Assessing suturing techniques using a virtual reality surgical simulator

Abstract

Advantages of virtual-reality simulators surgical skill assessment and training include more training time, no risk to patient, repeatable difficulty level, reliable feedback, without the resource demands, and ethical issues of animal-based training. We tested this for a key subtask and showed a strong link between skill in the simulator and in reality. Suturing performance was assessed for four groups of participants, including experienced surgeons and naive subjects, on a custom-made virtual-reality simulator. Each subject tried the experiment 30 times using five different types of needles to perform a standardized suture placement task. Traditional metrics of performance as well as new metrics enabled by our system were proposed, and the data indicate difference between trained and untrained performance. In all traditional parameters such as time, number of attempts, and motion quantity, the medical surgeons outperformed the other three groups, though differences were not significant. However, motion smoothness, penetration and exit angles, tear size areas, and orientation change were statistically significant in the trained group when compared with untrained group. This suggests that these parameters can be used in virtual microsurgery training.

Status of Microsurgical Simulation Training in Plastic Surgery

“…1 Various simulation assessment tools have been validated and deemed reliable in measuring residents' technical skills outside the operating room across multiple specialties, including microsurgery. 3,[5][6][7][8][9][10][11][12][13] In addition, various simulation training modules have been validated for improving performance in the operating room with training. [14][15][16][17][18][19][20] Despite these advances in microsurgical education, it is unknown how prevalent simulation is.…”

Assessment of microsurgery competency‐where are we now?

“…The lack of haptic feedback is another criticism of the virtual reality simulators. Studies on Virtual reality technology when applied to microsurgical training have concluded that it needs to be used in combination with other objective assessment tools until more research is conducted in this field to demonstrate its feasibility as an objective assessment tool in comparison to current more developed tools like the global rating scale …”

Machine learning distinguishes neurosurgical skill levels in a virtual reality tumor resection task

“…Most studies on operator performance have utilized "metrics." [6][7][8][9][10][11][12][13][14][15][16] A useful definition of "metrics" is that they are standards of reference by which performance, efficiency, and progress can be assessed. Individual metric can be used to assess aspects of operator performance.…”