Does training in a virtual reality simulator improve surgical performance?

Åhlberg, Gabrielle; Heikkinen, T.; Iselius, Lennart; Leijonmarck, Carl-Eric; Rutqvist, Jonny; Arvidsson, Dag

doi:10.1007/s00464-001-9025-6

Cited by 181 publications

(124 citation statements)

References 10 publications

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“…Most studies also used surrogate end points such as bench station or simulator tests to establish the transferability of skills, instead of assessing skills in real operations. The conclusion of the meta-analysis was that only few studies possess the necessary quality, that two studies showed a positive effect23 24 (real operation) and one study no effect25 (simulated operation) of simulator based training. Another common feature of the previous studies is that they were all carried out using basic skills rather than procedure specific simulation.…”

Section: Discussionmentioning

confidence: 99%

Effect of virtual reality training on laparoscopic surgery: randomised controlled trial

Larsen

Soerensen²,

Grantcharov

et al. 2009

BMJ

500

315

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Objective To assess the effect of virtual reality training on an actual laparoscopic operation.Design Prospective randomised controlled and blinded trial.Setting Seven gynaecological departments in the Zeeland region of Denmark.Participants 24 first and second year registrars specialising in gynaecology and obstetrics.Interventions Proficiency based virtual reality simulator training in laparoscopic salpingectomy and standard clinical education (controls).Main outcome measure The main outcome measure was technical performance assessed by two independent observers blinded to trainee and training status using a previously validated general and task specific rating scale. The secondary outcome measure was operation time in minutes.Results The simulator trained group (n=11) reached a median total score of 33 points (interquartile range 32-36 points), equivalent to the experience gained after 20-50 laparoscopic procedures, whereas the control group (n=10) reached a median total score of 23 (22-27) points, equivalent to the experience gained from fewer than five procedures (P<0.001). The median total operation time in the simulator trained group was 12 minutes (interquartile range 10-14 minutes) and in the control group was 24 (20-29) minutes (P<0.001). The observers’ inter-rater agreement was 0.79.Conclusion Skills in laparoscopic surgery can be increased in a clinically relevant manner using proficiency based virtual reality simulator training. The performance level of novices was increased to that of intermediately experienced laparoscopists and operation time was halved. Simulator training should be considered before trainees carry out laparoscopic procedures.Trial registration ClinicalTrials.gov NCT00311792.

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Section: Discussionmentioning

confidence: 99%

Effect of virtual reality training on laparoscopic surgery: randomised controlled trial

Larsen

Soerensen²,

Grantcharov

et al. 2009

BMJ

500

315

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“…Evidence suggests that simulators are valid instruments in the acquisition of MIS skills. 6,[8][9][10] Hamilton et al 11 established that laparoscopic skills developed outside the operating room are transferrable to actual performance of laparoscopic surgery.…”

Section: Methodsmentioning

confidence: 99%

Mapping the Maze of Minimally Invasive Surgery Simulators

Empel

Veer

Rijssen

et al. 2012

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Background: Conforming to, among other considerations, legal and ethical concerns for patient safety, there is an increasing demand to assess a surgeon's skills prior to performance in the operating room in pursuit of higherquality treatment. Training in minimally invasive surgery (MIS) must therefore be intensified, including team training. New methods to train and assess minimally invasive surgical skills are gaining interest. The goal of this review is to provide instructors with an overview of available MIS training tools. In this review, we discuss currently available simulators for MIS training. Applicability, validity, and construction of simulators are reviewed. Also, some of the leading training programs and assessment methods in MIS are reviewed. Methods: A literature search was performed on studies evaluating surgical task performance on a simulator, reviewing satisfaction with laparoscopic training programs, or validating simulators or assessment methods. Results: Simulators may be divided into simple box trainers and computer-based systems, such as virtual and augmented simulators. All have advantages and disadvantages. An overview is provided of currently available training systems, validity, trainee assessment, and the importance of training programs in MIS. Conclusions:No simulator yet provides the ability to train the entire set of required psychomotor skills or procedures for MIS. A multiyear training program combining various simulators for multiple-level training, including team training, should be constructed.

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“…Of the 21 studies that surveyed whether the training intercession brought about the change of execution time, 13 (62%) investigations announced factually statistically significant improvement. For instance, in one study scientists announced that the control group took 58% longer to play out the surgery 23 and in another study specialists detailed that the control group, all things considered, played out the surgery twice the length of the intervention group (24 minutes when contrasted with 12 minutes, p < 0.001). 24 In yet another investigation the intervention group was 29% quicker in dismembering the gallbladder during a cholecystectomy than the control one.…”

Section: Performance Time (N = 13 Studies)mentioning

confidence: 99%

“…Three (14%) of the 21 examines detailed huge change on suturing, cutting, and cautering abilities 8,23,24 in the training group when contrasted with the control group.…”

mentioning

confidence: 99%