Validation of a Simulator Set Up Entirely in an Academic Setting: Low-Cost Surgical Trainer Rather than High-Cost Videogame (original) (raw)
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Surgical Endoscopy, 2007
Background: The recent focus on quality of care and patient safety has been accompanied by increased interest in standardizing the training for laparoscopic surgeons. Studies have shown that laparoscopic simulators can be used to train surgical skills. Therefore, we designed an experiment to compare the effectiveness of two popular training systems. One system was based on a physical model, whereas the other used a virtual reality model. Methods: A total of 32 medical students and residents were tested on both simulators. Time required for task completion and number of errors committed were recorded and compared. Results: The physical training system differentiated among experience levels on three of the five tasks when time was used as a measure and four of five tasks when score was used, whereas the virtual reality system yielded statistically significant results in eight of 13 tasks for time and in five of 13 tasks for score. Conclusion: The physical model is more sensitive than the virtual reality one in detecting differences in levels of laparoscopic surgical experience.
Efficacy of a Domestic Simulator for Training in Laparoscopic Surgery
International Journal of Privacy and Health Information Management, 2017
To present the University of Genoa Advanced Simulation Center (SimAv) and the project of a trainer (eLap4D) that would achieve the equivalent goals of the fundamentals of laparoscopic surgery trainer at an economical cost. The validation process is going to be shown too. METHODS. The laparoscopic trainer is a physical low-cost laparoscopic training platform that reproduces the tactile feedback (eLaparo4d) integrated with a software for virtual anatomical realistic scenarios (Unity3D V 4.1). A sample of 20 students was selected, divided into 2 homogeneous groups with respect to the level of confidence with the use of video games, consoles, smartphones (this has been possible thanks to the use of a questionnaire, administered before the practical phase of training). The groups participated in a training program based on 5 basic laparoscopic skills (laparoscopic focusing and navigation, hand – eye – coordination and grasp coordination). So, a second and a third study sample was chosen,...
Evaluation of Laparoscopy Virtual Reality Training on the Improvement of Trainees’ Surgical Skills
Medicina
Background and objectives: The primary objective was to evaluate the benefit of training with virtual reality simulation. The secondary objective was to describe the short-term skill acquisition obtained by simulation training and to determine the factors affecting its magnitude. Materials and Methods: We prospectively performed a three-stage evaluation: face, constructive, and predictive to evaluate the training with a laparoscopic simulator with haptic feedback. The participants (n = 63) were divided according to their level of experience into three groups: 16% residents; 46% specialists and 38% were consultants. Results: Face evaluation demonstrates the acceptance of the design and realism of the tasks; it showed a median score of eight (IQR 3) on a Likert scale and 54% of participants (n = 34) gave the tissue feedback a moderate rating. Constructive evaluation demonstrates the improvement of the participants in the training session and the ability of the designed task to disting...
The American Journal of Surgery, 2003
Background: The study was carried out to analyze the learning rate for laparoscopic skills on a virtual reality training system and to establish whether the simulator was able to differentiate between surgeons with different laparoscopic experience. Methods: Forty-one surgeons were divided into three groups according to their experience in laparoscopic surgery: masters (group 1, performed more than 100 cholecystectomies), intermediates (group 2, between 15 and 80 cholecystectomies), and beginners (group 3, fewer than 10 cholecystectomies) were included in the study. The participants were tested on the Minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR) 10 consecutive times within a 1-month period. Assessment of laparoscopic skills included time, errors, and economy of hand movement, measured by the simulator. Results: The learning curves regarding time reached plateau after the second repetition for group 1, the fifth repetition for group 2, and the seventh repetition for group 3 (Friedman's tests P Ͻ0.05). Experienced surgeons did not improve their error or economy of movement scores (Friedman's tests, P Ͼ0.2) indicating the absence of a learning curve for these parameters. Group 2 error scores reached plateau after the first repetition, and group 3 after the fifth repetition. Group 2 improved their economy of movement score up to the third repetition and group 3 up to the sixth repetition (Friedman's tests, P Ͻ0.05). Experienced surgeons (group 1) demonstrated best performance parameters, followed by group 2 and group 3 (Mann-Whitney test P Ͻ0.05). Conclusions: Different learning curves existed for surgeons with different laparoscopic background. The familiarization rate on the simulator was proportional to the operative experience of the surgeons. Experienced surgeons demonstrated best laparoscopic performance on the simulator, followed by those with intermediate experience and the beginners. These differences indicate that the scoring system of MIST-VR is sensitive and specific to measuring skills relevant for laparoscopic surgery.
Low cost laparoscopic training platform: primary validation process
2015
The use of simulation in laparoscopic surgery training appears to be qualitatively effective if supported by a suitable evaluation system. The increasing demand of more complex laparoscopic simulators has inspired the creation of a 4d simulator which is a physical low-cost laparoscopic training platform that reproduces the tactile feedback (eLaparo4d) integrated with a software for virtual anatomical realistic scenarios (Unity3D V 4.1). The aim of the present project is to show the validation process results of this system using two instruments: the face validity and the construct validity. The face validity was used for an ergonomic analysis of the simulator, the construct to test the system's ability to differentiate expert users (experienced surgeons in laparoscopy) from non-experts (student without experience in laparoscopic surgery). A sample of 20 students was selected, divided into 2 homogeneous groups with respect to the level of confidence with the use of video games, c...
2011
Virtual Reality 350 caused by indirect manipulation and visualization of the patient. They have to acquire new cognitive and motor skills, and they have to accommodate to the reduced workspace and to visualizing the intervention through a 2D monitor. Due to these limitations, acquisition of MIS skills requires a long learning curve. Moreover, there is also a crescent pressure for safer, transparent and reproducible training programs. They should also allow for practice anywhere at any time, and make use of structured and objective training curricula to determine accurately the trainee´s preparation.
Development of the VBLaST™: a virtual basic laparoscopic skill trainer
International Journal of Medical Robotics and Computer Assisted Surgery
The FLS training tool box has now been adopted by the Society of Gastrointestinal Endoscopic Surgeons (SAGES) as an official training tool for minimally invasive procedures. To overcome the limitations of the physical FLS training tool box, we have developed a Virtual Basic Laparoscopic Skill Trainer (VBLaSTTM) system, which is a 3D simulator that will allow trainees to acquire basic laparoscopic skill. The outcome of this work is the development of an integrated visio-haptic workstation environment including force feedback devices and a stereo display interface whereby trainees can practice on virtual versions of the FLS. Realistic graphical rendering and high fidelity haptic interactions are achieved. Surgical skill training is a long and tedious process of acquiring fine motor skills. It is expected that residents would start on trainers such as VBLaSTTM and after reaching a certain level of competence would progress to the more complex trainers for training on specific surgical ...
Surgical …, 2005
Background: The aim of this study was to develop summary metrics and assess the construct validity for a virtual reality laparoscopic simulator (LapSim) by comparing the learning curves of three groups with different levels of laparoscopic expertise. Methods: Three groups of subjects (ÔexpertÕ, ÔjuniorÕ, and Ônaı¨veÕ) underwent repeated trials on three LapSim tasks. Formulas were developed to calculate scores for efficiency (Ôtime-errorÕ) and economy of ÔmotionÕ (Ômo-tionÕ) using metrics generated by the software after each drill. Data (mean ± SD) were evaluated by analysis of variance (ANOVA). Significance was set at p < 0.05. Results: All three groups improved significantly from baseline to final for both Ôtime-errorÕ and ÔmotionÕ scores. There were significant differences between groups in time error performances at baseline and final, due to higher scores in the ÔexpertÕ group. A significant difference in ÔmotionÕ scores was seen only at baseline. Conclusion: We have developed summary metrics for the LapSim that differentiate among levels of laparoscopic experience. This study also provides evidence of construct validity for the LapSim.
The Journal of Urology, 2009
To ensure patient safety and surgical efficiency, much emphasis has been placed on the training of laparoscopic skills using virtual reality simulators. The purpose of this study was to determine whether laparoscopic skills can be objectively quantified by measuring specific skill parameters during training in a virtual reality surgical simulator (VRSS). Materials and Methods: Ten medical students (with no laparoscopic experience) and ten urology residents (PGY3-5 with limited laparoscopic experience) were recruited to participate in a ten-week training course in basic laparoscopic skills (camera, cutting, peg transfer and clipping skills) on a VRSS. Data were collected from the training sessions. The time that individuals took to complete each task and the errors that they made were analyzed independently. Results: The mean time that individuals took to complete tasks was significantly different between the groups (p < 0.05), with the residents being faster than the medical students. The residents' group also completed the tasks with fewer errors. The majority of the subjects in both groups exhibited a significant improvement in their task completion time and error rate. Conclusion: The findings in this study demonstrate that laparoscopic skills can be objectively measured in a VRSS based on quantified skill parameters, including the time spent to complete skill tasks and the associated error rate. We conclude that a VRSS is a feasible tool for training and assessing basic laparoscopic skills.