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Rocket Science and Passion to Help People: the LAP-X Laparoscopic Simulator

Laparoscopy (also known as minimally invasive surgery) is a surgical procedure on which an operation in the abdomen or pelvis is performed through a small incision with a laparoscope (and a long, thin tube with a high-intensity light and a high-resolution camera at the front). The main benefits of this surgical technique are:

  • Shorter hospital stay and faster recovery time.
  • Less pain and bleeding after the operation.
  • Reduced scarring.

Minimally invasive surgery has been replacing the open standard technique in several surgical procedures. Nevertheless, inadequate training availability and a steep learning curve are recurrent barriers to the transition. Our LAP-X simulator enables learners to familiarize themselves with performance techniques, skills, and safety measures.

LAP-X was the first step that our CEO Dervis Demirtas made into the healthcare simulation industry. This is his story about the inspiration and development of the LAP-X.

From Rocket Science to Minimally Invasive Surgery

I was driven by two passions of mine: rocket science and becoming a doctor. I pursue the former, I went to TU Delft and get my degree in aerospace engineering.

One of the master’s courses we had back then was about “Turning Technology into Business”, where we were prepared with a strong conceptual foundation and active understanding of the dynamic process of technology-based entrepreneurship. As a class assignment, we chose and analyzed an original patent (usually old and expired) to evaluate the technology’s commercial potential.

The patent that caught my attention was the one under the names of three doctors about training surgeons. The idea was good, but there was room for improvement. I was eager to work on this patent as I felt it was literally calling out for me! It was an opportunity to nurture my passion for the world of medicine and contribute to the healthcare industry.

In the beginning, I had a vision of an innovative, useful, and more realistic tool to train surgeons. I remember building my prototype design with PVC tubes, broken scissors, and part of a joystick. When I presented it to my professor, she was utterly amazed and said that the design was indeed innovative and had great potential.

LAP-X Patent: US20190122582A1

My teacher suggested I apply for a patent and connected me with enthusiastic researchers and doctors for consultation. This is how the idea of building the laparoscopic simulators sparked! I always wanted to help people. What better way to do that than by helping doctors?

The Idea Grows

My product could save lives: having better-trained doctors will result in fewer mistakes, fewer failures, and fewer patients ending up in hospitals longer than they should be. This filled me with motivation. My drive was to build something better, faster, and more cost-effective. It was a long road ahead and every step was worth the effort.

Dervis Demirtas demonstrating a LAP-X exercise at the International Meeting of the European Association of Urology, 2015

“Having better-trained doctors will result in fewer mistakes, fewer failures, and fewer patients ending up in hospitals longer than they should be. Having better doctors saves lives”.

Dervis Demirtas

The technology that was available 20 years ago didn’t convey a feeling of realism; the instruments in the trainers were not remotely close to the real instrument and you could still feel some resistance on them. There wasn’t the same range of possibilities like we have today.
I identified these gaps and decided to build a solution with hybrid functionality. This would allow the user to work and measure exercises in the 3D world and make use of actual physical exercises. I wanted to shape my simulator to be realistic enough for surgery needs. Consequently, I built the hardware around an actual surgical instrument instead of building a system that tries to mimic the surgical instrument.
The final prototype was ready: Virtual reality trainer with box exercises. It would help students and surgeons improve their hand-eye coordination and give them the opportunity to measure their progress and leverage skills.
Furthermore, the system is made flexible to integrate additional modes and upgrades. It is hybrid in functionality, so you can use both VR and box training mode, or you can switch one mode and work on the other. Ergo, the three systems for the laparoscopic simulator we have today at MEDICAL-X are LAP-X BOX, LAP-X VR, and LAP-X Hybrid.

The LAP-X Nowadays

Our LAP-X is the most cost-efficient VR trainer in the market today and the only simulator using real surgical instruments.

Lap-X is not limited to one specialty. It is multidisciplinary and can be useful for different areas of surgery, even for different species. It is not exclusive for surgeons but also invaluable in training assistants. The system is flexible and adjustable for the purpose of training. It can be used in different sizes. For example, horse surgeons can adjust the system and make it usable as a horse simulator.
The instruments are also subject to development and changes. In order to accommodate a customer’s request, we remade one of our LAP-X units to support nursing training and help them train on how to scope. Instead of having two graspers in the LAP-X controllers, we built an endoscope. The controllers are separated and can be adjusted in different positions and angles. You can go as far as repositioning the controller to mimic the position of the actual instruments in the real body. This is how flexible our system is.

Surgeon Resident practicing with LAP-X Hybrid at Rijnland Ziekenhuis, 2014
Students trying the LAP-X at ROSMEDOBR Week of Medical Education, 2019

In terms of effectiveness; our system was featured in research about the effect of continuous motion parameter feedback on Laparoscopic Simulation Training made by the University Hospital of Muenster in Germany. They noted an increase and improvement of the skills of medical students after training with the LAP-X Hybrid, especially when it comes to hand-eye coordination.
Today, there are over 200 installations of the LAP-X around the world. It is still growing and it is satisfying to see how the units are being used by hospitals to test the students and to warm up their skills before they perform the actual surgery.
Our aim for the future is to keep the LAP-X system straight to the point and to serve its initial purpose by providing easily accessible, minimally invasive surgery simulation training for medical professionals at a low cost.

More about the LAP-X

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