Enhancing fundamental robot-assisted surgical proficiency by using a portable virtual simulator (original) (raw)
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A Virtual Reality Training Program for Improvement of Robotic Surgical Skills
The purpose of this study was to use a simulated virtual reality environment for training of surgical skills and then to identify if the learning that occurred was transferable to a real world surgical task. The virtual surgical tasks consisted of bimanual carrying, needle passing and mesh alignment. In this ongoing study, the experimental group (n=5) was trained by performing four blocks of the virtual surgical tasks using the da Vinci surgical robot. Pre and post training, all subjects were tested by performing a suturing task on a "life-like" suture pad. The control group (n=5) performed only the suturing task. Significantly larger pre and post differences were revealed in time to task completion (p<0.05) and total distance travelled by the dominant side instrument tip (p<0.01) in the experimental group as compared to the control group. These differences were specific to the suture running aspect of the surgical task. In conclusion, virtual reality surgical skills training may produce a significant learning effect that can transfer to actual robot-assisted laparoscopic procedures.
Performance Compared to Experience Level in a Virtual Reality Surgical Skills Trainer
Lecture Notes in Computer Science, 2007
A virtual reality (VR) manual skills experiment was conducted comparing Human performance measures to experiences indicated on a questionnaire handed out. How much do past experiences influence human performance on a VR surgical skills simulator? Performance measures included; time, accuracy, efficiency of motion and errors. Past experiences are among video games and computer proficiency. Results showed little or no relations between experience level and performance. Significant results could only be established for computer gaming experience versus task completion time, F(1, 22) = 3.3, p = .083. Participants familiar with computer gaming were able to carry out tasks faster than their counterparts.
Virtual Reality Training System for Anytime/Anywhere Acquisition of Surgical Skills: A Pilot Study
Military medicine, 2018
This article presents a hardware/software simulation environment suitable for anytime/anywhere surgical skills training. It blends the advantages of physical hardware and task analogs with the flexibility of virtual environments. This is further enhanced by a web-based implementation of training feedback accessible to both trainees and trainers. Our training system provides a self-paced and interactive means to attain proficiency in basic tasks that could potentially be applied across a spectrum of trainees from first responder field medical personnel to physicians. This results in a powerful training tool for surgical skills acquisition relevant to helping injured warfighters.
Face and construct validation of a next generation virtual reality (Gen2-VR(©)) surgical simulator
Surgical endoscopy, 2015
Surgical performance is affected by distractors and interruptions to surgical workflow that exist in the operating room. However, traditional surgical simulators are used to train surgeons in a skills laboratory that does not recreate these conditions. To overcome this limitation, we have developed a novel, immersive virtual reality (Gen2-VR(©)) system to train surgeons in these environments. This study was to establish face and construct validity of our system. The study was a within-subjects design, with subjects repeating a virtual peg transfer task under three different conditions: Case I: traditional VR; Case II: Gen2-VR(©) with no distractions and Case III: Gen2-VR(©) with distractions and interruptions. In Case III, to simulate the effects of distractions and interruptions, music was played intermittently, the camera lens was fogged for 10 s and tools malfunctioned for 15 s at random points in time during the simulation. At the completion of the study subjects filled in a 5-p...
Surgical Endoscopy and Other Interventional Techniques, 2022
Background The annual number of robotic surgical procedures is on the rise. Robotic surgery requires unique skills compared to other surgical approaches. Simulation allows basic robot skill acquisition and enhances patient safety. The purpose of this study was to evaluate the feasibility, effectiveness, and transferability of a mastery-based curriculum using a new virtual reality (VR) robotic simulator for surgery resident training. Methods Nineteen PGY2s and 22 PGY4s were enrolled. Residents completed a pretest and posttest consisting of five VR and three previously validated inanimate tasks. Training included practicing 33 VR tasks until a total score ≥ 90% ("mastery") was achieved using automated metrics (time, economy of motion). Inanimate performance was evaluated by two trained, blinded raters using video review metrics (time, errors, and modified OSATS). Outcomes were defined as: curriculum feasibility (completion rate, training time, repetitions), training effectiveness (pre/post training skill improvement), and skill transferability (skill transfer to validated inanimate drills). Wilcoxon signed-rank and Mann-Whitney U tests were used; median (IQR) reported. Results Thirty-four of 41 residents (83%) achieved mastery on all 33 VR tasks; median training time was 7 h (IQR: 5′26″-8′52″). Pretest vs. post-test performance improved (all p < 0.001) according to all VR and Inanimate metrics for both PGY2 and PGY4 residents. Significant pretest performance differences were observed between PGY2 and PGY4 residents for VR but not inanimate tasks; no PGY2 vs. PGY4 posttest performance differences were observed for both VR and inanimate tasks. Conclusion This mastery-based VR curriculum was associated with a high completion rate and excellent feasibility. Significant performance improvements were noted for both the VR and inanimate tasks, supporting training effectiveness and skill transferability. Additional studies examining validity evidence may help further refine this curriculum.
2020
BACKGROUND The high cost and low availability of virtual reality simulators in surgical specialty training programs in low- and middle-income countries make it necessary to develop and obtain sources of validity for new models of low-cost portable simulators that enable ubiquitous learning of psychomotor skills in minimally invasive surgery. OBJECTIVE The aim of this study was to obtain validity evidence for relationships to other variables, internal structure, and consequences of testing for the task scores of a new low-cost portable simulator mediated by gestures for learning basic psychomotor skills in minimally invasive surgery. This new simulator is called SIMISGEST-VR (Simulator of Minimally Invasive Surgery mediated by Gestures - Virtual Reality). METHODS In this prospective observational validity study, the authors looked for multiple sources of evidence (known group construct validity, prior videogaming experience, internal structure, test-retest reliability, and consequenc...
Progress in virtual reality simulators for surgical training and certification
The Medical journal of Australia, 2011
There is increasing evidence that educating trainee surgeons by simulation is preferable to traditional operating-room training methods with actual patients. Apart from reducing costs and risks to patients, training by simulation can provide some unique benefits, such as greater control over the training procedure and more easily defined metrics for assessing proficiency. Virtual reality (VR) simulators are now playing an increasing role in surgical training. However, currently available VR simulators lack the fidelity to teach trainees past the novice-to-intermediate skills level. Recent technological developments in other industries using simulation, such as the games and entertainment and aviation industries, suggest that the next generation of VR simulators should be suitable for training, maintenance and certification of advanced surgical skills. To be effective as an advanced surgical training and assessment tool, VR simulation needs to provide adequate and relevant levels of ...
Updates in surgery, 2018
Proficiency-based training has become essential in the training of surgeons such that on completion they can execute complex operations with novel surgical approaches including direct manual laparoscopic surgery (DMLS) and robotically assisted laparoscopic surgery (RALS). To this effect, several virtual reality (VR) simulators have been developed. The objective of the present study was to assess and establish proficiency gain curves for medical students on VR simulators for DMLS and RALS. Five medical students participated in training course consisting of didactic teaching and practical hands-on training with VR simulators for DMLS and RALS. Evaluation of didactic component was by questionnaire completed by participating students, who also were required to undertake selected exercises to reach proficiency at each VR simulator: (1) 12 tasks on LapSim VR (Surgical Science, Gothenburg, Sweden) for DMLS, and (2) six selected exercises on the dV-Trainer Mimic (Seattle, WA, United States)...
RANDOMIZED CONTROLLED TRIAL OF VIRTUAL REALITY AND HYBRID SIMULATION FOR ROBOTIC SURGICAL TRAINING
BJU International, 2011
Background: New Residency Review Committee requirements in general surgery require 50 colonoscopies. Simulators have been widely suggested to help prepare residents for live clinical experience. We assessed a computer-based colonoscopy simulator for effective transfer of skills to live patients. Methods: A randomized controlled trial included general surgery and internal medicine residents with limited endoscopic experience. Following a pretest, the treatment group (n ϭ 12) practiced on the simulator, while controls (n ϭ 12) received no additional training. Both groups then performed a colonoscopy on a live patient. Technical ability was evaluated by expert endoscopists using previously validated assessment instruments. Results: In the live patient setting, the treatment group scored significantly higher global ratings than controls (t (22) ϭ 1.84, P ϭ .04). Only 2 of the 8 computer-based performance metrics correlated significantly with previously validated global ratings of performance. Conclusions: Residents trained on a colonoscopy simulator prior to their first patient-based colonoscopy performed significantly better in the clinical setting than controls, demonstrating skill transfer to live patients. The simulator's performance metrics showed limited concurrent validity, suggesting the need for further refinement.