Development and implementation of a virtual reality laparoscopic colorectal training curriculum

Wynn, Greg; Lykoudis, Panagis M.; Berlingieri, Pasquale

doi:10.1016/j.amjsurg.2017.11.034

Cited by 19 publications

(32 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Some laparoscopic surgical simulators were validated in previous studies, such as the LapSim and LAP Mentor [ 20 – 22 ]. They were more valuable as a training tool than an inanimate box trainer [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Validation of a novel virtual reality simulation system with the focus on training for surgical dissection during laparoscopic sigmoid colectomy

et al. 2022

View full text Add to dashboard Cite

Background Mastery of technical skills is one of the fundamental goals of surgical training for novices. Meanwhile, performing laparoscopic procedures requires exceptional surgical skills compared to open surgery. However, it is often difficult for trainees to learn through observation and practice only. Virtual reality (VR)-based surgical simulation is expanding and rapidly advancing. A major obstacle for laparoscopic trainees is the difficulty of well-performed dissection. Therefore, we developed a new VR simulation system, Lap-PASS LP-100, which focuses on training to create proper tension on the tissue in laparoscopic sigmoid colectomy dissection. This study aimed to validate this new VR simulation system. Methods A total of 50 participants were asked to perform medial dissection of the meso-sigmoid colon on the VR simulator. Forty-four surgeons and six non-medical professionals working in the National Cancer Center Hospital East, Japan, were enrolled in this study. The surgeons were: laparoscopic surgery experts with > 100 laparoscopic surgeries (LS), 21 were novices with experience < 100 LS, and five without previous experience in LS. The participants’ surgical performance was evaluated by three blinded raters using Global Operative Assessment of Laparoscopic Skills (GOALS). Results There were significant differences (P-values < 0.044) in all GOALS items between the non-medical professionals and surgeons. The experts were significantly superior to the novices in one item of GOALS: efficiency ([4(4–5) vs. 4(3–4)], with a 95% confidence interval, p = 0.042). However, both bimanual dexterity and total score in the experts were not statistically different but tended to be higher than in the novices. Conclusions Our study demonstrated a full validation of our new system. This could detect the surgeons' ability to perform surgical dissection and suggest that this VR simulator could be an effective training tool. This surgical VR simulator might have tremendous potential to enhance training for surgeons.

show abstract

Section: Discussionmentioning

confidence: 99%

Validation of a novel virtual reality simulation system with the focus on training for surgical dissection during laparoscopic sigmoid colectomy

et al. 2022

View full text Add to dashboard Cite

show abstract

“…To date, CV has been demonstrated in procedural modules across a variety of VR simulators, such as the MIST nephrectomy [22], LapSim salpingectomy [23], LAP Mentor cholecystectomy [8] and sigmoid colectomy modules [11]. The present LAP Mentor appendicectomy module curriculum is based on a model of deliberate practice -where learners reflect and consciously seek improvement of performance with each repetition, to achieve expert performance rather than arrested development [24].…”

Section: Discussionmentioning

confidence: 99%

“…Over the last ten years, surgical educators have progressively focussed their attention on the development of structured training curricula with the aim of providing trainees with the relevant expertise needed for their surgical practice [8][9][10][11]. Since the majority of laparoscopic appendectomies are performed by surgeons in training [12], it is imperative that they are equipped with the necessary skills early in their career.…”

Section: Introductionmentioning

confidence: 99%

Development of a structured virtual reality curriculum for laparoscopic appendicectomy

Sinitsky

Fernando

Potts³

et al. 2020

The American Journal of Surgery

Self Cite

View full text Add to dashboard Cite

Background: Laparoscopic appendicectomy (LA) is a common surgical emergency procedure mainly performed by trainees. The aim was to develop a step-wise structured virtual reality (VR) curriculum for LA to allow junior surgeons to hone their skills in a safe and controlled environment.Methods: A prospective randomized study was designed using a high-fidelity VR simulator.Thirty-five novices and 25 experts participated in the assessment and their performances were compared to assess construct validity. Learning curve analysis was performed.Results: Five of the psychomotor tasks and all appendicectomy tasks showed construct validity. Learning was demonstrated in the majority of construct-valid tasks. A novel goaldirected VR curriculum for LA was constructed. Conclusions:A step-wise structured VR curriculum for LA is proposed with a framework which includes computer generated metrics and supports deliberate practice, spacing intervals, human instruction/feedback and assessment. Future study should test the feasibility of its implementation and transferability of acquired skill.

show abstract

“…In addition to surgical techniques, there has been a parallel improvement in laparoscopic equipment, such as advanced energy devices and visual display screen including 4K and 3D technology. Courses in advanced laparoscopic training and the availability of simulators [27][28][29] to practise skills outside the operating theatre can all contribute towards a shorter learning curve for the next wave of laparoscopic HPB surgeons. In our study, risk adjustment using the Iwate index reduced the observed learning curves for both surgeons for the end point of operating time, but did not affect the CUSUM plot for conversion rate.…”

Section: Hpbmentioning

confidence: 99%

Evaluating the learning curve for laparoscopic liver resection: a comparative study between standard and learning curve CUSUM

Sultana

Marudanayagam

Sutcliffe

2019

HPB

View full text Add to dashboard Cite

Background: Laparoscopic liver resection (LLR) requires training in both hepatobiliary surgery and advanced laparoscopy. Available data on LLR learning curves are derived from pioneer surgeons. The aims of this study were to evaluate the LLR learning curve for second generation surgeons, and to compare different CUSUM methodology with and without risk adjustment. Methods: Retrospective analysis of a prospective database of 111 consecutive patients who underwent LLR by two surgeons at a single centre between 2011 and 2016. The LLR learning curve for minor hepatectomy (MH) was evaluated for each surgeon using standard CUSUM before and after riskadjusting for operative difficulty using the Iwate index, and compared with Learning Curve (LC) CUSUM. The end points were operative time and conversion rate. Results: Standard CUSUM analysis identified a learning curve of 50-60 MH procedures. The corresponding learning curve reduced to 25-30 after risk-adjusting for operative difficulty, whilst LC-CUSUM identified a learning curve of 17-25 procedures. Conclusions: The learning curve for laparoscopic minor liver resection by second generation surgeons is shorter than that for pioneer surgeons. Laparoscopic HPB fellowship programmes may further shorten the learning curve, facilitating safe expansion of LLR. The LC-CUSUM method is an alternative technique that warrants further study.

show abstract

Development and implementation of a virtual reality laparoscopic colorectal training curriculum

Cited by 19 publications

References 30 publications

Validation of a novel virtual reality simulation system with the focus on training for surgical dissection during laparoscopic sigmoid colectomy

Validation of a novel virtual reality simulation system with the focus on training for surgical dissection during laparoscopic sigmoid colectomy

Development of a structured virtual reality curriculum for laparoscopic appendicectomy

Evaluating the learning curve for laparoscopic liver resection: a comparative study between standard and learning curve CUSUM

Contact Info

Product

Resources

About