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Objective metrics for hand-sewn bowel anastomoses can differentiate novice from expert surgeons. Surg Endosc 2023; 37:1282-1292. [PMID: 36180753 DOI: 10.1007/s00464-022-09584-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 08/25/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Assessing performance automatically in a virtual reality trainer or from recorded videos is advantageous but needs validated objective metrics. The purpose of this study is to obtain expert consensus and validate task-specific metrics developed for assessing performance in double-layered end-to-end anastomosis. MATERIALS AND METHODS Subjects were recruited into expert (PGY 4-5, colorectal surgery residents, and attendings) and novice (PGY 1-3) groups. Weighted average scores of experts for each metric item, completion time, and the total scores computed using global and task-specific metrics were computed for assessment. RESULTS A total of 43 expert surgeons rated our task-specific metric items with weighted averages ranging from 3.33 to 4.5 on a 5-point Likert scale. A total of 20 subjects (10 novices and 10 experts) participated in validation study. The novice group completed the task significantly more slowly than the experienced group (37.67 ± 7.09 vs 25.47 ± 7.82 min, p = 0.001). In addition, both the global rating scale (23.47 ± 4.28 vs 28.3 ± 3.85, p = 0.016) and the task-specific metrics showed a significant difference in performance between the two groups (38.77 ± 2.83 vs 42.58 ± 4.56 p = 0.027) following partial least-squares (PLS) regression. Furthermore, PLS regression showed that only two metric items (Stay suture tension and Tool handling) could reliably differentiate the performance between the groups (20.41 ± 2.42 vs 24.28 ± 4.09 vs, p = 0.037). CONCLUSIONS Our study shows that our task-specific metrics have significant discriminant validity and can be used to evaluate the technical skills for this procedure.
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Pérez-Escamirosa F, García-Cabra DA, Ortiz-Hernández JR, Montoya-Alvarez S, Ruíz-Vereo EA, Ordorica-Flores RM, Minor-Martínez A, Tapia-Jurado J. Face, content, and construct validity of the virtual immersive operating room simulator for training laparoscopic procedures. Surg Endosc 2022; 37:2885-2896. [PMID: 36509946 DOI: 10.1007/s00464-022-09797-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 11/27/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The aim of this work is to present the face, content, and construct validation of the virtual immersive operating room simulator (VIORS) for procedural training of surgeons' laparoscopic psychomotor skills and evaluate the immersive training experience. METHODS The VIORS simulator consists of an HMD Oculus Rift 2016 with a visor on a 1080 × 1200 pixel OLED screen, two positioning sensors with two adapted controls to simulate laparoscopic instruments, and an acrylic base to simulate the conventional laparoscopic setup. The immersion consists of a 360° virtual operating room environment, based on the EndoSuite at Hospital Infantil de Mexico Federico Gomez, which reproduces a configuration of equipment, instruments, and common distractions in the operating room during a laparoscopic cholecystectomy procedure. Forty-five surgeons, residents, and medicine students participated in this study: 27 novices, 13 intermediates, and 5 experts. They completed a questionnaire on the realism and operating room immersion, as well as their capabilities for laparoscopic procedural training, scored in the 5-point Likert scale. The data of instrument movement were recorded and analyzed using 13 movement analysis parameters (MAPs). The experience during training with VIORS was evaluated through NASA-TLX. RESULTS The participants were enthusiastic about the immersion and sensation levels of the VIORS simulator, with positive scores on the realism and its capabilities for procedural training using VIORS. The results proved that the VIORS simulator was able to differentiate between surgeons with different skill levels. Statistically significant differences were found in nine MAPs, demonstrating their construct validity for the objective assessment of the procedural laparoscopic performance. At cognitive level, the inversion experience proves a moderate mental workload when the laparoscopic procedure is carried out. CONCLUSION The VIORS simulator has been successfully presented and validated. The VIORS simulator is a useful and effective device for the training of procedural laparoscopic psychomotor skills.
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Affiliation(s)
- Fernando Pérez-Escamirosa
- Instituto de Ciencias Aplicadas y Tecnología (ICAT), Universidad Nacional Autónoma de México (UNAM), Circuito Exterior S/N, Ciudad Universitaria, Coyoacán, 04510, Mexico City, Mexico. .,Departamento de Informática Biomédica, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Circuito Interior, Av. Universidad 3000, Ciudad Universitaria, Coyoacán, 04510, Mexico City, Mexico.
| | - Damaris Areli García-Cabra
- Instituto de Ciencias Aplicadas y Tecnología (ICAT), Universidad Nacional Autónoma de México (UNAM), Circuito Exterior S/N, Ciudad Universitaria, Coyoacán, 04510, Mexico City, Mexico.,Facultad de Medicina, Universidad Veracruzana, Campus Minatitlán, Managua, Nueva Mina, 96760, Veracruz, Minatitlán, Mexico
| | - José Ricardo Ortiz-Hernández
- Servicio de Cirugía Pediátrica, Hospital Infantil de México Federico Gómez, Calle Dr. Márquez No. 162, Cuauhtémoc, Doctores, 06720, Mexico City, Mexico
| | - Salvador Montoya-Alvarez
- Sección de Bioelectrónica, Departamento de Ingeniería Eléctrica, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), Av. IPN 2508, Col. San Pedro Zacatenco, 07360, Mexico City, México
| | - Eduardo Alfredo Ruíz-Vereo
- División de Ingeniería en Computación, Facultad de Estudios Superiores Aragón, Universidad Nacional Autónoma de México (UNAM), Av. Hacienda de Rancho Seco S/N, Impulsora Popular Avícola, 57130, Netzahualcóyotl, Estado de Mexico, Mexico
| | - Ricardo Manuel Ordorica-Flores
- Servicio de Cirugía Pediátrica, Hospital Infantil de México Federico Gómez, Calle Dr. Márquez No. 162, Cuauhtémoc, Doctores, 06720, Mexico City, Mexico
| | - Arturo Minor-Martínez
- Sección de Bioelectrónica, Departamento de Ingeniería Eléctrica, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), Av. IPN 2508, Col. San Pedro Zacatenco, 07360, Mexico City, México
| | - Jesús Tapia-Jurado
- División de Estudios de Posgrado, Facultad de Medicina, Unidad de Simulación de Posgrado, Universidad Nacional Autónoma de México (UNAM), Circuito de los Posgrados S/N, C.U., Coyoacán, 04510, Mexico City, Mexico
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Takeda T, Shonaka T, Adachi Y, Otani M, Ohara M, Tani C, Kita K, Hasegawa K, Sumi Y. The evaluation of the correlation between origami crane training and Fundamentals of Laparoscopic Surgery (FLS). Heliyon 2022; 8:e11277. [DOI: 10.1016/j.heliyon.2022.e11277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 09/14/2022] [Accepted: 10/21/2022] [Indexed: 10/31/2022] Open
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Pérez-Escamirosa F, Medina-Alvarez D, Ruíz-Vereo EA, Ordorica-Flores RM, Minor-Martínez A, Tapia-Jurado J. Immersive Virtual Operating Room Simulation for Surgical Resident Education During COVID-19. Surg Innov 2020; 27:549-550. [PMID: 32787695 PMCID: PMC8685566 DOI: 10.1177/1553350620952183] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Fernando Pérez-Escamirosa
- Instituto de Ciencias Aplicadas y Tecnología (ICAT), 7180Universidad Nacional Autónoma de México (UNAM), Ciudad de México, México
| | - David Medina-Alvarez
- Instituto de Ciencias Aplicadas y Tecnología (ICAT), 7180Universidad Nacional Autónoma de México (UNAM), Ciudad de México, México
| | - Eduardo Alfredo Ruíz-Vereo
- Instituto de Ciencias Aplicadas y Tecnología (ICAT), 7180Universidad Nacional Autónoma de México (UNAM), Ciudad de México, México.,Computer Engineering Division, Facultad de Estudios Superiores Aragón, 7180Universidad Nacional Autónoma de México (UNAM), México
| | | | - Arturo Minor-Martínez
- Bioelectronic Sections, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), Ciudad de México, México
| | - Jesús Tapia-Jurado
- Postgraduate Surgical Simulation Unit, Faculty of Medicine, National Autonomous University of Mexico (UNAM), Ciudad de México, México
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Qi D, Petrusa E, Kruger U, Milef N, Abu-Nuwar MR, Haque M, Lim R, Jones DB, Turkseven M, Demirel D, Halic T, De S, Saillant N. Surgeons With Five or More Actual Cricothyrotomies Perform Significantly Better on a Virtual Reality Simulator. J Surg Res 2020; 252:247-254. [PMID: 32304931 PMCID: PMC7295680 DOI: 10.1016/j.jss.2020.03.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/28/2020] [Accepted: 03/08/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Discriminating performance of learners with varying experience is essential to developing and validating a surgical simulator. For rare and emergent procedures such as cricothyrotomy (CCT), the criteria to establish such groups are unclear. This study is to investigate the impact of surgeons' actual CCT experience on their virtual reality simulator performance and to determine the minimum number of actual CCTs that significantly discriminates simulator scores. Our hypothesis is that surgeons who performed more actual CCT cases would perform better on a virtual reality CCT simulator. METHODS 47 clinicians were recruited to participate in this study at the 2018 annual conference of the Society of American Gastrointestinal and Endoscopic Surgeons. We established groups based on three different experience thresholds, that is, the minimal number of CCT cases performed (1, 5, and 10), and compared simulator performance between these groups. RESULTS Participants who had performed more clinical cases manifested higher mean scores in completing CCT simulation tasks, and those reporting at least 5 actual CCTs had significantly higher (P = 0.014) simulator scores than those who had performed fewer cases. Another interesting finding was that classifying participants based on experience level, that is, attendings, fellows, and residents, did not yield statistically significant differences in skills related to CCT. CONCLUSIONS The simulator was sensitive to prior experience at a threshold of 5 actual CCTs performed.
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Affiliation(s)
- Di Qi
- Center for Modeling, Simulation, and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, New York.
| | - Emil Petrusa
- Department of Surgery, Massachusetts General Hospital, Harvard School of Medicine, Boston, Massachusetts
| | - Uwe Kruger
- Center for Modeling, Simulation, and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, New York; Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, New York
| | - Nicholas Milef
- Center for Modeling, Simulation, and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, New York
| | - Mohamad Rassoul Abu-Nuwar
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard School of Medicine, Boston, Massachusetts
| | - Mohamad Haque
- Anderson Simulation Center, Madigan Army Medical Center, Tacoma, Washigton
| | - Robert Lim
- Tripler Army Medical Center, Honolulu, Hawaii
| | - Daniel B Jones
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard School of Medicine, Boston, Massachusetts
| | - Melih Turkseven
- Center for Modeling, Simulation, and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, New York
| | - Doga Demirel
- Department of Computer Science, Florida Polytechnic University, Lakeland, Florida
| | - Tansel Halic
- Computer Science Department, University of Central Arkansas, Conway, Arkansas
| | - Suvranu De
- Center for Modeling, Simulation, and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, New York
| | - Noelle Saillant
- Department of Surgery, Massachusetts General Hospital, Harvard School of Medicine, Boston, Massachusetts
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Towards Virtual VATS, Face, and Construct Evaluation for Peg Transfer Training of Box, VR, AR, and MR Trainer. JOURNAL OF HEALTHCARE ENGINEERING 2019; 2019:6813719. [PMID: 30723539 PMCID: PMC6339710 DOI: 10.1155/2019/6813719] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/31/2018] [Accepted: 11/29/2018] [Indexed: 11/17/2022]
Abstract
The aim of this study is to develop and assess the peg transfer training module face, content and construct validation use of the box, virtual reality (VR), cognitive virtual reality (CVR), augmented reality (AR), and mixed reality (MR) trainer, thereby to compare advantages and disadvantages of these simulators. Training system (VatsSim-XR) design includes customized haptic-enabled thoracoscopic instruments, virtual reality helmet set, endoscope kit with navigation, and the patient-specific corresponding training environment. A cohort of 32 trainees comprising 24 novices and 8 experts underwent the real and virtual simulators that were conducted in the department of thoracic surgery of Yunnan First People's Hospital. Both subjective and objective evaluations have been developed to explore the visual and haptic potential promotions in peg transfer education. Experiments and evaluation results conducted by both professional and novice thoracic surgeons show that the surgery skills from experts are better than novices overall, AR trainer is able to provide a more balanced training environments on visuohaptic fidelity and accuracy, box trainer and MR trainer demonstrated the best realism 3D perception and surgical immersive performance, respectively, and CVR trainer shows a better clinic effect that the traditional VR trainer. Combining these in a systematic approach, tuned with specific fidelity requirements, medical simulation systems would be able to provide a more immersive and effective training environment.
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Arikatla V, Horvath S, Fu Y, Cavuoto L, De S, Schwaitzberg S, Enquobahrie A. Development and face validation of a virtual camera navigation task trainer. Surg Endosc 2018; 33:1927-1937. [PMID: 30324462 DOI: 10.1007/s00464-018-6476-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 10/02/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND The fundamentals of laparoscopic surgery (FLS) trainer box, which is now established as a standard for evaluating minimally invasive surgical skills, consists of five tasks: peg transfer, pattern cutting, ligation, intra- and extracorporeal suturing. Virtual simulators of these tasks have been developed and validated as part of the Virtual Basic Laparoscopic Skill Trainer (VBLaST) (Arikatla et al. in Int J Med Robot Comput Assist Surg 10:344-355, 2014; Zhang et al. in Surg Endosc 27(10):3603-3615, 2013; Sankaranarayanan et al. in J Laparoendosc Adv Surg Tech 20(2):153-157, 2010; Qi et al. J Biomed Inform 75:48-62, 2017). The virtual task trainers have many advantages including automatic real-time objective scoring, reduced costs, and eliminating human proctors. In this paper, we extend VBLaST by adding two camera navigation system tasks: (a) pattern matching and (b) path tracing. METHODS A comprehensive camera navigation simulator with two virtual tasks, simplified and cheaper hardware interface (compared to the prior version of VBLaST), graphical user interface, and automated metrics has been designed and developed. Face validity of the system is tested with medical students and residents from the University at Buffalo's medical school. RESULTS The subjects rated the simulator highly in all aspects including its usefulness in training to center the target and to teach sizing skills. The quality and usefulness of the force feedback scored the lowest at 2.62.
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Affiliation(s)
- Venkata Arikatla
- Medical Computing Team, Kitware Inc., 101 E Weaver Street, Suite G4, Carrboro, NC, 27510, USA.
| | - Sam Horvath
- Medical Computing Team, Kitware Inc., 101 E Weaver Street, Suite G4, Carrboro, NC, 27510, USA
| | - Yaoyu Fu
- School of Engineering and Applied Sciences, University at Buffalo, Buffalo, NY, USA
| | - Lora Cavuoto
- School of Engineering and Applied Sciences, University at Buffalo, Buffalo, NY, USA
| | - Suvranu De
- Center for Modeling, Simulation and Imaging in Medicine, RPI, Troy, NY, USA
| | | | - Andinet Enquobahrie
- Medical Computing Team, Kitware Inc., 101 E Weaver Street, Suite G4, Carrboro, NC, 27510, USA
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Sankaranarayanan G, Li B, Manser K, Jones SB, Jones DB, Schwaitzberg S, Cao CGL, De S. Face and construct validation of a next generation virtual reality (Gen2-VR) surgical simulator. Surg Endosc 2016; 30:979-85. [PMID: 26092010 PMCID: PMC4685027 DOI: 10.1007/s00464-015-4278-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 05/19/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION 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. METHODS AND PROCEDURES 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-point Likert scale feedback questionnaire. A total of sixteen subjects participated in this study. RESULTS Friedman test showed significant difference in scores between the three conditions (p < 0.0001). Post hoc analysis using Wilcoxon signed-rank tests with Bonferroni correction further showed that all the three conditions were significantly different from each other (Case I, Case II, p < 0.0001), (Case I, Case III, p < 0.0001) and (Case II, Case III, p = 0.009). Subjects rated that fog (mean 4.18) and tool malfunction (median 4.56) significantly hindered their performance. CONCLUSION The results showed that Gen2-VR simulator has both face and construct validity and that it can accurately and realistically present distractions and interruptions in a simulated OR, in spite of limitations of the current HMD hardware technology.
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Affiliation(s)
- Ganesh Sankaranarayanan
- Center for Modeling, Simulation and Imaging in Medicine (CeMSIM), Rensselaer Polytechnic Institute, 110 8th Street, JEC 2049, Troy, NY, 12180, USA.
| | - Baichun Li
- Center for Modeling, Simulation and Imaging in Medicine (CeMSIM), Rensselaer Polytechnic Institute, 110 8th Street, JEC 2049, Troy, NY, 12180, USA
- School of Mechanical Engineering and Automation, Northeastern University, Shenyang, People's Republic of China
| | | | | | | | | | | | - Suvranu De
- Center for Modeling, Simulation and Imaging in Medicine (CeMSIM), Rensselaer Polytechnic Institute, 110 8th Street, JEC 2049, Troy, NY, 12180, USA.
- Department of Mechanical, Aerospace and Nuclear Engineering, Rensselaer Polytechnic Institute, 110 8th Street, JEC 2049, Troy, NY, 12180, USA.
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Lahanas V, Loukas C, Georgiou E. A simple sensor calibration technique for estimating the 3D pose of endoscopic instruments. Surg Endosc 2015; 30:1198-204. [PMID: 26123335 DOI: 10.1007/s00464-015-4330-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 06/09/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The aim of this study was to describe a simple and easy-to-use calibration method that is able to estimate the pose (tip position and orientation) of a rigid endoscopic instrument with respect to an electromagnetic tracking device attached to the handle. METHODS A two-step calibration protocol was developed. First, the orientation of the instrument shaft is derived by performing a 360° rotation of the instrument around its shaft using a firmly positioned surgical trocar. Second, the 3D position of the instrument tip is obtained by allowing the tip to come in contact with a planar surface. RESULTS The results indicate submillimeter accuracy in the estimation of the tooltip position, and subdegree accuracy in the estimation of the shaft orientation, both with respect to a known reference frame. The assets of the proposed method are also highlighted by illustrating an indicative application in the field of augmented reality simulation. CONCLUSIONS The proposed method is simple, inexpensive, does not require employment of special calibration frames, and has potential applications not only in training systems but also in the operating room.
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Affiliation(s)
- Vasileios Lahanas
- Medical Physics Laboratory Simulation Centre, School of Medicine, University of Athens, Mikras Asias St. 75, 11527, Athens, Greece.
| | - Constantinos Loukas
- Medical Physics Laboratory Simulation Centre, School of Medicine, University of Athens, Mikras Asias St. 75, 11527, Athens, Greece
| | - Evangelos Georgiou
- Medical Physics Laboratory Simulation Centre, School of Medicine, University of Athens, Mikras Asias St. 75, 11527, Athens, Greece
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Amirian MJ, Lindner SM, Trabulsi EJ, Lallas CD. Surgical suturing training with virtual reality simulation versus dry lab practice: an evaluation of performance improvement, content, and face validity. J Robot Surg 2014. [DOI: 10.1007/s11701-014-0475-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Arikatla VS, Sankaranarayanan G, Ahn W, Chellali A, De S, Caroline GL, Hwabejire J, DeMoya M, Schwaitzberg S, Jones DB. Face and construct validation of a virtual peg transfer simulator. Surg Endosc 2013; 27:1721-9. [PMID: 23263645 PMCID: PMC3625247 DOI: 10.1007/s00464-012-2664-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 10/10/2012] [Indexed: 01/22/2023]
Abstract
BACKGROUND The Fundamentals of Laparoscopic Surgery (FLS) trainer box is now established as a standard for evaluating minimally invasive surgical skills. A particularly simple task in this trainer box is the peg transfer task which is aimed at testing the surgeon's bimanual dexterity, hand-eye coordination, speed, and precision. The Virtual Basic Laparoscopic Skill Trainer (VBLaST) is a virtual version of the FLS tasks which allows automatic scoring and real-time, subjective quantification of performance without the need of a human proctor. In this article we report validation studies of the VBLaST peg transfer (VBLaST-PT) simulator. METHODS Thirty-five subjects with medical background were divided into two groups: experts (PGY 4-5, fellows, and practicing surgeons) and novices (PGY 1-3). The subjects were asked to perform the peg transfer task on both the FLS trainer box and the VBLaST-PT simulator; their performance was evaluated based on established metrics of error and time. A new length of trajectory (LOT) metric has also been introduced for offline analysis. A questionnaire was used to rate the realism of the virtual system on a 5-point Likert scale. RESULTS Preliminary face validation of the VBLaST-PT with 34 subjects rated on a 5-point Likert scale questionnaire revealed high scores for all aspects of simulation, with 3.53 being the lowest mean score across all questions. A two-tailed Mann-Whitney test performed on the total scores showed significant (p = 0.001) difference between the groups. A similar test performed on the task time (p = 0.002) and the LOT (p = 0.004) separately showed statistically significant differences between the experts and the novices (p < 0.05). The experts appear to be traversing shorter overall trajectories in less time than the novices. CONCLUSION VBLaST-PT showed both face and construct validity and has promise as a substitute for the FLS for training peg transfer skills.
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Affiliation(s)
- Venkata S Arikatla
- Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, NY 12180, USA.
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