Virtual Reality Simulator Training of Laparoscopic Cholecystectomies — A Systematic Review

Abstract

Background and Aims: simulators are widely used in occupations where practice in authentic environments would involve high human or economic risks. surgical procedures can be simulated by increasingly complex and expensive techniques. this review gives an update on computer-based virtual reality (vr) simulators in training for laparoscopic cholecystectomies.Materials and Methods: from leading databases (medline, cochrane, embase), randomised or controlled trials and the latest systematic reviews were systematically searched and reviewed. twelve randomised trials involving simulators were identified and analysed, as well as four controlled studies. furthermore, seven studies comparing black boxes and simulators were included.Results: the results indicated any kind of simulator training (black box, vr) to be beneficial at novice level. after vr training, novice surgeons seemed to be able to perform their first live cholecystectomies with fewer errors, and in one trial the positive effect remained during the first ten cholecystectomies. no clinical follow-up data were found. optimal learning requires skills training to be conducted as part of a systematic training program. no data on the cost-benefit of simulators were found, the price of a vr simulator begins at eur 60 000.Conclusions: theoretical background to learning and limited research data support the use of simulators in the early phases of surgical training. the cost of buying and using simulators is justified if the risk of injuries and complications to patients can be reduced. Developing surgical skills requires repeated training. in order to achieve optimal learning a validated training program is needed.

Video-assisted surgery: suggestions for failure prevention in laparoscopic cholecystectomy

“…This procedure takes a relatively long period to learn, as the surgical trainee proceeds under supervision, gradually with increasing responsibility towards becoming an independently operating specialist expert surgeon (Ericsson 2004;Patel et al 2001;Silvennoinen et al 2009). Various methods for LC technical skill training for surgical residents have been implemented to aid this learning process such as box trainers and virtual reality simulators (Aggarwal et al 2009;Ikonen et al 2012). It is however noteworthy that half of the bile duct injuries occur during LCs that surgeons evaluate as "technically easy."…”

The development of a virtual reality training programme for ophthalmology: repeatability and reproducibility (part of the International Forum for Ophthalmic Simulation Studies)

“…Mastery of performance, especially of highly technical tasks such as microsurgery 1,2 and aviation 3 takes years of repeated practice to achieve. 4 In ophthalmology, evidence has emerged for a wider spread of performance in the early stages of training.…”

Teaching Methodology for the Training of a Laparoscopic Technique: Intestinal Anastomosis

“…Surgical apprentices can repeat training sessions as often as necessary to achieve mastery. The laparoscopic skills acquired through the simulation are transferred to the operating room with real patients [3] [4] [5].…”