A Randomized Controlled Study to Evaluate the Impact of Instrument and Laparoscope Length on Performance and Learning Curve in Single-Incision Laparoscopic Surgery

Balaji, Sathyan; Singh, Pritam; Sodergren, Mikael H.; Corker, Harry P.; Kwasnicki, Richard M.; Darzi, Ara; Paraskeva, Paraskevas

doi:10.1177/1553350615572657

Cited by 10 publications

(6 citation statements)

References 30 publications

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“…in line with previous research that shows higher workload ratings for VR trained groups compared with control groups [45][46][47]. When examining individual subscales, the NC group consistently reported slightly increased levels of workload during the real task for most subscales.…”

Section: Plos Onesupporting

confidence: 90%

Transfer of training—Virtual reality training with augmented multisensory cues improves user experience during training and task performance in the real world

et al. 2021

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Virtual reality (VR) can create safe, cost-effective, and engaging learning environments. It is commonly assumed that improvements in simulation fidelity lead to better learning outcomes. Some aspects of real environments, for example vestibular or haptic cues, are difficult to recreate in VR, but VR offers a wealth of opportunities to provide additional sensory cues in arbitrary modalities that provide task relevant information. The aim of this study was to investigate whether these cues improve user experience and learning outcomes, and, specifically, whether learning using augmented sensory cues translates into performance improvements in real environments. Participants were randomly allocated into three matched groups: Group 1 (control) was asked to perform a real tyre change only. The remaining two groups were trained in VR before performance was evaluated on the same, real tyre change task. Group 2 was trained using a conventional VR system, while Group 3 was trained in VR with augmented, task relevant, multisensory cues. Objective performance, time to completion and error number, subjective ratings of presence, perceived workload, and discomfort were recorded. The results show that both VR training paradigms improved performance for the real task. Providing additional, task-relevant cues during VR training resulted in higher objective performance during the real task. We propose a novel method to quantify the relative performance gains between training paradigms that estimates the relative gain in terms of training time. Systematic differences in subjective ratings that show comparable workload ratings, higher presence ratings and lower discomfort ratings, mirroring objective performance measures, were also observed. These findings further support the use of augmented multisensory cues in VR environments as an efficient method to enhance performance, user experience and, critically, the transfer of training from virtual to real environment scenarios.

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Section: Plos Onesupporting

confidence: 90%

Transfer of training—Virtual reality training with augmented multisensory cues improves user experience during training and task performance in the real world

et al. 2021

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“…In the past, some surgeons tried to use conventional rigid laparoscopic instrument to perform SIES. The mode of using instrument in SIES is feasible but usually results in "chop-stick" effect (11,(24)(25)(26). When the operative space in the abdominal wall created by the incision is small, the middle part of the instrument would be confined in the incision.…”

Section: Discussionmentioning

confidence: 99%

“…The first and simplest solution is to use instruments of different Table 5 The relative difficulty of the actions by using the designed steerable laparoscopic instrument was recorded length to minimize interference in the hand-held parts. A demerit of using different length instrument is that there would be some interferences in front effectors (25).…”

Section: Discussionmentioning

confidence: 99%

Significance of steerable laparoscopic instrument: usability-based evaluation in a simulation model

Chen¹,

Chang²,

Huang³

et al. 2019

Health Technol

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Background: Laparoscopic surgery had been developed for decades. The latest trend is to minimize the incision size and minimize the number of port incisions. When surgeons have to operate in the limited incision, interference between instruments will result in increasing difficulty of surgery. In the study, we tested the significance and efficacy of a newly developed laparoscopic instrument with conventional rigid laparoscopic instrument in an usability-based method.Methods: We used a standard laboratory setting for comparison of characteristics of the instruments. There are 10 surgeons participated in the study. The tests included common procedures that can be performed by these instruments. The efficiency and features are compared and analyzed. Results:The average time to learn to use the instrument is 3.8 minutes. In 6 tests of common laparoscopic techniques, including using instruments to moving a plastic tube in certain site, to throw a knot, to suture, to guide a string, to cut specimen and to open a candy with foil, performance of the two steerable laparoscopic instruments is similar but both performances are better than that of conventional rigid instrument. The benefits are much better in single port situation.Conclusions: Steerable design of the instrument is reasonable for clinical use. Steerable laparoscopic instrument can be an alternative to conventional rigid laparoscopic instrument.

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“…Also, due to the small sample size, no multivariate analysis of the effect of the teaching module on resident skill could be performed to control for factors such as resident experience level or quantity of US experience. Despite limited sample sizes, however, others have validated the effects of simulated training on resident learning with studies where small sample sizes were utilized (19, 20). Therefore, while our sample size was small, it was not outside of a reasonable range to be expected for this type of study.…”

Section: Discussionmentioning

confidence: 99%

Using an abdominal phantom to teach urology residents ultrasound-guided percutaneous needle placement

Filippou¹,

Odisho²,

Ramaswamy³

et al. 2016

Int. braz j urol.

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Introduction:To assess the effect of a hands-on ultrasound training session to teach urologic trainees ultrasound-guided percutaneous needle placement.Materials and methods:University of California, San Francisco (UCSF) urology residents completed a time trial, placing a needle into a phantom model target under ultrasound guidance. Participants were randomized into three educational exposure groups: Group 1's time trial occurred prior to any teaching intervention, group 2's after experiencing a hands-on training module, and group 3's after exposure to both the training module and one-on-one attending feedback. Needle placement speed and accuracy as well as trainees' perceived confidence in utilizing ultrasound were measured.Results:The study cohort consisted of 15 resident trainees. Seven were randomized to group 1, three to group 2, and five to group 3. All residents reported minimal prior ultrasound experience. Their confidence in using ultrasound improved significantly after completing the training module with the most significant improvement seen among junior residents. Time to needle placement was fastest after receiving attending feedback (46.6sec in group 3 vs. 82.7sec in groups 1 and 2, p<0.01). Accuracy also improved with attending feedback, though the number of repositioning attempts did not differ significantly between groups.Conclusions:A hands-on training module and use of an abdominal phantom trainer increased resident confidence and skill in their use of ultrasound to guide percutaneous needle positioning. Attending feedback is critical for improving accuracy in needle guidance toward a target. Ultrasound-guided needle positioning is a teachable skill and can be applicable to multiple urologic procedures.

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A Randomized Controlled Study to Evaluate the Impact of Instrument and Laparoscope Length on Performance and Learning Curve in Single-Incision Laparoscopic Surgery

Abstract: This study demonstrates that using instruments of different lengths can improve simulated SILS performance.

Cited by 10 publications

References 30 publications

Transfer of training—Virtual reality training with augmented multisensory cues improves user experience during training and task performance in the real world

Transfer of training—Virtual reality training with augmented multisensory cues improves user experience during training and task performance in the real world

Significance of steerable laparoscopic instrument: usability-based evaluation in a simulation model

Using an abdominal phantom to teach urology residents ultrasound-guided percutaneous needle placement

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