The Training of Resident Surgeons in Single-Port Thoracoscopic Surgery Wound Position Selection (OpVerse)

The Role of a Metaverse Surgical Simulation System in Guiding Incision Site Selection for Uniportal Video-Assisted Thoracoscopic Surgery

the metaverse system applied to the training of wound location selection for singleport thoracoscopic surgery. The experimental design is two groups of 40 computer tomography located superficially less than 2 cm lung nodule patients, one group uses the metaverse system to let resident physicians simulate the wound position on the digital twin organs of each patient, and the other group does not use it. The investigators will evaluate the surgeon's satisfaction with the surgical wound position and urgicalrelated results (such as surgery time, blood loss, etc.). The investigators expect that the system will help improve the appropriateness of resident physicians' choice of wound location for high-difficulty single-port thoracoscopic surgery, help them cross the first threshold necessary to familiarize themselves with the surgery faster, and accelerate learning.

Study Overview

• Status: Not yet recruiting
• Conditions: Surgical Education
• Intervention / Treatment: Other: Metaverse system (Patients); Other: Metaverse system (Resident Physician)

Detailed Description

The evolution of single-port thoracoscopic surgery, due to advancements in instrumentation and video technology, has seen a leap in progress since the 2010s.

Today, single-port thoracoscopic surgery has become the mainstream at NTU Thoracic Surgery, capable of performing simple wedge resections or complex pneumonectomies. Single-port thoracoscopic surgery, using only a single wound, aids patients in quickly regaining their preoperative normal life functions, with further reductions in pain. However, its learning curve is steep, with the appropriate choice of wound location being one of the most important thresholds for resident physicians to master this technique. Currently, NTU Surgery and the Media Lab have jointly developed a metaverse surgical simulation platform (OpVerse), creating digital twin organ models through 3D reconstruction software and modeling engines. In mixed reality, including lesion location and anatomical variations, are no different from specific real patients. Users can view and operate CT images and 3D models arbitrarily, mark important structural positions and directions, and measure distances with an XR helmet. The model can also be cross-referenced with CT through cross-sectional positioning. The investigators set up a thoracoscopic simulation lens in the system, superimposing the digital twin model on the patient on the operating table, and using the CT cross-section comparison function in the metaverse system to find the lesion location, resident physicians can repeatedly simulate the wound position through the system, and mark the expected entry wound position on the patient through virtual reality overlay. This project plans to conduct a randomized trial to explore the effectiveness of the metaverse system applied to the training of wound location selection for singleport thoracoscopic surgery. The experimental design is two groups of 40 computer tomography located superficially less than 2 cm lung nodule patients, one group uses the metaverse system to let resident physicians simulate the wound position on the digital twin organs of each patient, and the other group does not use it. The investigators will evaluate the surgeon's satisfaction with the surgical wound position and surgical related results (such as surgery time, blood loss, etc.).

The investigators expect that the system will help improve the appropriateness of resident physicians' choice of wound location for high-difficulty single-port thoracoscopic surgery, help them cross the first threshold necessary to familiarize themselves with the surgery faster, and accelerate learning.

• Study Type: Interventional
• Enrollment (Estimated): 80
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Chiang; Phone Number: +886972655136; Email: lycansblueray@gmail.com
• Study Contact Backup: Name: Chiang

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Aged 18 years or older.
• Diagnosed with a lung nodule no larger than 2cm in diameter. The lesion depth must be located within the outer third of the lung.
• Scheduled to undergo computer tomography-guided single-port thoracoscopic wedge resection at National Taiwan University Hospital (NTUH) or National Taiwan Cancer Center (NTUCC).
• Participants who have provided written informed consent for their imaging data to be used by the team to create digital twin models.

Exclusion Criteria:

• Patients with lesions larger than 2 cm.
• Patients not planned for single-port thoracoscopic wedge resection with computed tomography localization.
• Patients who have not provided written consent.
• Members of vulnerable populations.

Inclusion Criteria (Resident Physician):

• Third-year to fifth-year residents in the Department of Thoracic Surgery at National Taiwan University Hospital.

Exclusion Criteria (Resident Physician):

• Residents who are unwilling to participate in the study and decline to sign the consent form.
• Residents with a history of cybersickness.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Metaverse system; Residents use the Metaverse system before surgery to simulate wound closure locations on digital twin organs of the patient.	Other: Metaverse system (Patients); The experimental group will undergo preoperative training using the metaverse surgical simulation system for 15 minutes before selecting the surgical incision site (this refers to residents receiving the assisted training). The trial process requires participants' consent to provide high-resolution CT images as the basis for reconstructing digital twin organs. Except for the intervention training, the surgery, postoperative care, follow-up, and other treatment processes the participants receive will be the same as those for typical patients.; Other: Metaverse system (Resident Physician); The participants (residents) will receive 15 minutes of preoperative training using the Metaverse surgical simulation system. They will superimpose the digital twin model onto the patient on the operating table and use the CT cross-sectional matching function within the Metaverse system to locate the lesion. The participants (residents) can use the system to repeatedly simulate incision sites and mark planned entry points on the patient by overlaying the virtual model onto the real patient. Except for the intervention training with the system, the subsequent surgery, postoperative care, follow-up, and other treatment processes the patients receive will be the same as usual.
No Intervention: Crontrol group; The control group do not use the Metaverse system.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Operation time	Compare the length of operation time between the experimental group (trained using the Metaverse surgical simulation system for 15 minutes pre-operatively) and the control group. This analysis will assess whether pre-operative simulation training reduces operation time for residents.	24 hours

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Satisfaction Questionnaire for Attending Physicians	To improve the residents selection of wound locations during single-port thoracoscopic surgery, the attending physician will complete a post-operative questionnaire regarding the residents' pre-operative simulation training.	Through study completion, an average of 1 year.

Collaborators and Investigators

• Sponsor: National Taiwan University Hospital
• Investigators: Principal Investigator: Xu-Heng Chiang, MD, Department of Surgery, National Taiwain University Hospital

Study record dates

Study Major Dates

• Study Start (Estimated): August 15, 2025
• Primary Completion (Estimated): November 30, 2025
• Study Completion (Estimated): December 31, 2025

Study Registration Dates

• First Submitted: July 23, 2024
• First Submitted That Met QC Criteria: July 23, 2024
• First Posted (Actual): July 29, 2024

Study Record Updates

• Last Update Posted (Actual): May 14, 2025
• Last Update Submitted That Met QC Criteria: May 9, 2025
• Last Verified: July 1, 2024

More Information

Terms related to this study

• Keywords: Surgical Education; Surgical Simulation; Mixed Reality; Metaverse; Digital Twin; Single-Port Thoracoscopy
• Other Study ID Numbers: 202407156RINB

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No