Abstract
Purpose
Laparoscopic surgery is commonly used in many surgical procedures but requires a learning process to develop the necessary skills. Virtual reality simulators play an essential role within the training curricula. This paper aims to determine whether training in SINERGIA VR simulator allows novice surgeons to improve their basic psychomotor laparoscopic skills.
Methods
Forty-two people participated in this study, including 28 unexperience medical students and 14 expert surgeons who developed previously more than 100 laparoscopic procedures. Medical students made a pre-training test in LapMentor II; then, they trained in SINERGIA and they finally accomplished a post-training test in LapMentor II. Experts just made one trial in LapMentor II. A statistical analysis was carried out and results of pre- and post-training tests of novices were compared with Wilcoxon signed-rank test. Pre- and post-training tests of novices were also compared with results of experts with Mann–Whitney U test.
Results
Most metrics provided by LapMentor II and included in this study show significant differences when comparing pre- and post-training tests of novices. Analysis of pre-training test of novices and experts results show significant differences in all analyzed metrics for all studied tasks. On the other hand, LapMentor was not able to distinguish between experts and novices after training in SINERGIA for any metric in the camera manipulation task and for some metrics of the other tasks.
Conclusions
Training in SINERGIA VR simulator allows improvement of basic psychomotor laparoscpic skills and transferring them to another virtual simulator. Therefore, it could be used in laparoscopic surgery training programs.
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References
Yamaguchi S, Konishi K, Yasunaga T, Yoshida D, Kinjo N, Kobayashi K et al (2007) Construct validity for eye-hand coordination skill on a virtual reality laparoscopic surgical simulator. Surg Endosc 21(12): 2253–2257
Da Luz Moreira A, Kiran RP, Kirat HT, Remzi FH, Geisler DP, Church JM et al (2010) Laparoscopic versus open colectomy for patients with American Society of Anesthesiology (ASA) classifications 3 and 4: the minimally invasive approach is associated with significantly quicker recovery and reduced costs. Surg Endosc 24(6): 1280–1286
Lazzarino AI, Nagpal K, Bottle A, Faiz O, Moorthy K, Aylin P (2010) Open versus minimally invasive esophagectomy: trends of utilization and associated outcomes in England. Ann Surg 252(2): 292–298
Rodríguez JI, Turienzo E, Vigal G, Brea A (2006) Formación quirúrgica con simuladores en centros de entrenamiento. Cir Esp 79(6): 342–348
Fowler DL (2010) Enabling, implementing and validating training methods in laparoscopic surgery. World J Surg 34(4): 621–624
Fried GM, Feldman LS, Vassiliou MC, Fraser SA, Stanbridge D, Ghitulescu G et al (2004) Proving the value of simulation in laparoscopic surgery. Ann Surg 240(3): 518–528
Usón J, Sánchez FM, Sánchez MA, Pérez FJ, Hashizume M (2007) Simuladores laparoscópicos. In: Uson J, Sánchez FM, Pascual S, Climent S (eds) Formación en cirugía laparoscópica paso a paso, 3rd edn. Centro de Cirugía de Mínima Invasión, Cáceres, pp 21–89
Sánchez-Margallo FM, Díaz-Guemes I, Perez FJ, Sánchez MA, Loscertales B, Usón J (2009) Preliminary results with a training program for thoracoscopic atrial fibrillation therapy. Surg Endosc 23(8): 1882–1886
Andreatta PB, Woodrum DT, Birkmeyer JD, Yellamanchilli RK, Doherty GM, Gauger PG et al (2006) Laparoscopic skills are improved with LapMentor training: results of a randomized, double-blinded study. Ann Surg 243(6): 854–863
Gallagher AG, Lederman AB, McGlade K, Satava RM, Smith CD (2004) Discriminative validity of the minimally invasive surgical trainer in virtual reality (MISTVR) using criteria levels based on expert performance. Surg Endosc 18(4): 660–665
Gallagher AG, Ritter EM, Champion H, Higgins G, Fried MP, Moses G et al (2005) Virtual reality simulation for the operating room: proficiency-based training as a paradigm shift in surgical skills training. Ann Surg 241(2): 364–372
Kanumuri P, Ganai S, Wohaibi EM, Bush RW, Grow DR, Seymour NE (2008) Virtual reality and computer-enhanced training devices equally improve laparoscopic surgical skill in novices. JSLS 12(3): 219–226
Gauger PG, Hauge LS, Andreatta PB, Hamstra SJ, Hillard ML, Arble EP et al (2010) Laparoscopic simulation training with proficiency targets improves practice and performance of novice surgeons. Am J Surg 199(1): 72–80
Botden SM, Jakimowicz JJ (2009) What is going on in augmented reality simulation in laparoscopic surgery?. Surg Endosc 23(8): 1693–1700
Thijssen AS, Marlies PS (2010) Contemporary virtual reality laparoscopy simulators: quicksand or solid grounds for assessing surgical trainees?. Am J Surg 199(4): 529–541
McDougall EM (2007) Validation of surgical simulators. J Endourol 21(3): 244–247
Debes AJ, Aggarwal R, Balasundaram I, Jacobsen MB (2010) A tale of two trainers: virtual reality versus a video trainer for acquisition of basic laparoscopic skills. Am J Surg 199(6): 840–845
Lehmann KS, Ritz JP, Maass H, Cakmak HK, Kuehnapfel UG, Germer CT et al (2005) A prospective randomized study to test the transfer of basic psychomotor skills from virtual reality to physical reality in a comparable training setting. Ann Surg 241(3): 442–449
Lamata P, Gómez E, Sánchez-Margallo F, López Ó, Monserrat C, García V et al (2007) Sinergia laparoscopic virtual reality simulador: didactic design and technical development. Comput Methods Programs Biomed 85(3): 273–283
Sánchez-Peralta LF, Sánchez-Margallo FM, Moyano-Cuevas JL, Pagador JB, Enciso-Sanz S, Sánchez-González P et al (2010) Construct and face validity of Sinergia laparoscopic virtual reality simulator. Int J Comput Assist Radiol Surg 5(4): 307–315
Aggarwal R, Crochet P, Dias A, Misra A, Ziprin P, Darzi A (2009) Development of a virtual reality training curriculum for laparoscopic cholecystectomy. Br J Surg 96(9): 1086–1093
Zhang A, Hünerbein M, Dai Y, Schlag PM, Beller S (2008) Construct validity testing of a laparoscopic surgery simulator (Lap Mentor): evaluation of surgical skill with a virtual laparoscopic training simulator. Surg Endosc 22(6): 1440–1444
Woodrum DT, Andreatta PB, Yellamanchilli RK (2006) Construct validity of the LapSim laparoscopic surgical simulator. Am J Surg 191(1): 28–32
McDougall EM, Corica FA, Boker JR (2006) Construct validity testing of a laparoscopic surgical simulator. J AM Coll Surg 202(5): 779–787
Seymour N (2008) VR to OR: a review of the evidence that virtual reality simulation improves operating room performance. World J Surg 32(2): 182–188
Andreatta PB, Woodrum DT, Gauger PG, Minter RM (2008) LapMentor metrics possess limited construct validity. Simul Healthc 3(1): 16–25
Kahol K, Vankipuram M, Smith ML (2009) Cognitive simulators for medical education and training. J Biomed Inform 42: 593–604
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Moyano-Cuevas, J.L., Sánchez-Margallo, F.M., Sánchez-Peralta, L.F. et al. Validation of SINERGIA as training tool: a randomized study to test the transfer of acquired basic psychomotor skills to LapMentor. Int J CARS 6, 839–846 (2011). https://doi.org/10.1007/s11548-011-0561-9
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DOI: https://doi.org/10.1007/s11548-011-0561-9