Operators believe patient-specific rehearsal improve individual and team performance

Introduction: Rehearsing endovascular aortic aneurysm repair on patient-specific data is recent within virtual reality simulation and opens up new possibilities for operators to prepare for complex procedures. This study evaluated the feasibility of patient-specific rehearsal (PsR) and assessed operators' appraisal of the VIST-LAB simulator from Mentice.Material and methods: CT-data was segmented and uploaded to the simulator, and simulated for 30 elective EVAR patients. Operators were asked how they perceived the PsR on a Likert scale after the PsR (once) and after the following procedure (each time).Results: Patients were simulated and operated by 14 operators, always in pairs of one vascular surgeon and one interventional radiologist. The operators estimated that PsR improved individual and team performance (median 4), and recommended the use of PsR in general (median 4) and for difficult cases (median 5). The simulator realism got moderate scores (median 2-3). Inexperienced operators seemed to appreciate the PsR the most.Conclusions: PsR was feasible and was evaluated by operators to improve individual and team performance. Inexperienced users were more positive towards PsR than experienced users. PsR realism and the ease of importing patient-specific data can still be improved, and further studies to quantify and precisely identify benefits are needed.

[1]  R. Aggarwal,et al.  Role of patient‐specific virtual reality rehearsal in carotid artery stenting , 2012, The British journal of surgery.

[2]  Isabelle Van Herzeele,et al.  Patient-specific Rehearsal Before EVAR: Influence on Technical and Nontechnical Operative Performance. A Randomized Controlled Trial , 2016, Annals of surgery.

[3]  J. Adams.  Historical review and appraisal of research on the learning, retention, and transfer of human motor skills. , 1987 .

[4]  A. Leahy,et al.  Virtual reality simulation in endovascular surgical training. , 2008, The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland.

[5]  S. Haulon,et al.  Management of abdominal aortic aneurysms clinical practice guidelines of the European society for vascular surgery. , 2011, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[6]  Rafael Beyar,et al.  Real case virtual reality training prior to carotid artery stenting , 2010, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[7]  W. Nicholson,et al.  Use of virtual reality simulation for mission rehearsal for carotid stenting. , 2007, JAMA.

[8]  F Vermassen,et al.  A Multicentre Trial of Patient specific Rehearsal Prior to EVAR: Impact on Procedural Planning and Team Performance. , 2017, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[9]  I. Grunwald,et al.  A Pilot Study Assessing the Impact of 3-D Printed Models of Aortic Aneurysms on Management Decisions in EVAR Planning , 2016, Vascular and endovascular surgery.

[10]  L. Konge,et al.  A National Needs Assessment to Identify Technical Procedures in Vascular Surgery for Simulation Based Training. , 2017, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[11]  John J. van den Dobbelsteen,et al.  Force feedback and basic laparoscopic skills , 2008, Surgical Endoscopy.

[12]  Variations in Abdominal Aortic Aneurysm Care: A Report From the International Consortium of Vascular Registries , 2016, Circulation.

[13]  A. Darzi,et al.  Endovascular skills training and assessment. , 2007, Journal of vascular surgery.

[14]  C. Bicknell,et al.  Patient-Specific Simulation of Endovascular Thoracic Aortic Repair: Initial Experience. , 2017, The Annals of thoracic surgery.

[15]  P A Webb,et al.  A review of rapid prototyping (RP) techniques in the medical and biomedical sector , 2000, Journal of medical engineering & technology.

[16]  R. Aggarwal,et al.  Patient-specific rehearsal prior to EVAR: a pilot study. , 2013, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[17]  P. Holt,et al.  Effect of Endovascular Aneurysm Repair on the Volume–Outcome Relationship in Aneurysm Repair , 2009, Circulation. Cardiovascular quality and outcomes.

[18]  D. Gillespie,et al.  Simulation case rehearsals for carotid artery stenting. , 2009, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[19]  S. Hamstra,et al.  Reconsidering fidelity in simulation-based training. , 2014, Academic medicine : journal of the Association of American Medical Colleges.

[20]  N. Rudarakanchana,et al.  Evidence overview for shunting, patching, type of endarterectomy and anesthesia during carotid surgery. , 2014 .

[21]  Rajesh Aggarwal,et al.  Recent Advancements in Medical Simulation: Patient-Specific Virtual Reality Simulation , 2012, World Journal of Surgery.

[22]  K. Illig,et al.  An approach to EVAR simulation using patient specific modeling. , 2014, Annals of vascular surgery.

[23]  A. Darzi,et al.  Efficient implementation of patient-specific simulated rehearsal for the carotid artery stenting procedure: part-task rehearsal. , 2011, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[24]  A Saratzis,et al.  Role of Simulation in Endovascular Aneurysm Repair (EVAR) Training: A Preliminary Study. , 2017, European Journal of Vascular and Endovascular Surgery.

[25]  Kathleen R Rosen,et al.  The history of medical simulation. , 2008, Journal of critical care.

[26]  S. Mafeld,et al.  The role of simulation in the development of endovascular surgical skills , 2016, Perspectives on Medical Education.

[27]  W I M Willaert,et al.  Patient-specific endovascular simulation influences interventionalists performing carotid artery stenting procedures. , 2011, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[28]  Cecilie Våpenstad,et al.  Procedural virtual reality simulation in minimally invasive surgery , 2013, Surgical Endoscopy.

[29]  F. Rybicki,et al.  Medical 3D Printing for the Radiologist. , 2015, Radiographics : a review publication of the Radiological Society of North America, Inc.

[30]  R. Rutherford.  Open versus endovascular stent graft repair for abdominal aortic aneurysms: an historical view. , 2012, Seminars in vascular surgery.

[31]  Y. Chan,et al.  Evidence for Endovascular Simulation Training: A Systematic Review. , 2016, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[32]  Erlend Fagertun Hofstad,et al.  Lack of transfer of skills after virtual reality simulator training with haptic feedback , 2017, Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy.

[33]  R. Aggarwal,et al.  Improving results for carotid artery stenting by validation of the anatomic scoring system for carotid artery stenting with patient-specific simulated rehearsal. , 2012, Journal of vascular surgery.

[34]  Rajesh Aggarwal,et al.  Patient-specific simulation in carotid artery stenting. , 2010, Journal of vascular surgery.

[35]  A. Freyrie,et al.  The Role of Simulation in Boosting the Learning Curve in EVAR Procedures. , 2017, Journal of surgical education.