Hybrid Surgical Simulator: A Temporal Bone Simulator Validation Study of the Stryker Surgical Simulator (S3)

Abstract

Introduction The Stryker Surgical Simulator is a hybrid, temporal bone simulator that uses both tactile and haptic feedback combined with a computer interface. We sought to validate this simulator as an otolaryngology resident training tool for performing tympanomastoidectomy. Materials and Methods 15 residents and staff performed five basic cortical mastoidectomies. Staff surgeons comprised the “expert” cohort and resident surgeons comprised the “trainee” cohort. Subjective evaluation of the face validity and content validity was assessed via pre- and postquestionnaires. Objective evaluation of content validity was assessed through grading of each temporal bone dissection specimen, comparing time to task completion, and calculating the rate of injury to critical structures. Study approved by the Institutional Review Board (2013.0001). Results Post hoc questionnaires showed that both staff and residents subjectively rated the simulator favorably on face validity, content validity, and all global assessment categories, though there were no significant distinctions between groups (P > 0.05). The resident group had a significantly longer drilling time compared with the staff group throughout the series of tympanomastoidectomies (P = 0.008), and both groups showed a decrease in time to task completion with repetitive drilling. However, there were no significant differences in surgical performance as evaluated by a blinded senior neurotologist (P = 0.52). There were also no critical injuries recorded by the simulator in any of the 75 trials, preventing any evaluation on this measure. Conclusions Despite favorable subjective evaluations by both staff and residents, objective discrimination between experienced and novice participants was not achieved. This was likely in part due to inherent design flaws of the simulator. This emphasizes the potential shortcomings of surgical simulation models for highly technical procedures and points to the importance of intensive study and validation prior to incorporation of commercial training models into surgical training programs.

Validation of a surgical drill with a haptic interface in spine surgery

“…Meyer et al compared the drilling performance of a bone simulator with a haptic system between the trainee resident group and the expert staff surgeon group. They concluded that there were no significant differences in surgical time or the accuracy of the surgical technique 13 . Thus, the use of a spine surgery simulator with a haptic system may be useful for spine surgery education, which has a steep learning curve.…”

“…Several previous reports described the availability of haptic technology for surgical simulators [12][13][14] . Meyer et al compared the drilling performance of a bone simulator with a haptic system between the trainee resident group and the expert staff surgeon group.…”

Criação e validação de modelo de osso temporal em 3D para simulação pré-cirúrgica de otite média crônica colesteatomatosa

“…Os protocolo MiSSES, com questões adaptadas de outros estudos de validação de osso temporal 3D e criações 3D com foco em otorrinolaringologia [6,7,15,30,39,41,42] , com participação e anuência na sua construção de Deborah M.…”

“…A maioria dos participantes afirmou que os ossos temporais impressos em 3D devem ser incorporados ao currículo de treinamento de dissecção óssea temporal e que eles recomendariam o modelo de osso temporal impresso em 3D para outros estagiários. Nossos resultados sugerem o já discriminado em outros estudos, em que se evidencia que o modelo do osso temporal impresso em 3D é um treinamento valioso ferramenta de aprendizagem de procedimentos otológicos [6,15] .…”

“…De acordo com o conselho de credenciamento para graduação médica os requisitos centrais de competência da educação em cirurgia estipulam que os residentes de otorrinolaringologia devem demonstrar conhecimento de anatomia e mostrar competência nas habilidades práticas englobando a dissecção do osso temporal [6] .…”