Airway
WKA-5R

(Waseda Kyotokagaku Airway-No.5R)
1. Introduction

This study reports on the development of an Airway Management Training System. Airway management is a standard operation executed in emergency and operating rooms. However, medical accidents occur due to unskilled operations. In order to avoid accidents, medical doctors undergo to mannequin-based training. However, traditional training techniques do not provide quantitative information on the trainee's performance and are not capable to assess the trainee's performance based on the quantitative information. In this context, we proposed an innovative training system which can provide quantitative information on the trainee's performance and are capable to assess the trainee's performance based on the quantitative information. From the concept of the proposed innovative training system, in 2011, Takanishi Laboratory developed Waseda Kyotokagaku Airway No. 5R (WKA-5R)

 ・Development of new deformable tongue mechanism
 ・Development of sensing system in the tongue

Fig.1 Medical simulator
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2. Mechanism

The difficulty of the airway management depends on the shapes and size of the patient's tongue. In order to reproduce the various patiant's tongues with WKA-5R, we developed two new deformable tongue mechanism. And we developed two sensing systems in the tongue in order to measure the deformation of patient's tongues.



2.1 Deformable tongue mechanism

This shows the tongue mechanism of tongue-swallowing. (Fig.3)


Fig.2 Mechanical modeling of large tongue mechanism

The tongue is enlarged reproduction mechanism to change the height of the tongue model by stretching from the inside to the tongue in the model abdomen soft material of different rigidity. Enlarged tongue state is possible to reproduce stepwisely, and can be inflated up to 10 mm or tongue.

Movement of large tongue(MPGfile,59sec,16.6MB)
       

This shows the tongue mechanism of large tongue.


Fig.3 Machanical modeling of tongue-swallowing mechanism

Tongue base subsidence state are reproduced by rotating 30 ° the point of a straight line connecting the valley-like tongue base and epiglottis. Tongue-swllowing state is possible to reproduce stepwisely, can make more than 16 mm maximum tongue-swallowing.

Movement of tongue-swallowing(MPGfile,15sec,2.3MB)

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2.2 Sensing system in the tongue

This shows the deformation sensor to measure angle of epiglottis.(Fig.4)


Fig.4 Deformable sensor

The doctors lift the tongue and epiglottis up the laryngoscope to identify the vocal code. We developed the defomation sensor able to measure angle of epiglottis with bending sensors.

       

This shows the force and position sensor to measure intensity of applied force on each point of the tongue base.(Fig.5)


Fig.5 Force and position sensor

The laryngoscopes should be inserted into the right side of the tongue base. We developed the force and position sensor able to measure intensity of applied force on each point of the tongue base, with sponges and photoreflectors.


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3. Movement of WKA-5R



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4. Future work

By applying the concept of the innovative training system, Takanishi Lab. proposes a novel and effective airway management training system.Beginning in 2006, Takanishi Lab. have been developing an airway management training system, WKA (Waseda Kyoto Kagaku Airway), which likewise aims for commercialization in the near future. Takanishi Lab. presented the Waseda Kyotokagaku Airway No. 1 Refined (WKA-1R) which has embedded sensor systems to provide quantitative information on the trainee’s performance. In 2007, Takanishi Lab. also developed the Waseda Kyotokagaku Airway No.2 (WKA-2) in order to reproduce airway difficulties such as various cases and individual difficulties in order to simulate the real-world conditions of the task. In 2008, Takanishi Lab. also developed Waseda Kyotokagaku Airway No.3 (WKA-3) which has 6 embedded actuators and 56 embedded sensors. These sensors cannot only measure quantitative information on the trainee’s performance, but can also simulate the real world conditions of the task by applying force control to the system. In 2009, Takanishi Lab. proposed Waseda Kyotokagaku Airway No.4 (WKA-4), which meets all those requirements of effective innovative training systems. Particularly, for the simulation of the motions of those parts as in a real human being, the WKA-4 improved mechanisms with high-fidelity simulated human anatomy, and Virtual Compliance Control is implemented to reproduce the stiffness of the human’s muscles. In 2010, Takanishi Lab. proposed Waseda Kyotokagaku Airway No.5 (WKA-5), which provided the high-fidelity simulated human anatomy. In 2011, Takanishi Lab. proposed Waseda Kyotokagaku Airway No.5R (WKA-5R), which provided the two tongue deformation mechanism and the two sensing systems in the tongue. We will improve those mentioned defects of the WKA-5R for better simulation of the real-world conditions of the task.


Fig. 6 Research Roadmap
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