Development and Evaluation of a High Fidelity Cleft Palate Simulator for Surgical Training and for Development of a Robotic Approach to Infant Cleft Palate Surgery

Abstract

Cleft palate is one of the most common birth defects requiring surgical repair for proper speech development and feeding. The surgical procedure is challenging due to the small confines of the infant oral cavity, as well as the delicate tissue handling and dissections required. Surgical access, visualization and instrument manipulation is limited. As a result, cleft palate repair is both difficult to learn with limited teaching opportunities as well as technically challenging to perform. A simulator that incorporates the fidelity necessary to capture the critical steps of cleft palate surgery is a valuable training tool providing a safe environment to practice. In addition, a surgical robot provides improved access, visualization and precision within small workspaces that may overcome the challenges of using traditional instruments. The objectives of this work are to develop and evaluate a high fidelity cleft palate simulator to enhance cleft palate surgery training and to develop a robotic approach to infant cleft palate repair using the simulator as a test bed. The simulator was evaluated and found to be an effective, anatomically accurate and valuable training tool that enhances training metrics such as technical performance. The simulator was utilized to perform infant robotic cleft palate surgery using the latest da Vinci速 robotic surgical systems. Overall, the robotic procedures provide superior visualization and access. The da Vinci速 testing guided development of a novel instrument wrist mechanism with more optimal design characteristics for the infant oral cavity workspace and cleft palate surgery.