Development of New Generation Portable Camera-Aided Surgical Simulator for Cognitive Training in Laparoscopic Cholecystectomy

Laparoscopic cholecystectomy (LC) is the standard procedure for gallbladder removal, but improper identification of anatomical structures can lead to biliary duct injury (BDI). The critical view of safety (CVS) is a standardized technique designed to mitigate this risk. However, existing surgical training systems primarily emphasize haptic feedback and physical skill development, making them expensive and less accessible. This paper presents the next-generation Portable Camera-Aided Surgical Simulator (PortCAS), a cost-effective, portable, vision-based surgical training simulator designed to enhance cognitive skill acquisition in LC. The system consists of an enclosed physical module equipped with a vision system, a single-board computer for real-time instrument tracking, and a virtual simulation interface that runs on a user-provided computer. Unlike traditional simulators, PortCAS prioritizes cognitive training over force-based interactions, eliminating the need for costly haptic components. The system was evaluated through user studies assessing accuracy, usability, and training effectiveness. Results demonstrate that PortCAS provides a sufficiently accurate tracking performance for training surgical skills such as CVS, offering a scalable and accessible solution for surgical education.