Simulation of laparoscopic ultrasound imaging and suturing of the bile duct using silicone

The laparoscopic treatment of gallstone is a complex procedure requiring multiple skills, notably laparoscopic ultrasounds imaging and laparoscopic suturing. This procedure has many benefits comparing to open surgery, but still fail to be generalised because of these challenging steps. Surgical simulation can provide a useful way to train for the complex skills required by the surgery in a safe environment. This study focuses on the evaluation of the utilisation of silicone to create a simulator for this procedure. Silicone samples are tested quantitively and qualitatively. The qualitative evaluation compares the ultrasound examination of the silicone samples to the images of ultrasound captured during a real procedure. For the quantitative evaluation, the density, the speed of sound in the material, and the mechanical properties are measured and compared to the properties of the soft tissues. The qualitative evaluation shows that silicone requires the addition of scattering agents to be visible using ultrasound, especially for the hardest silicones which are the most suitable to simulate the bile duct in term of mechanical properties. The quantitative evaluation shows that the density of silicone and the Young modulus are close to the properties of soft tissues, but the speed of sound is slower in the silicone, which results in deformed images. A solution is to perform image processing, which can lead to a more realistic appearance of the images.