Imperial College London

Dr Alastair Barrow

Faculty of MedicineDepartment of Surgery & Cancer

Honorary Research Fellow



+44 (0)20 3312 6379a.barrow




45Paterson WingSt Mary's Campus





Publication Type

3 results found

Korzeniowski P, Brown DC, Sodergren M, Barrow A, Bello Fet al., 2016, Validation of NOViSE – a novel Natural Orifice Virtual Surgery Simulator, Surgical Innovation, Vol: 24, Pages: 55-65, ISSN: 1553-3514

The goal of this study was to establish face, content and construct validity of NOViSE – the first force-feedback enabled virtual reality (VR) simulator for Natural Orifice Transluminal Endoscopic Surgery (NOTES). Fourteen surgeons and surgical trainees performed three simulated hybrid trans-gastric cholecystectomies using a flexible endoscope on NOViSE. Four of them were classified as “NOTES experts” who had independently performed ten or more animal or human NOTES procedures. Seven participants were classified as ‘Novices’ and three as ‘Gastroenterologists’ with no or minimal NOTES experience. A standardized five-point Likert-scale questionnaire was administered to assess the face and content validity. NOViSE showed good overall face and content validity. In 14 out of 15 statements pertaining to face validity (graphical appearance, endoscope and tissue behaviour, overall realism), ≥50% of responses were “agree” or “strongly agree”. In terms of content validity, 85.7% of participants agreed or strongly agreed that NOViSE is a useful training tool for NOTES and 71.4% that they would recommend it to others. Construct validity was established by comparing a number of performance metrics such as task completion times, path lengths, applied forces, etc. NOViSE demonstrated early signs of construct validity. Experts were faster and used a shorter endoscopic path length than novices in all but one task. The results indicate that NOViSE authentically recreates a trans-gastric hybrid cholecystectomy and sets promising foundations for the further development of a VR training curriculum for NOTES without compromising patient safety or requiring expensive animal facilities.

Journal article

Korzeniowski P, Barrow A, Sodergren M, Hald N, Bello Fet al., 2016, NOViSE: a virtual natural orifice transluminal endoscopic surgery simulator, International Journal of Computer Assisted Radiology and Surgery, Vol: 11, Pages: 2303-2315, ISSN: 1861-6410

Purpose: Natural Orifice Transluminal Endoscopic Surgery (NOTES) is a novel technique in minimally invasive surgery whereby a flexible endoscope is inserted via a natural orifice to gain access to the abdominal cavity, leaving no external scars. This innovative use of flexible endoscopy creates many new challenges and is associated with a steep learning curve for clinicians. Methods: We developed NOViSE - the first force-feedback enabled virtual reality simulator for NOTES training supporting a flexible endoscope. The haptic device is custom built and the behaviour of the virtual flexible endoscope is based on an established theoretical framework – the Cosserat Theory of Elastic Rods. Results: We present the application of NOViSE to the simulation of a hybrid trans-gastric cholecystectomy procedure. Preliminary results of face, content and construct validation have previously shown that NOViSE delivers the required level of realism for training of endoscopic manipulation skills specific to NOTES Conclusions: VR simulation of NOTES procedures can contribute to surgical training and improve the educational experience without putting patients at risk, raising ethical issues or requiring expensive animal or cadaver facilities. In the context of an experimental technique, NOViSE could potentially facilitate NOTES development and contribute to its wider use by keeping practitioners up to date with this novel surgical technique. NOViSE is a first prototype and the initial results indicate that it provides promising foundations for further development.

Journal article

Barrow A, Akhtar K, Gupte C, Bello Fet al., 2013, Requirements analysis of a 5 degree of freedom haptic simulator for orthopedic trauma surgery., Stud Health Technol Inform, Vol: 184, Pages: 43-47, ISSN: 0926-9630

There are currently few Virtual Reality simulators for orthopedic trauma surgery. The current simulators provide only a basic recreation of the manual skills involved, focusing instead on the procedural and anatomical knowledge required. One factor limiting simulation of the manual skills is the complexity of adding realistic haptic feedback, particularly torques. This paper investigates the requirements, in terms of forces and workspace (linear and rotational), of a haptic interface to simulate placement of a lag screw in the femoral head, such as for fixation of a fracture in the neck of the femur. To measure these requirements, a study has been conducted involving 5 subjects with experience performing this particular procedure. The results gathered are being used to inform the design of a new haptic simulator for orthopedic trauma surgery.

Journal article

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