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Azher S, Mills A, He J, Hyjazie T, Tokuno J, Quaiattini A, Harley JM. Findings Favor Haptics Feedback in Virtual Simulation Surgical Education: An Updated Systematic and Scoping Review. Surg Innov 2024; 31:331-341. [PMID: 38486132 PMCID: PMC11047018 DOI: 10.1177/15533506241238263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
BACKGROUND Virtual simulations (VSs) enhance clinical competencies and skills. However, a previous systematic review of 9 RCT studies highlighted a paucity of literature on the effects of haptic feedback in surgical VSs. An updated systematic and scoping review was conducted to encompass more studies and a broader range of study methodologies. METHODS A systematic literature search was conducted on July 31, 2023, in MEDLINE, Embase, and Cochrane. English language studies comparing haptic vs non-haptic conditions and using VSs were included. Studies were evaluated and reported using PRISMA-ScR guidelines. RESULTS Out of 2782 initial studies, 51 were included in the review. Most studies used RCT (21) or crossover (23) methodologies with medical residents, students, and attending physicians. Most used post-intervention metrics, while some used pre- and post-intervention metrics. Overall, 34 performance results from studies favored haptics, 3 favored non-haptics, and the rest showed mixed or equal results. CONCLUSION This updated review highlights the diverse application of haptic technology in surgical VSs. Haptics generally enhances performance, complements traditional teaching methods, and offers personalized learning with adequate simulator validation. However, a sparsity of orienting to the simulator, pre-/post-study designs, and small sample sizes poses concerns with the validity of the results. We underscore the urgent need for standardized protocols, large-scale studies, and nuanced understanding of haptic feedback integration. We also accentuate the significance of simulator validation, personalized learning potential, and the need for researcher, educator, and manufacturer collaboration. This review is a guidepost for navigating the complexities and advancements in haptic-enhanced surgical VSs.
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Affiliation(s)
- Sayed Azher
- Department of Surgery, McGill University, Montreal, QC, Canada
- Simulation, Affect, Innovation, Learning, and Surgery (SAILS) Lab, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Aralia Mills
- Simulation, Affect, Innovation, Learning, and Surgery (SAILS) Lab, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Jinzhi He
- Simulation, Affect, Innovation, Learning, and Surgery (SAILS) Lab, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Taliah Hyjazie
- Simulation, Affect, Innovation, Learning, and Surgery (SAILS) Lab, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Junko Tokuno
- Steinberg Centre for Simulation and Interactive Learning, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Andrea Quaiattini
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, QC, Canada
| | - Jason M. Harley
- Department of Surgery, McGill University, Montreal, QC, Canada
- Simulation, Affect, Innovation, Learning, and Surgery (SAILS) Lab, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Steinberg Centre for Simulation and Interactive Learning, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
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Sparn MB, Teixeira H, Chatziisaak D, Schmied B, Hahnloser D, Bischofberger S. Virtual reality simulation training in laparoscopic surgery - does it really matter, what simulator to use? Results of a cross-sectional study. BMC MEDICAL EDUCATION 2024; 24:589. [PMID: 38807093 PMCID: PMC11134658 DOI: 10.1186/s12909-024-05574-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/17/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Virtual reality simulation training plays a crucial role in modern surgical training, as it facilitates trainees to carry out surgical procedures or parts of it without the need for training "on the patient". However, there are no data comparing different commercially available high-end virtual reality simulators. METHODS Trainees of an international gastrointestinal surgery workshop practiced in different sequences on LaparoS® (VirtaMed), LapSim® (Surgical Science) and LapMentor III® (Simbionix) eight comparable exercises, training the same basic laparoscopic skills. Simulator based metrics were compared between an entrance and exit examination. RESULTS All trainees significantly improved their basic laparoscopic skills performance, regardless of the sequence in which they used the three simulators. Median path length was initially 830 cm and 463 cm on the exit examination (p < 0.001), median time taken improved from 305 to 167 s (p < 0.001). CONCLUSIONS All Simulators trained efficiently the same basic surgery skills, regardless of the sequence or simulator used. Virtual reality simulation training, regardless of the simulator used, should be incorporated in all surgical training programs. To enhance comparability across different types of simulators, standardized outcome metrics should be implemented.
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Affiliation(s)
- Moritz B Sparn
- Department of Surgery, Kantonsspital St. Gallen, CH-9007, St. Gallen, Switzerland
| | - Hugo Teixeira
- Department of Surgery, Centre Hospitalier Universitaire Vaudois, CH-1011, Lausanne, Switzerland
| | | | - Bruno Schmied
- Department of Surgery, Kantonsspital St. Gallen, CH-9007, St. Gallen, Switzerland
| | - Dieter Hahnloser
- Department of Surgery, Centre Hospitalier Universitaire Vaudois, CH-1011, Lausanne, Switzerland.
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Toale C, Morris M, Kavanagh DO. Training and assessment using the LapSim laparoscopic simulator: a scoping review of validity evidence. Surg Endosc 2023; 37:1658-1671. [PMID: 36123545 DOI: 10.1007/s00464-022-09593-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/25/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The LapSim (Surgical Science, Sweden) laparoscopic simulator is a high-fidelity virtual reality simulator for use in endoscopic surgical training. This review critiques the current validity evidence for the LapSim laparoscopic simulator, specifically with respect to its potential use as a tool and method of training and assessment in surgery. METHODS A scoping review of the MEDLINE (PubMed), EMBASE, Cochrane and Web of Science databases was conducted in accordance with PRISMA guidelines (2020)-scoping review extension. Articles were included if they presented validity evidence for the use of the LapSim in operative skill training or assessment, in accordance with Messick's validity framework. European Association of Endoscopic Surgeons (EAES) guidelines (2005) were used to provide recommendations for the use of the LapSim in operative performance training and assessments. RESULTS Forty-nine articles were included. An EAES level 2 recommendation was provided with regard to the internal consistency reliability of automated performance metrics in assessing performance. An EAES recommendation of 2 was awarded with respect to the ability of the LapSim to discriminate based on case volume and overall laparoscopic experience (relationships with other variables). Performance assessment metrics on the LapSim correlate with improved performance in the operating room (EAES level of recommendation 1-consequential validity). CONCLUSION The LapSim has accumulated substantial evidence supporting the validity of its use in surgical training and assessment. Future studies should explore the relationship between the achievement of performance benchmarks on the LapSim and subsequent patient outcomes, and interrogate the benefits of implementing virtual reality simulation training and assessment curricula in post-graduate surgical training programmes.
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Affiliation(s)
- Conor Toale
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, 121 St Stephen's Green, Dublin 2, D02 YN77, Ireland.
| | - Marie Morris
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, 121 St Stephen's Green, Dublin 2, D02 YN77, Ireland
| | - Dara O Kavanagh
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, 121 St Stephen's Green, Dublin 2, D02 YN77, Ireland
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Verhoeven DJ, Hillemans V, Leijte E, Verhoeven BH, Botden SMBI. Assessment of Minimally Invasive Suturing Skills: Is Instrument Tracking an Accurate Prediction? J Laparoendosc Adv Surg Tech A 2023; 33:137-145. [PMID: 35900263 DOI: 10.1089/lap.2022.0313] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Minimally invasive surgery (MIS) suturing demands advanced surgical skills. Therefore, it is important these skills are adequately trained and assessed. Assessment and feedback can consist of judgments and scores of expert observers or objective parameters using instrument tracking. The aim of this study was to determine to what extent objective parameters correspond to expert assessment. Methods: Participants performed an intracorporeal suturing task on the EoSim simulator repeatedly (maximum 20 repetitions) during training. The best discriminating parameters, which previously shown construct validation, were combined into a composite score, using regression analysis. All videos were blinded and assessed by 2 independent reviewers using the validated laparoscopic suturing competency assessment tool (LS-CAT). These scores were compared with the composite score. Results: A 100 videos of 16 trainees, during separate points on their learning curve, and 8 experts were used. The parameters "time" and "distance" were statistically significantly correlated with all LS-CAT domains. The composite score (calculated from "time" and "distance") showed improvement between the first and the last knot (57% versus 94%, P < .001). Also the LS-CAT score improved (28 versus 17, P < .001). However, the correlation of the composite score with the LS-CAT score was weak (R: 0.351), with an accuracy of 55/100 when pooling the outcomes based on inadequate, adequate, or good performance. Conclusion: Instrument tracking parameters (using Surgtrac) could give an indication of the skill level, however, it missed important elements, essential for reliable assessment. Therefore, expert assessment remains superior to determine the skill level in MIS suturing skills.
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Affiliation(s)
| | - Vera Hillemans
- Department of Surgery, Radboudumc, Nijmegen, The Netherlands
| | - Erik Leijte
- Department of Surgery, Radboudumc, Nijmegen, The Netherlands.,Department of Urology, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands
| | - Bas H Verhoeven
- Department of Surgery, Radboudumc, Nijmegen, The Netherlands
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Champavier PG, Beyer-Berjot L, Arnoux PJ, Py M, Casanova R, Berdah S, Birnbaum DJ, Guilbaud T. An Ex Situ Cadaver Liver Training Model Continuously Pressurized to Simulate Specific Skills Involved in Laparoscopic Liver Resection: the Lap-Liver Trainer. J Gastrointest Surg 2023; 27:521-533. [PMID: 36624325 DOI: 10.1007/s11605-022-05566-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 12/17/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Laparoscopic liver resection (LLR) requires delicate skills. The aim of the study was to develop a training model mimicking as much as possible intraoperative bleeding and bile leakage during LLR. We also assessed the educational value of the training model. METHODS The Lap-liver trainer (LLT) combined a continuously pressurized ex situ cadaver liver and a customized mannequin. The customized mannequin was designed by computer-aided design and manufactured by 3D printing. The left lateral sectionectomy (LLS) was chosen to assess the feasibility of a LLR with the LLT. Eighteen volunteers were recruited to perform LLS and to assess the educational value of the LLT using a Likert scale. RESULTS The customized mannequin consisted of a close laparoscopic training device based on a simplified reconstruction of the abdominal cavity in laparoscopic conditions. Ex situ cadaver livers were pressurized to simulate blood and bile supplies. Each expert surgeon (n = 3) performed two LLS. They were highly satisfied of simulation conditions (4.80 ± 0.45) and strongly recommended that the LLT should be incorporated into a teaching program (5.00 ± 0.0). Eight novice and 4 intermediate surgeons completed a teaching program and performed a LLS. Overall, the level of satisfaction was high (4.92 ± 0.29), and performing such a procedure under simulation conditions benefited their learning and clinical practice (4.92 ± 0.29). CONCLUSIONS The LLT could provide better opportunities for trainees to acquire and practice LLR skills in a more realistic environment and to improve their ability to deal with specific events related to LLR.
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Affiliation(s)
| | - Laura Beyer-Berjot
- Aix-Marseille Univ, Univ Gustave Eiffel, LBA, Marseille, France.,Aix-Marseille Univ, Center for Surgical Teaching and Research (CERC), Marseille, France.,Aix-Marseille Univ, APHM, Hôpital Nord, Department of Digestive Surgery, Marseille, France
| | | | - Max Py
- Aix-Marseille Univ, Univ Gustave Eiffel, LBA, Marseille, France
| | | | - Stéphane Berdah
- Aix-Marseille Univ, Univ Gustave Eiffel, LBA, Marseille, France.,Aix-Marseille Univ, Center for Surgical Teaching and Research (CERC), Marseille, France.,Aix-Marseille Univ, APHM, Hôpital Nord, Department of Digestive Surgery, Marseille, France
| | - David Jérémie Birnbaum
- Aix-Marseille Univ, Center for Surgical Teaching and Research (CERC), Marseille, France.,Aix-Marseille Univ, APHM, Hôpital Nord, Department of Digestive Surgery, Marseille, France
| | - Théophile Guilbaud
- Aix-Marseille Univ, Univ Gustave Eiffel, LBA, Marseille, France.,Aix-Marseille Univ, Center for Surgical Teaching and Research (CERC), Marseille, France.,Aix-Marseille Univ, APHM, Hôpital Nord, Department of Digestive Surgery, Marseille, France
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Vamadevan A, Konge L, Stadeager M, Bjerrum F. Haptic simulators accelerate laparoscopic simulator training, but skills are not transferable to a non-haptic simulator: a randomized trial. Surg Endosc 2023; 37:200-208. [PMID: 35918547 DOI: 10.1007/s00464-022-09422-4] [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: 03/10/2022] [Accepted: 06/24/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Laparoscopy requires specific psychomotor skills and can be challenging to learn. Most proficiency-based laparoscopic training programs have used non-haptic virtual reality simulators; however, haptic simulators can provide the tactile sensations that the surgeon would experience in the operating room. The objective was to investigate the effect of adding haptic simulators to a proficiency-based laparoscopy training program. METHODS A randomized controlled trial was designed where residents (n = 36) were randomized to proficiency-based laparoscopic simulator training using haptic or non-haptic simulators. Subsequently, participants from the haptic group completed a follow-up test, where they had to reach proficiency again using the non-haptic simulator. Participants from the non-haptic group returned to train until reaching proficiency again using the non-haptic simulator. RESULTS Mean completion times during the intervention were 120 min (SD 38.7 min) and 183 min (SD 66.3 min) for the haptic group and the non-haptic group, respectively (p = 0.001). The mean times to proficiency during the follow-up test were 107 min (SD 41.0 min) and 58 min (SD 23.7 min) for the haptic and the non-haptic group, respectively (p < 0.001). The haptic group was not faster to reach proficiency in the follow-up test than during the intervention (p = 0.22). In contrast, the non-haptic group reached the required proficiency level significantly faster in the follow-up test (p < 0.001). CONCLUSION Haptic virtual reality simulators reduce the time to reach proficiency compared to non-haptic simulators. However, the acquired skills are not transferable to the conventional non-haptic setting.
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Affiliation(s)
- Anishan Vamadevan
- Copenhagen Academy for Medical Education and Simulation, Centre for HR and Education, The Capital Region, Copenhagen, Denmark.
| | - Lars Konge
- Copenhagen Academy for Medical Education and Simulation, Centre for HR and Education, The Capital Region, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Morten Stadeager
- Copenhagen Academy for Medical Education and Simulation, Centre for HR and Education, The Capital Region, Copenhagen, Denmark.,Department of Surgery, Hvidovre Hospital, Copenhagen University Hospital, Hvidovre, Denmark
| | - Flemming Bjerrum
- Copenhagen Academy for Medical Education and Simulation, Centre for HR and Education, The Capital Region, Copenhagen, Denmark.,Department of Surgery, Zealand University Hospital, Køge, Denmark
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Hong M, Rozenblit JW. An Adaptive Force Guidance System for Computer-Guided Laparoscopy Training. IEEE TRANSACTIONS ON CYBERNETICS 2022; 52:8019-8031. [PMID: 33600333 DOI: 10.1109/tcyb.2021.3051837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
We present an adaptive force guidance system for laparoscopic surgery skills training. This system consists of self-adjusting fuzzy sliding-mode controllers and switching mode controllers to provide proper force feedback. Using virtual fixtures, the proposed system restricts motions or guides a trainee to navigate a surgical instrument in a 3-D space in a manner that mimics a human instructor who would teach the trainees by holding their hands. The self-adjusting controllers incorporate human factors, such as different force sensitivity and proficiency levels. The proposed system was implemented and evaluated using the computer-assisted surgical trainer (CAST). The effects of the force guidance system are presented based on the experimental test results.
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Porto JÚT, Eifler LS, Steffen LP, Rabaioli GF, Tomazzoni JM. Use of simulators in video laparoscopic surgery in medical training: a prospective court study with medicine academic at a university in Southern Brazil. ACTA ACUST UNITED AC 2020; 47:e20202608. [PMID: 33406213 DOI: 10.1590/0100-6991e-20202608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/06/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION the onset of minimally invasive surgery, such as laparoscopic surgery, was accompanied by an increased frequency of complications, many of which were life-threatening. With the objective of minimizing morbidity and mortality and accelerating the learning curve, video laparoscopic surgery simulators were developed to improve the psychomotor skills required for these procedures. OBJECTIVE to compare the performance of second year medical students of the Lutheran University of Brazil, in simulated videolaparoscopic surgeries performed at the Realistic Simulation Center of the Faculty of Health Sciences of Porto Alegre. METHOD prospective cohort study with 16 medical students with no prior experience in video-surgery simulation. The students performed simulated exercises and were evaluated regarding Coordination, Navigation by Instrument and Time in the accomplishment of the procedures. RESULTS the sample consisted of 69% women and 31% men with a mean age of 23.2 years. The students obtained better results in the second simulation application. The skill in Navigation by Instrument task was the one that showed the best evolution in the studied group. The Total Time in the accomplishment of the procedures was the parameter with greater difference between the successive simulations. CONCLUSION medical students presented a significant improvement in their performance with the repetition of the simulation exercises, demonstrating that the Laparoscopic Surgery Simulators are a promising tool in medical training and development of surgical skills.
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Lacki M, Rossa C. Design and Control of a 3 Degree-of-Freedom Parallel Passive Haptic Device. IEEE TRANSACTIONS ON HAPTICS 2020; 13:720-732. [PMID: 32224464 DOI: 10.1109/toh.2020.2983037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Teleoperated robotic surgery and surgical simulation provide surgeons with tools that can improve the health outcomes of their patients. The limiting factor in many of these systems, however, is the lack of a haptic system that can render high impedance without compromising transparency or stability. To address this issue, we constructed a 3-Degree-of-Freedom haptic device using brakes as actuators. A novel controller is also proposed to increase the range of forces the device can generate and eliminate stiction. The device uses a modified Delta kinematic structure making it light and rigid. Since brakes are intrinsically stable, the device safely generates a wide range of impedance making it well suited for many surgical applications. The novel controller attempts to minimize the sum of forces acting perpendicular to the virtual surface eliminating un-smooth force output and stiction characteristic to passive devices, while increasing the range of displayable forces. The controller was validated using six testing scenarios where it rendered contact with frictionless surfaces. When using the controller, the device rendered the desired surface without stiction. Since the controller successfully rendered complex geometry, it can also work in other applications, such as robotic surgery and surgical simulation.
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Sainsbury B, Łącki M, Shahait M, Goldenberg M, Baghdadi A, Cavuoto L, Ren J, Green M, Lee J, Averch TD, Rossa C. Evaluation of a Virtual Reality Percutaneous Nephrolithotomy (PCNL) Surgical Simulator. Front Robot AI 2020; 6:145. [PMID: 33501160 PMCID: PMC7805868 DOI: 10.3389/frobt.2019.00145] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 12/11/2019] [Indexed: 12/31/2022] Open
Abstract
Percutaneous Nephrolithotomy is the standard surgical procedure used to remove large kidney stones. PCNL procedures have a steep learning curve; a physician needs to complete between 36 and 60 procedures, to achieve clinical proficiency. Marion Surgical K181 is a virtual reality surgical simulator, which emulates the PCNL procedures without compromising the well-being of patients. The simulator uses a VR headset to place a user in a realistic and immersive operating theater, and haptic force-feedback robots to render physical interactions between surgical tools and the virtual patient. The simulator has two modules for two different aspects of PCNL kidney stone removal procedure: kidney access module where the user must insert a needle into the kidney of the patient, and a kidney stone removal module where the user removes the individual stones from the organ. In this paper, we present user trials to validate the face and construct validity of the simulator. The results, based on the data gathered from 4 groups of users independently, indicate that Marion's surgical simulator is a useful tool for teaching and practicing PCNL procedures. The kidney stone removal module of the simulator has proven construct validity by identifying the skill level of different users based on their tool path. We plan to continue evaluating the simulator with a larger sample of users to reinforce our findings.
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Affiliation(s)
- Ben Sainsbury
- Faculty of Science, Ontario Tech University, Oshawa, ON, Canada
| | - Maciej Łącki
- Faculty of Engineering and Applied Science, Ontario Tech University, Oshawa, ON, Canada
| | - Mohammed Shahait
- University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | | | | | - Lora Cavuoto
- University of Buffalo, Buffalo, NY, United States
| | - Jing Ren
- Faculty of Engineering and Applied Science, Ontario Tech University, Oshawa, ON, Canada
| | - Mark Green
- Faculty of Science, Ontario Tech University, Oshawa, ON, Canada
| | - Jason Lee
- St. Michael's Hospital, Toronto, ON, Canada
| | - Timothy D Averch
- University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Carlos Rossa
- Faculty of Engineering and Applied Science, Ontario Tech University, Oshawa, ON, Canada
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Hagelsteen K, Johansson R, Ekelund M, Bergenfelz A, Anderberg M. Performance and perception of haptic feedback in a laparoscopic 3D virtual reality simulator. MINIM INVASIV THER 2019; 28:309-316. [DOI: 10.1080/13645706.2018.1539012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Kristine Hagelsteen
- Practicum Clinical Skills Centre, Skåne University Hospital, Lund, Sweden
- Department of Clinical Sciences, Surgery, Lund University, Skåne University Hospital, Lund, Sweden
| | - Richard Johansson
- Practicum Clinical Skills Centre, Skåne University Hospital, Lund, Sweden
| | - Mikael Ekelund
- Practicum Clinical Skills Centre, Skåne University Hospital, Lund, Sweden
- Department of Clinical Sciences, Surgery, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Anders Bergenfelz
- Practicum Clinical Skills Centre, Skåne University Hospital, Lund, Sweden
- Department of Clinical Sciences, Surgery, Lund University, Skåne University Hospital, Lund, Sweden
| | - Magnus Anderberg
- Practicum Clinical Skills Centre, Skåne University Hospital, Lund, Sweden
- Department of Clinical Sciences, Paediatrics, Lund University, Skåne University Hospital, Lund, Sweden
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Bugdadi A, Sawaya R, Bajunaid K, Olwi D, Winkler-Schwartz A, Ledwos N, Marwa I, Alsideiri G, Sabbagh AJ, Alotaibi FE, Al-Zhrani G, Maestro RD. Is Virtual Reality Surgical Performance Influenced by Force Feedback Device Utilized? JOURNAL OF SURGICAL EDUCATION 2019; 76:262-273. [PMID: 30072262 DOI: 10.1016/j.jsurg.2018.06.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 05/19/2018] [Accepted: 06/19/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The study objectives were to assess if surgical performance and subjective assessment of a virtual reality simulator platform was influenced by changing force feedback devices. DESIGN Participants used the NeuroVR (formerly NeuroTouch) simulator to perform 5 practice scenarios and a realistic scenario involving subpial resection of a virtual reality brain tumor with simulated bleeding. The influence of force feedback was assessed by utilizing the Omni and Entact haptic systems. Tier 1, tier 2, and tier 2 advanced metrics were used to compare results. Operator subjective assessment of the haptic systems tested utilized seven Likert criteria (score 1 to 5). SETTING The study is carried out at the McGill Neurosurgical Simulation Research and Training Centre, Montreal Neurological Institute and Hospital, Montreal, Canada. PARTICIPANTS Six expert operators in the utilization of the NeuroVR simulator platform. RESULTS No significant differences in surgical performance were found between the two haptic devices. Participants significantly preferred the Entact system on all 7 Likert criteria of subjective assessment. CONCLUSIONS Our results show no statistical differences in virtual reality surgical performance utilizing the two bimanual haptic devices tested. Subjective assessments demonstrated that participants preferred the Entact system. Our results suggest that to maximize realism of the training experience educators employing virtual reality simulators may find it useful to assess expert opinion before choosing a force feedback device.
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Affiliation(s)
- Abdulgadir Bugdadi
- Neurosurgical Simulation Research and Training Centre, Department of Neurosurgery and Neurology, McGill University, Montreal, Quebec, Canada; Department of Surgery, Faculty of Medicine, Umm Al-Qura University, Makkah Almukarramah, Saudi Arabia.
| | - Robin Sawaya
- Neurosurgical Simulation Research and Training Centre, Department of Neurosurgery and Neurology, McGill University, Montreal, Quebec, Canada
| | - Khalid Bajunaid
- Neurosurgical Simulation Research and Training Centre, Department of Neurosurgery and Neurology, McGill University, Montreal, Quebec, Canada; Division of Neurosurgery, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Duaa Olwi
- Neurosurgical Simulation Research and Training Centre, Department of Neurosurgery and Neurology, McGill University, Montreal, Quebec, Canada; King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Alexander Winkler-Schwartz
- Neurosurgical Simulation Research and Training Centre, Department of Neurosurgery and Neurology, McGill University, Montreal, Quebec, Canada
| | - Nicole Ledwos
- Neurosurgical Simulation Research and Training Centre, Department of Neurosurgery and Neurology, McGill University, Montreal, Quebec, Canada
| | - Ibrahim Marwa
- Neurosurgical Simulation Research and Training Centre, Department of Neurosurgery and Neurology, McGill University, Montreal, Quebec, Canada
| | - Ghusn Alsideiri
- Neurosurgical Simulation Research and Training Centre, Department of Neurosurgery and Neurology, McGill University, Montreal, Quebec, Canada; Department of Surgery, College of Medicine, Sultan Qaboos University, Muscat, Oman
| | - Abdulrahman Jafar Sabbagh
- Neurosurgical Simulation Research and Training Centre, Department of Neurosurgery and Neurology, McGill University, Montreal, Quebec, Canada; Division of Neurosurgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; Clinical Skill and Simulation Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Fahad E Alotaibi
- Neurosurgical Simulation Research and Training Centre, Department of Neurosurgery and Neurology, McGill University, Montreal, Quebec, Canada; National Neuroscience Institute, Department of Neurosurgery, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Gmaan Al-Zhrani
- Neurosurgical Simulation Research and Training Centre, Department of Neurosurgery and Neurology, McGill University, Montreal, Quebec, Canada; National Neuroscience Institute, Department of Neurosurgery, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Rolando Del Maestro
- Neurosurgical Simulation Research and Training Centre, Department of Neurosurgery and Neurology, McGill University, Montreal, Quebec, Canada
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Overtoom EM, Horeman T, Jansen FW, Dankelman J, Schreuder HWR. Haptic Feedback, Force Feedback, and Force-Sensing in Simulation Training for Laparoscopy: A Systematic Overview. JOURNAL OF SURGICAL EDUCATION 2019; 76:242-261. [PMID: 30082239 DOI: 10.1016/j.jsurg.2018.06.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 04/24/2018] [Accepted: 06/13/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To provide a systematic overview of the literature assessing the value of haptic and force feedback in current simulators teaching laparoscopic surgical skills. DATA SOURCES The databases of Pubmed, Cochrane, Embase, Web of Science, and Google Scholar were searched to retrieve relevant studies published until January 31st, 2017. The search included laparoscopic surgery, simulation, and haptic or force feedback and all relevant synonyms. METHODS Duplicates were removed, and titles and abstracts screened. The remaining articles were subsequently screened full text and included in this review if they followed the inclusion criteria. A total of 2 types of feedback have been analyzed and will be discussed separately: haptic- and force feedback. RESULTS A total of 4023 articles were found, of which 87 could be used in this review. A descriptive analysis of the data is provided. Results of the added value of haptic interface devices in virtual reality are variable. Haptic feedback is most important for more complex tasks. The interface devices do not require the highest level of fidelity. Haptic feedback leads to a shorter learning curve with a steadier upward trend. Concerning force feedback, force parameters are measured through force sensing systems in the instrument and/or the environment. These parameters, especially in combination with motion parameters, provide box trainers with an objective evaluation of laparoscopic skills. Feedback of force-use both real time and postpractice has been shown to improve training. CONCLUSIONS Haptic feedback is added to virtual reality simulators to increase the fidelity and thereby improve training effect. Variable results have been found from adding haptic feedback. It is most important for more complex tasks, but results in only minor improvements for novice surgeons. Force parameters and force feedback in box trainers have been shown to improve training results.
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Affiliation(s)
- Evelien M Overtoom
- Department of Gynaecology and Reproductive Medicine, University Medical Center Utrecht and Department of Gynaecologic Oncology, UMC Utrecht Cancer Centre, Utrecht, The Netherlands
| | - Tim Horeman
- Department of Biomechanical Engineering, Faculty of Mechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - Frank-Willem Jansen
- Department of Biomechanical Engineering, Faculty of Mechanical Engineering, Delft University of Technology, Delft, The Netherlands; Department of Gynaecology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Jenny Dankelman
- Department of Biomechanical Engineering, Faculty of Mechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - Henk W R Schreuder
- Department of Gynaecology and Reproductive Medicine, University Medical Center Utrecht and Department of Gynaecologic Oncology, UMC Utrecht Cancer Centre, Utrecht, The Netherlands.
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Liu W, Zheng X, Wu R, Jin Y, Kong S, Li J, Lu J, Yang H, Xu X, Lv Y, Zhang X. Novel laparoscopic training system with continuously perfused ex-vivo porcine liver for hepatobiliary surgery. Surg Endosc 2017; 32:743-750. [PMID: 28733731 DOI: 10.1007/s00464-017-5731-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Accepted: 07/13/2017] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To introduce a novel laparoscopic training system with a continuously perfused ex-vivo porcine liver for hepatobiliary surgery. BACKGROUND Existing models for laparoscopic training, such as box trainers and virtual reality simulators, often fail to provide holistic training and real haptic feedback. We have formulated a new training system that addresses these problems. METHODS Real-Liver Laptrainer consists of a porcine liver, customized mannequin, ex-vivo machine perfusion system, and monitoring software. We made a detailed comparison of Real-Liver Laptrainer with the LapSim virtual reality simulator and the FLS Trainer Box systems. Five laparoscopic surgeons assessed the new system on multiple features. We assessed the performances of 43 trainees who used the new system to perform laparoscopic cholecystectomy (LC) three times. RESULTS Real-Liver Laptrainer offered more functions and better tactile feedback than the FLS or LapSim system. All five surgeons graded the quality of the new system as realistic. The utility of the system for training was scored as 3.6 ± 1.1 on a scale of 1-5. Between the first and third attempts, the number of successfully performed LCs increased (9 vs 14 vs 23; P = .011), while the numbers of liver damage incidents (25 vs. 21 vs. 18, P = .303) and gallbladder perforations decreased (17 vs. 12 vs. 9, P = .163). The mean LC operation time significantly decreased (63 vs. 50 vs. 44, P < .0001). CONCLUSION Real-Liver Laptrainer is a feasible, stable, and practical training model that has potential for improving the laparoscopic skills of surgeons.
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Affiliation(s)
- Wenyan Liu
- Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Xinglong Zheng
- Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Rongqian Wu
- Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Yinbin Jin
- College of Electrical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Shu Kong
- Institute of Medical Engineering, Medical School of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Jianpeng Li
- Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Jianwen Lu
- Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Huan Yang
- Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Xianghua Xu
- Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Yi Lv
- Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China.
| | - Xiaogang Zhang
- Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China.
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Våpenstad C, Hofstad EF, Bø LE, Kuhry E, Johnsen G, Mårvik R, Langø T, Hernes TN. Lack of transfer of skills after virtual reality simulator training with haptic feedback. MINIM INVASIV THER 2017; 26:346-354. [DOI: 10.1080/13645706.2017.1319866] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Cecilie Våpenstad
- Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Medical Technology, SINTEF Technology and Society, Trondheim, Norway
- The Central Norway Regional Health Authority, Trondheim, Norway
- The Norwegian National Advisory Unit for Advanced Laparoscopic Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- The Norwegian National Advisory Unit for Ultrasound and Image-Guided Therapy, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Erlend Fagertun Hofstad
- Department of Medical Technology, SINTEF Technology and Society, Trondheim, Norway
- The Norwegian National Advisory Unit for Advanced Laparoscopic Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- The Norwegian National Advisory Unit for Ultrasound and Image-Guided Therapy, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Lars Eirik Bø
- Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Medical Technology, SINTEF Technology and Society, Trondheim, Norway
- The Central Norway Regional Health Authority, Trondheim, Norway
- The Norwegian National Advisory Unit for Advanced Laparoscopic Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- The Norwegian National Advisory Unit for Ultrasound and Image-Guided Therapy, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Esther Kuhry
- Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Gastrointestinal Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Gjermund Johnsen
- The Norwegian National Advisory Unit for Advanced Laparoscopic Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Gastrointestinal Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Ronald Mårvik
- Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- The Norwegian National Advisory Unit for Advanced Laparoscopic Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- The Norwegian National Advisory Unit for Ultrasound and Image-Guided Therapy, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Gastrointestinal Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Thomas Langø
- Department of Medical Technology, SINTEF Technology and Society, Trondheim, Norway
- The Norwegian National Advisory Unit for Ultrasound and Image-Guided Therapy, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Toril Nagelhus Hernes
- Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- The Norwegian National Advisory Unit for Ultrasound and Image-Guided Therapy, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Lemos JD, Hernandez AM, Soto-Romero G. An Instrumented Glove to Assess Manual Dexterity in Simulation-Based Neurosurgical Education. SENSORS 2017; 17:s17050988. [PMID: 28468268 PMCID: PMC5469341 DOI: 10.3390/s17050988] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 04/01/2017] [Accepted: 04/07/2017] [Indexed: 12/03/2022]
Abstract
The traditional neurosurgical apprenticeship scheme includes the assessment of trainee’s manual skills carried out by experienced surgeons. However, the introduction of surgical simulation technology presents a new paradigm where residents can refine surgical techniques on a simulator before putting them into practice in real patients. Unfortunately, in this new scheme, an experienced surgeon will not always be available to evaluate trainee’s performance. For this reason, it is necessary to develop automatic mechanisms to estimate metrics for assessing manual dexterity in a quantitative way. Authors have proposed some hardware-software approaches to evaluate manual dexterity on surgical simulators. This paper presents IGlove, a wearable device that uses inertial sensors embedded on an elastic glove to capture hand movements. Metrics to assess manual dexterity are estimated from sensors signals using data processing and information analysis algorithms. It has been designed to be used with a neurosurgical simulator called Daubara NS Trainer, but can be easily adapted to another benchtop- and manikin-based medical simulators. The system was tested with a sample of 14 volunteers who performed a test that was designed to simultaneously evaluate their fine motor skills and the IGlove’s functionalities. Metrics obtained by each of the participants are presented as results in this work; it is also shown how these metrics are used to automatically evaluate the level of manual dexterity of each volunteer.
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Affiliation(s)
- Juan Diego Lemos
- Bioinstrumentation and Clinical Engineering Research Group-GIBIC, Bioengineering Department, Engineering Faculty, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín 050010, Colombia.
| | - Alher Mauricio Hernandez
- Bioinstrumentation and Clinical Engineering Research Group-GIBIC, Bioengineering Department, Engineering Faculty, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín 050010, Colombia.
| | - Georges Soto-Romero
- LAAS-CNRS, Université de Toulouse, CNRS, Toulouse 31400, France.
- ISIFC, Université de Franche-Comté, Besançon 25000, France.
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Hagelsteen K, Langegård A, Lantz A, Ekelund M, Anderberg M, Bergenfelz A. Faster acquisition of laparoscopic skills in virtual reality with haptic feedback and 3D vision. MINIM INVASIV THER 2017; 26:269-277. [DOI: 10.1080/13645706.2017.1305970] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Kristine Hagelsteen
- Practicum Clinical Skills Center, Skåne University Hospital, Lund, Sweden
- Department of Clinical Sciences, Surgery, Lund University, Skåne University Hospital, Lund, Sweden
| | - Anders Langegård
- Practicum Clinical Skills Center, Skåne University Hospital, Lund, Sweden
| | - Adam Lantz
- Practicum Clinical Skills Center, Skåne University Hospital, Lund, Sweden
| | - Mikael Ekelund
- Practicum Clinical Skills Center, Skåne University Hospital, Lund, Sweden
- Department of Clinical Sciences, Surgery, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Magnus Anderberg
- Practicum Clinical Skills Center, Skåne University Hospital, Lund, Sweden
- Department of Clinical Sciences, Paediatrics, Lund University, Skåne University Hospital, Lund, Sweden
| | - Anders Bergenfelz
- Practicum Clinical Skills Center, Skåne University Hospital, Lund, Sweden
- Department of Clinical Sciences, Surgery, Lund University, Skåne University Hospital, Lund, Sweden
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18
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Fransson BA, Chen CY, Noyes JA, Ragle CA. Instrument Motion Metrics for Laparoscopic Skills Assessment in Virtual Reality and Augmented Reality. Vet Surg 2016; 45:O5-O13. [DOI: 10.1111/vsu.12483] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Boel A. Fransson
- Department of Veterinary Clinical Sciences; Washington State University; Pullman Washington
| | - Chi-Ya Chen
- Department of Veterinary Clinical Sciences; Washington State University; Pullman Washington
| | - Julie A. Noyes
- Department of Veterinary Clinical Sciences; Washington State University; Pullman Washington
| | - Claude A. Ragle
- Department of Veterinary Clinical Sciences; Washington State University; Pullman Washington
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19
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Alaker M, Wynn GR, Arulampalam T. Virtual reality training in laparoscopic surgery: A systematic review & meta-analysis. Int J Surg 2016; 29:85-94. [PMID: 26992652 DOI: 10.1016/j.ijsu.2016.03.034] [Citation(s) in RCA: 146] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 02/25/2016] [Accepted: 03/12/2016] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Laparoscopic surgery requires a different and sometimes more complex skill set than does open surgery. Shortened working hours, less training times, and patient safety issues necessitates that these skills need to be acquired outside the operating room. Virtual reality simulation in laparoscopic surgery is a growing field, and many studies have been published to determine its effectiveness. AIMS This systematic review and meta-analysis aims to evaluate virtual reality simulation in laparoscopic abdominal surgery in comparison to other simulation models and to no training. METHODS A systematic literature search was carried out until January 2014 in full adherence to PRISMA guidelines. All randomised controlled studies comparing virtual reality training to other models of training or to no training were included. Only studies utilizing objective and validated assessment tools were included. RESULTS Thirty one randomised controlled trials that compare virtual reality training to other models of training or to no training were included. The results of the meta-analysis showed that virtual reality simulation is significantly more effective than video trainers, and at least as good as box trainers. CONCLUSION The use of Proficiency-based VR training, under supervision with prompt instructions and feedback, and the use of haptic feedback, has proven to be the most effective way of delivering the virtual reality training. The incorporation of virtual reality training into surgical training curricula is now necessary. A unified platform of training needs to be established. Further studies to assess the impact on patient outcomes and on hospital costs are necessary. (PROSPERO Registration number: CRD42014010030).
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Affiliation(s)
- Medhat Alaker
- ICENI Centre, Colchester General Hospital, Department of Colorectal Surgery, Colchester CO 45JL, UK.
| | - Greg R Wynn
- ICENI Centre, Colchester General Hospital, Department of Colorectal Surgery, Colchester CO 45JL, UK
| | - Tan Arulampalam
- ICENI Centre, Colchester General Hospital, Department of Colorectal Surgery, Colchester CO 45JL, UK
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Sawada A, Kume N, Fukuda J, Matsui Y, Yoshimura K, Ogawa O. Development of a Novel Tool for Assessing Deformation and Hardness of Real Organs: Pressure Measuring Grasper (PMEG). ADVANCED BIOMEDICAL ENGINEERING 2016. [DOI: 10.14326/abe.5.68] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Atsuro Sawada
- Department of Urology, Graduate school of Medicine, Kyoto University
| | - Naoto Kume
- EHR Research Unit, Graduate school of Informatics, Kyoto University
| | | | - Yoshiyuki Matsui
- Department of Urology, Graduate school of Medicine, Kyoto University
| | | | - Osamu Ogawa
- Department of Urology, Graduate school of Medicine, Kyoto University
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Ahlborg L, Hedman L, Nisell H, Felländer-Tsai L, Enochsson L. Simulator training and non-technical factors improve laparoscopic performance among OBGYN trainees. Acta Obstet Gynecol Scand 2014; 92:1194-201. [PMID: 24461067 DOI: 10.1111/aogs.12218] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 07/10/2013] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To investigate how simulator training and non-technical factors affect laparoscopic performance among residents in obstetrics and gynecology. DESIGN In this prospective study, trainees were randomized into three groups. The first group was allocated to proficiency-based training in the LapSimGyn(®) virtual reality simulator. The second group received additional structured mentorship during subsequent laparoscopies. The third group served as control group. At baseline an operation was performed and visuospatial ability, flow and self-efficacy were assessed. All groups subsequently performed three tubal occlusions. Self-efficacy and flow were assessed before and/or after each operation. SETTING Simulator training was conducted at the Center for Advanced Medical Simulation and Training, Karolinska University Hospital. Sterilizations were performed at each trainee's home clinic. POPULATION Twenty-eight trainees/residents from 21 hospitals in Sweden were included. METHODS/MAIN OUTCOME MEASURES Visuospatial ability was tested by the Mental Rotation Test-A. Flow and self-efficacy were assessed by validated scales and questionnaires. Laparoscopic performance was measured as the duration of surgery. Visuospatial ability, self-efficacy and flow were correlated to the laparoscopic performance using Spearman's correlations. Differences between groups were analyzed by the Mann-Whitney U-test. RESULTS No differences across groups were detected at baseline. Self-efficacy scores before and flow scores after the third operation were significantly higher in the trained groups. Duration of surgery was significantly shorter in the trained groups. Flow and self-efficacy correlate positively with laparoscopic performance. CONCLUSIONS Simulator training and non-technical factors appear to improve the laparoscopic performance among trainees/residents in obstetrics and gynecology.
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Affiliation(s)
- Liv Ahlborg
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden; Center for Advanced Medical Simulation and Training (CAMST), Karolinska University Hospital, Stockholm, Sweden; Department of Obstetrics and Gynecology, Södertälje Hospital, Södertälje, Sweden; Division of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden
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Perceiving haptic feedback in virtual reality simulators. Surg Endosc 2013; 27:2391-7. [DOI: 10.1007/s00464-012-2745-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 11/26/2012] [Indexed: 10/27/2022]
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