Evaluation of Laparoscopy Virtual Reality Training on the Improvement of Trainees' Surgical Skills

Abstract

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 distinguish the experienced from the inexperienced surgeon based on the performance score, at task I (transfer of pegs) and II (laparoscopic salpingectomy). There was an improvement in both tasks with a significant increase in score and reduction in time. The study showed that those with a high score at the pre-test recorded a high score post-test, showing a significant pair-wise comparison (Z) and correlation (p) showing a significant statistical significance (p < 0.001). The predictive evaluation demonstrates the beneficiary effect of training four weeks afterward on the practice of surgeons addressed with five questions. It showed an improvement regarding implementation into daily routine, performance of procedure, suturing, shortening of the operative time, and complication management. Conclusions: Virtual reality simulation established high ratings for both realism and training capacity, including clinical relevance, critical relevance, and maintaining training enthusiasm.

Keywords: evaluation of virtual reality; laparoscopy; learning curve; surgical simulation.

Figure 1

Shows the virtual reality simulator.

Figure 2

Shows the factors affecting the magnitude of short-term skill acquisition; participants who had more experience as camera assistants, surgeons, and in video games achieved more gain in task I. Also, a shorter initial time and higher initial score predicted higher gains in both tasks.

Figure 3

Shows the factors affecting the magnitude of short-term skill acquisition, participants with fewer years of experience as camera assistants excelled in reducing the time taken to complete the task given, as shown by the directly proportional relationship between the initial time and the value of time reduced between trials.