Report of a group developing a virtual reality simulator for arthroscopic surgery of the knee joint.

Apprenticeship training of surgical skills is time consuming and can lead to surgical errors. Our group is developing an arthroscopic virtual reality knee simulator for training orthopaedic residents in arthroscopic surgery before live-patient operating room experience. The simulator displays realistic human knee anatomy derived from the Visible Human Dataset developed by the National Library of Medicine and incorporates active force-feedback haptic technology. Our premise is that postgraduate year 2 residents completing a formal virtual education program who are trained to reach a proficiency standard in the techniques and protocol for an arthroscopic knee examination will complete a diagnostic arthroscopy on an actual patient in less time with greater accuracy, less iteration of movement of the arthroscope, and less damage to the patient's tissue compared with residents in the control group learning and practicing the arthroscopic knee examination procedures through the residency program's established education and training program. The validation study, done at eight orthopaedic residency programs, will commence in early 2006 and will take one year to complete. We anticipate that proficiency obtained on the simulator will transfer to surgical skills in the operating room.

[1]  Robert A Pedowitz,et al.  Evaluation of a virtual reality simulator for arthroscopy skills development. , 2002, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[2]  K P Sherman,et al.  A portable virtual environment knee arthroscopy training system with objective scoring. , 1999, Studies in health technology and informatics.

[3]  Brad H. Feldman,et al.  Virtual reality simulation. , 2007, Ophthalmology.

[4]  V. Spitzer,et al.  The visible human dataset: The anatomical platform for human simulation , 1998, The Anatomical record.

[5]  J D Mabrey,et al.  A comparison of operative times in arthroscopic ACL reconstruction between orthopaedic faculty and residents: the financial impact of orthopaedic surgical training in the operating room. , 2001, The Iowa orthopaedic journal.

[6]  Louise Moody,et al.  A flexible virtual reality tutorial for the training and assessment of arthroscopic skills. , 2004, Studies in health technology and informatics.

[7]  A Darzi,et al.  The PreOp flexible sigmoidoscopy trainer. Validation and early evaluation of a virtual reality based system. , 2002, 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]  K. Moorthy,et al.  Validity and reliability of a virtual reality upper gastrointestinal simulator and cross validation using structured assessment of individual performance with video playback , 2004, Surgical Endoscopy And Other Interventional Techniques.

[10]  William E Garrett,et al.  Virtual reality simulation of arthroscopy of the knee. , 2002, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[11]  V. Spitzer,et al.  The visible human male: a technical report. , 1996, Journal of the American Medical Informatics Association : JAMIA.

[12]  P. Ström,et al.  Validation and learning in the Procedicus KSA virtual reality surgical simulator , 2003, Surgical Endoscopy And Other Interventional Techniques.

[13]  PD Dr. Werner Müller,et al.  The Knee , 1982, Springer Berlin Heidelberg.

[14]  V M Spitzer,et al.  The visible human: a new language for communication in health care education. , 1997, Caduceus.

[15]  Tien-Tsin Wong,et al.  Virtual reality based system for training on knee arthroscopic surgery. , 2004, Studies in health technology and informatics.

[16]  M. Bridges,et al.  The financial impact of teaching surgical residents in the operating room. , 1999, American journal of surgery.

[17]  A. Darzi,et al.  The PreOp flexible sigmoidoscopy trainer , 2002, Surgical Endoscopy And Other Interventional Techniques.

[18]  T. Brennan,et al.  Incidence and types of adverse events and negligent care in Utah and Colorado. , 2000, Medical care.

[19]  J E Lemons,et al.  Arthroscopy training using a "black box" technique. , 1993, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[20]  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.

[21]  Mark W Scerbo,et al.  Determining the efficacy of an immersive trainer for arthroscopy skills. , 2005, Studies in health technology and informatics.