Validation of SINERGIA as training tool: a randomized study to test the transfer of acquired basic psychomotor skills to LapMentor

PurposeLaparoscopic surgery is commonly used in many surgical procedures but requires a learning process to develop the necessary skills. Virtual reality simulators play an essential role within the training curricula. This paper aims to determine whether training in SINERGIA VR simulator allows novice surgeons to improve their basic psychomotor laparoscopic skills.MethodsForty-two people participated in this study, including 28 unexperience medical students and 14 expert surgeons who developed previously more than 100 laparoscopic procedures. Medical students made a pre-training test in LapMentor II; then, they trained in SINERGIA and they finally accomplished a post-training test in LapMentor II. Experts just made one trial in LapMentor II. A statistical analysis was carried out and results of pre- and post-training tests of novices were compared with Wilcoxon signed-rank test. Pre- and post-training tests of novices were also compared with results of experts with Mann–Whitney U test.ResultsMost metrics provided by LapMentor II and included in this study show significant differences when comparing pre- and post-training tests of novices. Analysis of pre-training test of novices and experts results show significant differences in all analyzed metrics for all studied tasks. On the other hand, LapMentor was not able to distinguish between experts and novices after training in SINERGIA for any metric in the camera manipulation task and for some metrics of the other tasks.ConclusionsTraining in SINERGIA VR simulator allows improvement of basic psychomotor laparoscpic skills and transferring them to another virtual simulator. Therefore, it could be used in laparoscopic surgery training programs.

[1]  R. M. Satava,et al.  Discriminative validity of the Minimally Invasive Surgical Trainer in Virtual Reality (MIST-VR) using criteria levels based on expert performance , 2004, Surgical Endoscopy And Other Interventional Techniques.

[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]  Aimin Zhang,et al.  Construct validity testing of a laparoscopic surgery simulator (Lap Mentor®) , 2008, Surgical Endoscopy.

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

[5]  R. Clayman,et al.  Construct validity testing of a laparoscopic surgical simulator. , 2006, Journal of the American College of Surgeons.

[6]  Kamal Nagpal,et al.  Open Versus Minimally Invasive Esophagectomy: Trends of Utilization and Associated Outcomes in England , 2010, Annals of surgery.

[7]  Paul G Gauger,et al.  Laparoscopic Skills Are Improved With LapMentor™ Training: Results of a Randomized, Double-Blinded Study , 2006, Annals of surgery.

[8]  J. Rodríguez-García,et al.  Formación quirúrgica con simuladores en centros de entrenamiento , 2006 .

[9]  S. Botden,et al.  What is going on in augmented reality simulation in laparoscopic surgery? , 2008, Surgical Endoscopy.

[10]  P. Andreatta,et al.  Construct validity of the LapSim laparoscopic surgical simulator. , 2006, American journal of surgery.

[11]  Mithra Vankipuram,et al.  Cognitive simulators for medical education and training , 2009, J. Biomed. Informatics.

[12]  N. Seymour VR to OR: A Review of the Evidence that Virtual Reality Simulation Improves Operating Room Performance , 2008, World Journal of Surgery.

[13]  Paul G Gauger,et al.  Laparoscopic simulation training with proficiency targets improves practice and performance of novice surgeons. , 2010, American journal of surgery.

[14]  Feza H. Remzi,et al.  Laparoscopic versus open colectomy for patients with American Society of Anesthesiology (ASA) classifications 3 and 4: the minimally invasive approach is associated with significantly quicker recovery and reduced costs , 2010, Surgical Endoscopy.

[15]  Pablo Lamata,et al.  SINERGIA laparoscopic virtual reality simulator: Didactic design and technical development , 2007, Comput. Methods Programs Biomed..

[16]  Marlies P Schijven,et al.  Contemporary virtual reality laparoscopy simulators: quicksand or solid grounds for assessing surgical trainees? , 2010, American journal of surgery.

[17]  Dennis L. Fowler,et al.  Enabling, Implementing, and Validating Training Methods in Laparoscopic Surgery , 2010, World Journal of Surgery.

[18]  Sabha Ganai,et al.  Virtual Reality and Computer-Enhanced Training Devices Equally Improve Laparoscopic Surgical Skill in Novices , 2008, JSLS : Journal of the Society of Laparoendoscopic Surgeons.

[19]  Georg Bretthauer,et al.  A Prospective Randomized Study to Test the Transfer of Basic Psychomotor Skills From Virtual Reality to Physical Reality in a Comparable Training Setting , 2005, Annals of surgery.

[20]  A. Darzi,et al.  Development of a virtual reality training curriculum for laparoscopic cholecystectomy , 2009, The British journal of surgery.

[21]  Francisco M. Sánchez-Margallo,et al.  Preliminary results with a training program for thoracoscopic atrial fibrillation therapy , 2009, Surgical Endoscopy.

[22]  Paul G Gauger,et al.  LapMentor Metrics Possess Limited Construct Validity , 2008, Simulation in healthcare : journal of the Society for Simulation in Healthcare.

[23]  Makoto Hashizume,et al.  Construct validity for eye–hand coordination skill on a virtual reality laparoscopic surgical simulator , 2007, Surgical Endoscopy.

[24]  Enrique J. Gómez,et al.  Construct and face validity of SINERGIA laparoscopic virtual reality simulator , 2010, International Journal of Computer Assisted Radiology and Surgery.

[25]  Elspeth M McDougall,et al.  Validation of surgical simulators. , 2007, Journal of endourology.

[26]  Rajesh Aggarwal,et al.  A tale of two trainers: virtual reality versus a video trainer for acquisition of basic laparoscopic skills. , 2010, American journal of surgery.