation, when he does he can be found under the bonnet of an old car, restoring one of his collection.