InSimo and AGOF’s story is one of partnership that has led to the creation of 4 clinical obstetric ultrasound cases, with 5 additional exercises focused on fetal ultrasound coming very soon. To highlight this milestone, we invite you to hear Pierre-Jean Bensoussan, President of InSimo, and Frédéric Glicenstein, President of AGOF. They reflect on their teams’ collaborative work, their shared ambitions, and their future projects.

How did the collaboration between InSimo and AGOF start?

Pierre-Jean : The partnership with AGOF is linked to the development of our online ultrasound simulation software, diSplay U/S, designed to be widely accessible and partially free, with no equipment required.

diSplay U/S was born during the first 2020 lockdown, initially focused on lung ultrasound content for COVID-19 patients diagnosis and follow-up. We then decided to continue investing in this project, expanding diSplay U/S into a more generic ultrasound simulator.

We involved doctors and trainers to co-develop new exercises and training paths, incorporating crucial medical expertise. After presenting our simulator at numerous events, including SoFraSimS 2022, Maxime Ros, CEO of KEYROS MEDICA and renowned neurosurgeon and surgical pedagogy expert using virtual reality, introduced us. Things then moved quickly; after a demo, Frédéric saw potential in our simulator, and we began developing obstetric ultrasound exercises and setting up this partnership and its funding.

Frédéric : In 2018, while preparing for my Master’s year, I learned about IRCAD’s work on anatomical structures segmentation. Unfortunately, a training program on the subject couldn’t be realized at the time.
It was only in 2022 that Maxime Ros connected us with InSimo and Pierre-Jean. Discovering the diSplay U/S simulator was an instant revelation: a perfect tool to support our efforts to modernize gynecology and obstetrics simulation.

What synergies exist between the teams?

Frédéric : The InSimo team works closely with doctors, making communication easy since we share a similar language. My Master’s in 3D Imaging Production is also a real asset in understanding our discussions and developing fetal ultrasound clinical cases.

Pierre-Jean : I completely agree with Frédéric. There is a genuine synergy between doctors and engineers. We are truly in a partnership with AGOF, working hand in hand.

Can you share an anecdote or memorable moment in your collaboration?

This year, AGOF and InSimo are launching a second webseries, “AGOF Ultrasound.” What does this project entail?

Webseries AGOF : Fetal ultrasound training

“Practice to learn”

How did InSimo come to collaborate with Barbara?

For you Barbara, why is a project like ROBOTiS important?

Why is it important to involve a medical expert for such a project?

“The more we highlight the problems, the more we identify the needs.”

What lessons do you learn from this collaboration?

“A triple knot in live demo!”

Do you remember a key moment of the project?

Pierre-Jean : “One of the moments that stood out for me was when I saw Barbara tie a triple knot during a live demo! I honestly thought there were some unattainable steps in terms of simulation. I’ve been working on suturing research projects for years (…) I know it’s a very complex subject. Seeing a surgeon manipulate the simulator and chain several knots in a row is impressive ”

“A new collaboration with the Institute of Image Guided Surgery”

What is the next step for ROBOTiS?

Before the puncture, I was a little stressed which seems normal to me, but the intern who accompanied me had already shown me the procedure several times and she knew how to put me at ease. The patient was quite stressed because she had had a bad experience before, and the pathology she suffers from requires depletive lumbar punctures (evacuation of excessive cerebrospinal fluid) quite regularly. When I introduced the needle, she let out a cry of fear which made me jump but I was able to continue after a few seconds of pause and the rest went well. The patient didn’t seem to be in too much pain, and the puncture was a success.
I think that before performing your first puncture, it is necessary to have seen the procedure several times in order to be comfortable with the preparation of the gesture and then the puncture itself. Generally, an intern is with you at the beginning, to answer your questions, and help you if need, then you quickly become independent.

Any last advice?

Relax as much as possible, put the patient at ease, and everything will be fine. 

The stages of the patient’s preparation, the equipment, the disinfection ran through smoothly. However there is always a great apprehension when performing a first procedure (especially when it occurs at the start of externship) and I was very apprehensive when introducing the needle. I made a first attempt with an atraumatic needle which failed. I felt the vertebrate and couldn’t change the trajectory. I then tried again with a traumatic needle, but the problem was the same, I felt the bone. My intern then took over by modifying the trajectory, and was able to complete the procedure. Fortunately, the patient was calm and rather well reassured by the nursing team during the procedure. I think the training is quite adequate, but in my case, it would have been more effective if the simulation training had been organized earlier.

Any last advice?

You really need to see several lumbar punctures before doing the first one, to learn the procedure by imitation.

It was also the first puncture for the patient, but he was quite confident. He didn’t particularly panic, and didn’t hurt too much during the procedure. He didn’t flinch at all when I inserted the needle, just a little “ouch” when I started. It was quite reassuring for me because there were no screams or sudden movements, which allowed me to stay focused on my gesture while remaining in my bubble.

To improve the training, it is imperative that each student be able to attend at least one puncture before doing one. You have to train to locate the landmarks on a patient, and not hesitate to ask for help. And of course, you have to practice the gesture beforehand if possible, on a simulator or model. The ideal is to be able to repeat all the practical aspects of the procedure (disinfection, putting on sterile gloves, pricking the patient, filling the tubes, etc.), so that the sequence of gestures is more fluid thereafter.

Any last advice?

Don’t stress too much, don’t hesitate to ask your intern to guide you, and don’t panic if you don’t get it right the first time! You can repeat it several times.