Virtual-reality training improves angled telescope skills in novice laparoscopists.

BACKGROUND Based on prior success of virtual-reality (VR) trainers in imparting surgical skills, a randomized and controlled study was designed to determine whether VR training improves angled-telescope operative performance. METHODS Third-year medical students received instruction on the use of an angled laparoscope and subsequently underwent performance assessment of angled telescope navigational tasks in an anesthetized porcine model. Subjects were then randomized to objective-based training with an angled-telescope simulator (EndoTower; Verefi Technologies, Elizabethtown, PA) versus no training, followed by reassessment of performance. RESULTS Initially, there were no significant differences between VR-trained (n = 9) and control (n = 10) groups. After training, object visualization, scope orientation, and horizon error scores were significantly better in VR-trained than control groups; subject-matched improvement in orientation score was 50.9% versus 10.8% (P < .05). CONCLUSIONS VR training in angled laparoscope use improves operative performance of novices. These data support growing evidence that VR training is highly effective in improving surgical skills outside of the clinical setting.

[1]  A. Peracchia,et al.  Surgical Education in the Third Millennium , 2001 .

[2]  R. Satava,et al.  Virtual Reality Simulation for the Operating Room: Proficiency-Based Training as a Paradigm Shift in Surgical Skills Training , 2005, Annals of surgery.

[3]  Andrew L Warshaw,et al.  Residency training in surgery in the 21st century: a new paradigm. , 2004, Surgery.

[4]  C D Smith,et al.  Simulation technology in surgical education: can we assess manipulative skills and what does it mean to the learner. , 1998, Studies in health technology and informatics.

[5]  Daniel B. Jones,et al.  Comparison of video trainer and virtual reality training systems on acquisition of laparoscopic skills , 2002, Surgical Endoscopy And Other Interventional Techniques.

[6]  G. Fried,et al.  Proving the Value of Simulation in Laparoscopic Surgery , 2004, Annals of surgery.

[7]  A. Gallagher,et al.  Virtual reality training leads to faster adaptation to the novel psychomotor restrictions encountered by laparoscopic surgeons , 2001, Surgical Endoscopy.

[8]  R. Satava,et al.  Virtual Reality Training Improves Operating Room Performance: Results of a Randomized, Double-Blinded Study , 2002, Annals of surgery.

[9]  A G Gallagher,et al.  Surgical simulation—a ‘good idea whose time has come’ , 2003, The British journal of surgery.

[10]  R. Reznick,et al.  Teaching and testing technical skills. , 1993, American journal of surgery.

[11]  T. Grantcharov,et al.  Randomized clinical trial of virtual reality simulation for laparoscopic skills training , 2004, The British journal of surgery.

[12]  A. Karim Qayumi,et al.  Computer-assisted learning: cyberPatient--a step in the future of surgical education. , 1999, Journal of investigative surgery : the official journal of the Academy of Surgical Research.

[13]  D A Rogers,et al.  Improving Continuing Medical Education for Surgical Techniques: Applying the Lessons Learned in the First Decade of Minimal Access Surgery , 2001, Annals of surgery.

[14]  A. Darzi,et al.  Objective assessment of technical skills in surgery , 2003, BMJ : British Medical Journal.

[15]  Richard M Satava,et al.  Reliability and validity of Endotower, a virtual reality trainer for angled endoscope navigation. , 2002, Studies in health technology and informatics.

[16]  Kaufmann Cr.  Computers in surgical education and the operating room. , 2001 .