Development of an ex vivo simulated training model for laparoscopic liver resection

Abstract

The adapted ProMIS augmented reality simulator provided junior surgeons with a realistic learning environment in which to familiarise themselves with the equipment and techniques required for LLR. The model also allows assessment of the performance of individuals over time and within a peer group. Construct validity is proven for the suturing component of the model.

A cost effective analysis of a laparoscopic versus an open left lateral sectionectomy in a liver transplant unit

“…Many skills for laparoscopic procedures can be learnt on simulators and the skills are transferable to the operating theatre . However, reports of ex vivo training models are limited and we were only able to find one study looking at the outcomes of trainees performing LLLS . Our study is in agreement with Hasegawa et al .…”

“…As LLR requires advanced laparoscopic skills coupled with liver resection expertise, training opportunities can be limited. There was only one study assessing LLLS as a training operation whereas others were compared in ex vivo models …”

Advanced training in laparoscopic abdominal surgery: A systematic review

“…Strickland et al assessed the construct validity of a liver tumorectomy in an AR simulator, 31 whilst Udomsawaengsup et al described a training course on cadavers involving, along with other resections, a liver procedure. However, the type of procedure was not specified.…”

“…Two studies assessed construct validity for the ProMIS™, either for laparoscopic sigmoid colectomy 30 or for hepatic tumorectomy. 31 Leblanc et al assessed metrics and rating scales for laparoscopic sigmoid colectomy in 4 studies: 2 randomized crossover studies 17, 18 compared hand-assisted (HAL) and straight laparoscopic (SL) sigmoid colectomies, and 2 other studies compared rating scales and trainees' satisfaction on ProMIS™ and cadavers. 24, 25 Whilst satisfaction was significantly better with cadavers (p < 0.001), trainers rated generic (p = 0.008) and specific skills (p = 0.028) more accurately on the simulator.…”

“…9, 28, 44, 45, 55 Furthermore, some tools have been proven to be construct-valid. 9, 29-31 However, very few studies assessed the transfer of advanced technical skills from training tools to live procedures, especially in the OR.…”