1
|
Fransson BA. New Training Options for Minimally Invasive Surgery Skills. Vet Clin North Am Small Anim Pract 2024; 54:603-613. [PMID: 38485606 DOI: 10.1016/j.cvsm.2024.02.001] [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] [Indexed: 05/25/2024]
Abstract
Veterinary minimally invasive surgery (MIS) training options are becoming more available. This article reviews new developments in this area and the current evidence for manual skills and cognitive training of MIS.
Collapse
Affiliation(s)
- Boel A Fransson
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA.
| |
Collapse
|
2
|
Zhang J, Luo Z, Zhang R, Ding Z, Fang Y, Han C, Wu W, Cen G, Qiu Z, Huang C. The transition of surgical simulation training and its learning curve: a bibliometric analysis from 2000 to 2023. Int J Surg 2024; 110:01279778-990000000-01461. [PMID: 38729115 PMCID: PMC11175803 DOI: 10.1097/js9.0000000000001579] [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: 11/23/2023] [Accepted: 04/25/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Proficient surgical skills are essential for surgeons, making surgical training an important part of surgical education. The development of technology promotes the diversification of surgical training types. This study analyzes the changes in surgical training patterns from the perspective of bibliometrics, and applies the learning curves as a measure to demonstrate their teaching ability. METHOD Related papers were searched in the Web of Science database using the following formula: TS=((training OR simulation) AND (learning curve) AND (surgical)). Two researchers browsed the papers to ensure that the topics of articles were focused on the impact of surgical simulation training on the learning curve. CiteSpace, VOSviewer and R packages were applied to analyze the publication trends, countries, authors, keywords and references of selected articles. RESULT Ultimately, 2461 documents were screened and analyzed. The USA is the most productive and influential country in this field. Surgical endoscopy and other interventional techniques publish the most articles, while surgical endoscopy and other interventional techniques is the most cited journal. Aggarwal Rajesh is the most productive and influential author. Keyword and reference analyses reveal that laparoscopic surgery, robotic surgery, virtue reality (VR) and artificial intelligence (AI) were the hotspots in the field. CONCLUSION This study provided a global overview of the current state and future trend in the surgical education field. The study surmised the applicability of different surgical simulation types by comparing and analyzing the learning curves, which is helpful for the development of this field.
Collapse
Affiliation(s)
- Jun Zhang
- Department of Gastrointestinal Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, the People’s Republic of China
| | - Zai Luo
- Department of Gastrointestinal Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, the People’s Republic of China
| | - Renchao Zhang
- Department of Gastrointestinal Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, the People’s Republic of China
| | - Zehao Ding
- Department of Gastrointestinal Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, the People’s Republic of China
- The Affiliated Chuzhou Hospital of Anhui Medical University, Anhui, the People's Republic of China
| | - Yuan Fang
- Department of Gastrointestinal Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, the People’s Republic of China
| | - Chao Han
- Department of Gastrointestinal Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, the People’s Republic of China
| | - Weidong Wu
- Department of Gastrointestinal Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, the People’s Republic of China
| | - Gang Cen
- The Affiliated Chuzhou Hospital of Anhui Medical University, Anhui, the People's Republic of China
| | - Zhengjun Qiu
- Department of Gastrointestinal Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, the People’s Republic of China
| | - Chen Huang
- Department of Gastrointestinal Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, the People’s Republic of China
- The Affiliated Chuzhou Hospital of Anhui Medical University, Anhui, the People's Republic of China
| |
Collapse
|
3
|
Hiemstra LA, Hilary W, Sasyniuk TM, Sarah K. Orthopaedic Sport Medicine Surgeons and Fellows Value Immersive Virtual Reality for Improving Surgical Training, Procedural Planning, and Distance Learning. J ISAKOS 2024:S2059-7754(24)00089-0. [PMID: 38734310 DOI: 10.1016/j.jisako.2024.05.002] [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: 01/30/2024] [Revised: 05/05/2024] [Accepted: 05/06/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Overall, the potential utility of iVR technology in orthopaedic surgery is promising. The attitudes of medical students and surgical trainees on VR simulated surgical training have been overwhelmingly positive. However, further research and understanding of the attitudes of practicing orthopaedic surgeons and Fellows are needed to appreciate its benefits for clinical practice. PURPOSE The purpose of this study was to assess the attitudes of Canadian orthopaedic surgeons and Fellows on the value of iVR for surgical training, clinical practice, and distance learning. METHODS Forty-three orthopedic surgeons and Fellows attended a VRthrscopy™ Knee Module (Conmed Corporation, Largo, USA) demonstration. The view and audio from the lead headset were cast to a large screen so the audience could follow the procedure in real-time. Immediately after the presentation, the audience members were given a paper questionnaire assessing their perceptions and attitudes toward iVR or use in orthopaedic learning, clinical practice and distance education and mentoring. RESULTS iVR was perceived to be valuable for the field of orthopaedic surgery. All 13 questions were rated with mean Likert scores of five or greater indicating observed value for all 13 questions. The respondents indicated that iVR had value (score of 5 or greater) in each questionnaire domain, with agreement ranging from 78-98% for teaching and learning, 66-97% for clinical practice, and 88-100% for distance education and mentoring questions. CONCLUSION This study has demonstrated that a group of Canadian sport medicine orthopedic surgeons and Fellows had favourable attitudes towards, and perceived that iVR has value in, orthopaedic surgical training, clinical practice, and distance learning and mentorship. The potential for utilizing iVR technology for distance learning, mentorship and global education appears promising.
Collapse
Affiliation(s)
- Laurie A Hiemstra
- Banff Sport Medicine Foundation, PO Box 1300, Banff, Alberta Canada T1L 1B3; Department of Surgery, University of Calgary, North Tower Foothills Medicine Centre, 1403 29(th) St. NW, Calgary, Alberta, Canada, T2N 2T9.
| | - Williams Hilary
- Banff Sport Medicine Foundation, PO Box 1300, Banff, Alberta Canada T1L 1B3.
| | - Treny M Sasyniuk
- Banff Sport Medicine Foundation, PO Box 1300, Banff, Alberta Canada T1L 1B3.
| | - Kerslake Sarah
- Banff Sport Medicine Foundation, PO Box 1300, Banff, Alberta Canada T1L 1B3.
| |
Collapse
|
4
|
Gu J, Cao J, Cao W, Chen Y, Wei F. Optimized reusable modular 3D-printed models of choledochal cyst to simulate laparoscopic and robotic bilioenteric anastomosis. Sci Rep 2024; 14:8807. [PMID: 38627503 PMCID: PMC11021543 DOI: 10.1038/s41598-024-59351-6] [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] [Received: 01/11/2024] [Accepted: 04/09/2024] [Indexed: 04/19/2024] Open
Abstract
Laparoscopic and robotic surgery is a challenge to the surgeon's hand-eye coordination ability, which requires constant practice. Traditional mentor training is gradually shifting to simulation training based on various models. Laparoscopic and robotic bilioenteric anastomosis is an important and difficult operation in hepatobiliary surgery. We constructed and optimized the reusable modular 3D-printed models of choledochal cyst. The aim of this study was to verify the ability of this optimized model to distinguish between surgeons with different levels of proficiency and the benefits of repeated practice. A total of 12 surgeons with different levels participated in the study. Operation completion time and OSATS score were recorded. The model was validated by Likert scale. Surgeons were shown the steps and contents before performing laparoscopic or robotic bilioenteric anastomosis using the model. Surgeons with different levels of experience showed different levels when performing laparoscopic bilioenteric anastomosis on this model. Repeated training can significantly shorten the time of laparoscopic bilioenteric anastomosis and improve the operation scores of surgeons with different levels of experience. At the same time, preliminary results have shown that the performance of surgeons on the domestic robotic platform was basically consistent with their laparoscopic skills. This model may distinguish surgeons with different levels of experience and may improve surgical skills through repeated practice. It is worth noting that in order to draw more reliable conclusions, more subjects should be collected and more experiments should be done in the future.
Collapse
Affiliation(s)
- Jing Gu
- Department of General Surgery, Cancer Center, Division of Hepatobiliary and Pancreatic Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang Province, China
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang Province, China
| | - Jie Cao
- Ningbo Chuangdao 3D Medical Technology Co., Ltd., Ningbo, 315336, Zhejiang Province, China
| | - Wenli Cao
- Department of General Surgery, Cancer Center, Division of Hepatobiliary and Pancreatic Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang Province, China
- Department of Public Health, Hangzhou Medical College, Hangzhou, 310059, Zhejiang Province, China
| | - Yusuo Chen
- Department of General Surgery, Cancer Center, Division of Hepatobiliary and Pancreatic Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang Province, China
- Department of Clinical Medicine, Hangzhou Medical College, Hangzhou, 310059, Zhejiang Province, China
| | - Fangqiang Wei
- Department of General Surgery, Cancer Center, Division of Hepatobiliary and Pancreatic Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang Province, China.
| |
Collapse
|
5
|
Hertz P, Rattenborg S, Haug TR, Houlind K, Konge L, Bjerrum F. Training and assessment for colorectal surgery and appendicectomy- a systematic review. Colorectal Dis 2024; 26:597-608. [PMID: 38396135 DOI: 10.1111/codi.16905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/07/2023] [Accepted: 12/28/2023] [Indexed: 02/25/2024]
Abstract
AIM There is currently an increased focus on competency-based training, in which training and assessment play a crucial role. The aim of this systematic review is to create an overview of hands-on training methods and assessment tools for appendicectomy and colon and rectal surgery procedures using either an open, laparoscopic or robot-assisted approach. METHOD A systematic review of Medline, Embase, Cochrane and Scopus databases was conducted following the PRISMA guidelines. We conducted the last search on 9 March 2023. All published papers describing hands-on training, evaluation of performance data and development of assessment tools were eligible. The quality of studies and the validity evidence of assessment tools are reported. RESULTS Fifty-one studies were identified. Laparoscopic assessment tools are abundant, but the literature still lacks good-quality assessment tools for open appendicectomy, robotic colectomy and open rectal surgery. Overall, there is a lack of discussion regarding the establishment of pass/fail standards and the consequences of assessment. Virtual reality simulation is used more for appendicectomy than colorectal procedures. Only a few of the studies investigating training were of acceptable quality. There is a need for high-quality studies in open and robotic-assisted colon surgery and all approaches to rectal surgery. CONCLUSION This review provides an overview of current training methods and assessment tools and identifies where more research is needed based on the quality of the studies and the current validity evidence.
Collapse
Affiliation(s)
- Peter Hertz
- Department of Surgery, Hospital Lillebaelt, University of Southern Denmark, Kolding, Denmark
- Department of Regional Health Research, University of Southern Denmark, Kolding, Denmark
- Copenhagen Academy for Medical Education and Simulation (CAMES), Center for HR and Education, Copenhagen, Denmark
| | - Søren Rattenborg
- Department of Regional Health Research, University of Southern Denmark, Kolding, Denmark
- Department of Surgery, Hospital Lillebaelt Vejle, Colorectal Cancer Center South, University of Southern Denmark DK, Kolding, Denmark
| | - Tora R Haug
- Department of Surgery, Gødstrup Hospital, Herning, Denmark
- Aarhus University, Aarhus, Denmark
| | - Kim Houlind
- Department of Regional Health Research, University of Southern Denmark, Kolding, Denmark
- Department of Vascular Surgery, Hospital Lillebaelt, University of Southern Denmark, Kolding, Denmark
| | - Lars Konge
- Copenhagen Academy for Medical Education and Simulation (CAMES), Center for HR and Education, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Flemming Bjerrum
- Copenhagen Academy for Medical Education and Simulation (CAMES), Center for HR and Education, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Gastrounit, Surgical Section, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark
| |
Collapse
|
6
|
Wczysla K, Sparn M, Schmied B, Hahnloser D, Bischofberger S. There is a need for a paradigm shift in laparoscopic surgical training: results of a nationwide survey among teaching hospitals in Switzerland. BMC MEDICAL EDUCATION 2024; 24:205. [PMID: 38413927 PMCID: PMC10900659 DOI: 10.1186/s12909-024-05209-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 02/21/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Surgical training curricula have changed little over the past decades. Current advances in surgical techniques, especially in minimally invasive surgery, as well as the rapidly changing socioeconomic environment pose a major challenge for the training of young surgeons. The aim of this survey was to provide a representative overview of the surgical training landscape in Switzerland focusing on laparoscopic surgical training: How do department chairs of teaching hospitals deal with the above challenges, and what should a future training curriculum look like? METHODS This is a prospective, questionnaire-based, cross-sectional study among the heads of departments of all certified surgical teaching hospitals in Switzerland. RESULTS The overall response rate was 56% (48/86) and 86% (19/22) for tertiary centers. Two-thirds of the centers (32) organize themselves in training networks. Laparoscopic training courses are offered in 25 (52%) hospitals, mainly in tertiary centers. Self-training opportunities exist in 40 (83%) hospitals. In addition to commercial (27) and self-built (7) box trainers, high-fidelity trainers are available in 16 (33%) hospitals. A mandatory training curriculum exists in 7 (15%) facilities, and a training assessment is performed in 15 (31%) institutions. Thirty-two (65%) heads of departments indicated that residents have sufficient practical exposure in the operating room, but the ability to work independently with obtaining the specialist title is seen critically (71%). They state that the surgical catalog does not adequately reflect the manual skills of the resident (64%). The desire is for training to be restructured from a numbers-based to a performance-based curriculum (53%) and for tools to assess residents' manual skills (56%) to be introduced. CONCLUSIONS Department chairs stated that the existing curriculum in Switzerland does not meet the requirements of a modern training curriculum. This study highlights the need to create an improved, competency-based curriculum that ensures the training of a new generation of surgeons, taking into account the growing evidence of the effectiveness of state-of-the-art training modalities such as simulation or proficiency-based training.
Collapse
Affiliation(s)
- Karolina Wczysla
- Department of Surgery, Kantonsspital St. Gallen, Rorschacher Strasse 95, CH-9007, St. Gallen, Switzerland
| | - Moritz Sparn
- Department of Surgery, Kantonsspital St. Gallen, Rorschacher Strasse 95, CH-9007, St. Gallen, Switzerland
| | - Bruno Schmied
- Department of Surgery, Kantonsspital St. Gallen, Rorschacher Strasse 95, CH-9007, St. Gallen, Switzerland
| | - Dieter Hahnloser
- Department of Surgery, Centre Hôpitalier Universitaire Vaudois, CH-1011, Lausanne, Switzerland
| | - Stephan Bischofberger
- Department of Surgery, Kantonsspital St. Gallen, Rorschacher Strasse 95, CH-9007, St. Gallen, Switzerland.
| |
Collapse
|
7
|
Kronborg SH, Karbing DS, Arshad A, Lundgaard AC. Four different models for simulation-based training of bronchoscopic procedures. BMC Pulm Med 2024; 24:23. [PMID: 38195463 PMCID: PMC10777524 DOI: 10.1186/s12890-024-02846-9] [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] [Received: 06/08/2023] [Accepted: 01/04/2024] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Flexible bronchoscopy procedures require detailed anatomical knowledge and advanced technical skills. Simulation-based training offers a patient-safe training environment that can be more efficient than patient-based training. Physical models are cheaper than virtual reality simulators and allow trainees to be acquainted with the equipment used in the clinic. The choice of a physical model for training depends on the local context. The aim of this study was to compare four different bronchoscopy models for flexible bronchoscopy training. METHODS The BronchoBoy manikin, the Koken manikin, a human cadaver, and a preserved porcine lung were included in the study. Seven physicians experienced in bronchoscopy performed a bronchoscopic airway inspection, bronchoalveolar lavage (BAL), and tissue sampling on all four models with performance evaluated by observation and participant evaluation of models by questionnaire. RESULTS Nineteen segments were identified in all human anatomy models, and the only significant difference found was that only the Thiel embedded cadaver allowed all participants to enter RB1 with an instrument in the working channel (p = 0.001). The Thiel embedded cadaver and the BronchoBoy manikin had low fluid return on BAL (22 and 52 ml), whereas the Koken manikin and the preserved porcine lung had high return (132 and 134 ml), (p = 0.017). Tissue samplings were only completed in the preserved porcine lung and the Thiel embedded cadaver (p < 0.001). CONCLUSIONS An anatomically correct bronchoscopy is best simulated with the Koken manikin or the Thiel embedded cadaver. Bronchoalveolar lavage should be simulated with the Koken manikin or the preserved porcine lung. Tissue sampling procedures are best simulated using the Thiel embedded cadaver or the preserved porcine lung.
Collapse
Affiliation(s)
- Sissel Højsted Kronborg
- Global Clinical Affairs, Clinical Application, Ambu A/S, Baltorpbakken 13, Ballerup, 2750, Denmark.
- Department of Health Science and Technology, Aalborg University, Selma Lagerløfs Vej 249, Gistrup, 9260, Denmark.
| | - Dan Stieper Karbing
- Department of Health Science and Technology, Aalborg University, Selma Lagerløfs Vej 249, Gistrup, 9260, Denmark
| | - Arman Arshad
- Department of Respiratory Medicine, Odense University Hospital, J. B. Winsløvs Vej 4, Odense, Denmark
| | - Anna Charlotte Lundgaard
- Global Clinical Affairs, Clinical Application, Ambu A/S, Baltorpbakken 13, Ballerup, 2750, Denmark
| |
Collapse
|
8
|
Zhang X, Wang Z, Sun W, Mukherjee M. Real-time non-uniform surface refinement model for lung adenocarcinoma surgery. Med Biol Eng Comput 2024; 62:183-193. [PMID: 37755619 DOI: 10.1007/s11517-023-02924-w] [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] [Received: 03/22/2023] [Accepted: 09/01/2023] [Indexed: 09/28/2023]
Abstract
Soft tissue models play a crucial role in virtual surgery. However, most existing methods use uniform meshes and overall refinement to construct inhomogeneous soft tissues for virtual lungs. This leads to a complex computation and poor model realism. Therefore, a real-time non-uniform surface refinement model (RNSM) for lung adenocarcinoma surgery is proposed in this paper. First, to better describe the inhomogeneous soft tissues, the tetrahedra are subdivided to different degrees depending on their densities, which reduce the model's complexity while ensuring accuracy. Second, to improve the model accuracy, the model surface is subdivided using the Loop subdivision method. Finally, an optimal algorithm based on deformation radius is designed to enhance the deformation in real-time, in which a linear attenuation method of physical quantities is used to simulate the deformation of the weak deformation regions directly, and the finite element method (FEM) is used for the strong deformation regions. The experimental results show that the model is more accurate and faster than the existing soft tissue models for lung adenocarcinoma surgery simulation.
Collapse
Affiliation(s)
- Xiaorui Zhang
- Engineering Research Center of Digital Forensics, Jiangsu Engineering Center of Network Monitoring, School of Computer and Software, Ministry of Education, Nanjing University of Information Science & Technology, Nanjing, 210044, China.
- College of Computer and Information Engineering, Nanjing Tech University, Nanjing, 211816, China.
- Jiangsu Collaborative Innovation Center of Atmospheric Environment and Equipment Technology (CICAEET), Nanjing University of Information Science & Technology, Nanjing, 210044, China.
- School of Automation, Nanjing University of Information Science & Technology, Nanjing, 210044, China.
| | - Zhaoming Wang
- Engineering Research Center of Digital Forensics, Jiangsu Engineering Center of Network Monitoring, School of Computer and Software, Ministry of Education, Nanjing University of Information Science & Technology, Nanjing, 210044, China
- School of Automation, Nanjing University of Information Science & Technology, Nanjing, 210044, China
| | - Wei Sun
- College of Computer and Information Engineering, Nanjing Tech University, Nanjing, 211816, China
- Jiangsu Collaborative Innovation Center of Atmospheric Environment and Equipment Technology (CICAEET), Nanjing University of Information Science & Technology, Nanjing, 210044, China
- School of Automation, Nanjing University of Information Science & Technology, Nanjing, 210044, China
| | - Mithun Mukherjee
- School of Automation, Nanjing University of Information Science & Technology, Nanjing, 210044, China
- School of Artificial Intelligence, Nanjing University of Information Science & Technology, Nanjing, 210044, China
| |
Collapse
|
9
|
Xia J, Wu J, Chen H, Mao J, Xu X, Zhang J, Yang J, Wang Z. Assessment of laparoscopic intracorporeal intestinal anastomosis training using simulation-based 3D printed models: exploring surgical performance and learning curves. Int J Surg 2023; 109:2953-2961. [PMID: 37498142 PMCID: PMC10583936 DOI: 10.1097/js9.0000000000000582] [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: 04/23/2023] [Accepted: 06/25/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND AND AIMS Intestinal anastomosis is a clinical procedure widely used to reconstruct the digestive tract, but authentic laparoscopic intracorporeal intestinal anastomosis (LIIA) models are lacking. However, three-dimensional (3D) printing can enable authentic and reusable models. In this paper, a novel cost-effective 3D-printing training model of LIIA is designed and the authenticity and validity of the model are tested. METHODS A fused deposition modeling 3D printing and an assembled lab model were built to test LIIA. Fifteen surgeons were required to perform LIIA, and their operation score and time were recorded and analyzed. Five experts were invited to assess the face and content validity of the models. A study was also performed to further evaluate and validate the learning curve of surgeons. RESULTS The difference in modified anastomosis objective structured assessment of technical skills (MAOSATS) scores between the expert, intermediate, and novice groups were significant (64.1±1.8: 48.5±1.7: 29.5±3.1, P <0.001). In addition, the operation time of the procedure was statistically different for all three groups (21.5±1.9: 30.6±2.8:70.7±4.0, P<0.001 ). The five experts rated the face and content validity of the model very highly, with the median being four out of five. Surgeons who underwent repeated training programs showed improved surgical performance. After eight training sessions, the novices' performance was similar to that of the average level of untrained intermediates, while the operation scores of the intermediates were close to that of the average level of experts. CONCLUSIONS In this study, it is found that the LIIA model exhibits excellent face, content, and construct validity. Repeated simulation training of the LIIA training program improved the surgeon's operative performance, so the model is considered one of the most effective methods for LIIA training and assessment of surgical quality in the future and for reducing healthcare costs.
Collapse
Affiliation(s)
- Jianfu Xia
- Department of General Surgery, The Dingli Clinical College of Wenzhou Medical University, Wenzhou Central Hospital, Wenzhou
- Department of Clinical Medicine, Suzhou Medical College of Soochow University, Suzhou
- Department of Hernia Surgery, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Junjie Wu
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Hao Chen
- The Second Clinical Medical College, Zhejiang Chinese Medical University
| | - Jinlei Mao
- The Second Clinical Medical College, Zhejiang Chinese Medical University
| | - Xiaodong Xu
- College of Materials Science and Engineering, Zhejiang University of Technology
| | - Jing Zhang
- College of Materials Science and Engineering, Zhejiang University of Technology
| | - Jin Yang
- Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Zhifei Wang
- Department of Hernia Surgery, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| |
Collapse
|
10
|
Kaplan N, Marques M, Scharf I, Yang K, Alkureishi L, Purnell C, Patel P, Zhao L. Virtual Reality and Augmented Reality in Plastic and Craniomaxillofacial Surgery: A Scoping Review. Bioengineering (Basel) 2023; 10:bioengineering10040480. [PMID: 37106667 PMCID: PMC10136227 DOI: 10.3390/bioengineering10040480] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
Virtual reality (VR) and augmented reality (AR) have evolved since their introduction to medicine in the 1990s. More powerful software, the miniaturization of hardware, and greater accessibility and affordability enabled novel applications of such virtual tools in surgical practice. This scoping review aims to conduct a comprehensive analysis of the literature by including all articles between 2018 and 2021 pertaining to VR and AR and their use by plastic and craniofacial surgeons in a clinician-as-user, patient-specific manner. From the initial 1637 articles, 10 were eligible for final review. These discussed a variety of clinical applications: perforator flaps reconstruction, mastectomy reconstruction, lymphovenous anastomosis, metopic craniosynostosis, dermal filler injection, auricular reconstruction, facial vascularized composite allotransplantation, and facial artery mapping. More than half (60%) involved VR/AR use intraoperatively with the remainder (40%) examining preoperative use. The hardware used predominantly comprised HoloLens (40%) and smartphones (40%). In total, 9/10 Studies utilized an AR platform. This review found consensus that VR/AR in plastic and craniomaxillofacial surgery has been used to enhance surgeons' knowledge of patient-specific anatomy and potentially facilitated decreased intraoperative time via preoperative planning. However, further outcome-focused research is required to better establish the usability of this technology in everyday practice.
Collapse
Affiliation(s)
- Nicolas Kaplan
- Division of Plastic, Reconstructive and Cosmetic Surgery, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Mitchell Marques
- Division of Plastic, Reconstructive and Cosmetic Surgery, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Isabel Scharf
- Division of Plastic, Reconstructive and Cosmetic Surgery, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Kevin Yang
- The Craniofacial Center, Division of Plastic, Reconstructive, and Cosmetic Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Lee Alkureishi
- The Craniofacial Center, Division of Plastic, Reconstructive, and Cosmetic Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA
- Shriners Children's Chicago Hospital, Chicago, IL 60707, USA
| | - Chad Purnell
- The Craniofacial Center, Division of Plastic, Reconstructive, and Cosmetic Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA
- Shriners Children's Chicago Hospital, Chicago, IL 60707, USA
| | - Pravin Patel
- The Craniofacial Center, Division of Plastic, Reconstructive, and Cosmetic Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA
- Shriners Children's Chicago Hospital, Chicago, IL 60707, USA
| | - Linping Zhao
- The Craniofacial Center, Division of Plastic, Reconstructive, and Cosmetic Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA
- Shriners Children's Chicago Hospital, Chicago, IL 60707, USA
| |
Collapse
|
11
|
Lee S, Shetty AS, Cavuoto L. Modeling of Learning Processes Using Continuous-Time Markov Chain for Virtual-Reality-Based Surgical Training in Laparoscopic Surgery. IEEE TRANSACTIONS ON LEARNING TECHNOLOGIES 2023; 17:462-473. [PMID: 38617582 PMCID: PMC11013959 DOI: 10.1109/tlt.2023.3236899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Recent usage of Virtual Reality (VR) technology in surgical training has emerged because of its cost-effectiveness, time savings, and cognition-based feedback generation. However, the quantitative evaluation of its effectiveness in training is still not studied thoroughly. This paper demonstrates the effectiveness of a VR-based surgical training simulator in laparoscopic surgery and investigates how stochastic modeling represented as Continuous-time Markov-chain (CTMC) can be used to explicit the training status of the surgeon. By comparing the training in real environments and in VR-based training simulators, the authors also explore the validity of the VR simulator in laparoscopic surgery. The study further aids in establishing learning models of surgeons, supporting continuous evaluation of training processes for the derivation of real-time feedback by CTMC-based modeling.
Collapse
Affiliation(s)
- Seunghan Lee
- Industrial and Systems Engineering Department at Mississippi State University
| | | | - Lora Cavuoto
- Industrial and Systems Engineering at the University at Buffalo, Buffalo, NY, USA
| |
Collapse
|
12
|
Balla A, Sartori A, Botteri E, Podda M, Ortenzi M, Silecchia G, Guerrieri M, Agresta F. Augmented reality (AR) in minimally invasive surgery (MIS) training: where are we now in Italy? The Italian Society of Endoscopic Surgery (SICE) ARMIS survey. Updates Surg 2023; 75:85-93. [PMID: 36131182 DOI: 10.1007/s13304-022-01383-6] [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: 06/17/2022] [Accepted: 09/12/2022] [Indexed: 01/19/2023]
Abstract
Minimally invasive surgery (MIS) is a widespread approach in general surgery. Computer guiding software, such as the augmented reality (AR), the virtual reality (VR) and mixed reality (MR), has been proposed to help surgeons during MIS. This study aims to report these technologies' current knowledge and diffusion during surgical training in Italy. A web-based survey was developed under the aegis of the Italian Society of Endoscopic Surgery (SICE). Two hundred and seventeen medical doctors' answers were analyzed. Participants were surgeons (138, 63.6%) and residents in surgery (79, 36.4%). The mean knowledge of the role of the VR, AR and MR in surgery was 4.9 ± 2.4 (range 1-10). Most of the participants (122, 56.2%) did not have experience with any proposed technologies. However, although the lack of experience in this field, the answers about the functioning of the technologies were correct in most cases. Most of the participants answered that VR, AR and MR should be used more frequently for the teaching and training and during the clinical activity (170, 80.3%) and that such technologies would make a significant contribution, especially in training (183, 84.3%) and didactic (156, 71.9%). Finally, the main limitations to the diffusion of these technologies were the insufficient knowledge (182, 83.9%) and costs (175, 80.6%). Based on the present study, in Italy, the knowledge and dissemination of these technologies are still limited. Further studies are required to establish the usefulness of AR, VR and MR in surgical training.
Collapse
Affiliation(s)
- Andrea Balla
- UOC of General and Minimally Invasive Surgery, Hospital "San Paolo", Largo Donatori del Sangue 1, 00053, Rome, Civitavecchia, Italy.
| | - Alberto Sartori
- Department of General Surgery, Ospedale Di Montebelluna, Via Palmiro Togliatti, 16, 31044, Montebelluna, Treviso, Italy
| | - Emanuele Botteri
- General Surgery, ASST Spedali Civili Di Brescia PO Montichiari, Via Boccalera 325018, Montichiari, Brescia, Italy
| | - Mauro Podda
- Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Monica Ortenzi
- Department of General Surgery, Università Politecnica Delle Marche, Piazza Roma 22, 60121, Ancona, Italy
| | - Gianfranco Silecchia
- Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, "La Sapienza" University of Rome-Polo Pontino, Bariatric Centre of Excellence IFSO-EC, Rome, Italy
| | - Mario Guerrieri
- Department of General Surgery, Università Politecnica Delle Marche, Piazza Roma 22, 60121, Ancona, Italy
| | - Ferdinando Agresta
- Department of General Surgery, AULSS2 Trevigiana del Veneto, Hospital of Vittorio Veneto, Vittorio Veneto, Treviso, Italy
| | | |
Collapse
|
13
|
Cioffi SPB, Granieri S, Scaravilli L, Molteni M, Altomare M, Spota A, Virdis F, Bini R, Renzi F, Reitano E, Ragozzino R, Gupta S, Chiara O, Cimbanassi S, Albanesi F, Altomare M, Andreatta E, Baldari L, Benuzzi L, Bevilaqua E, Bonomi AM, Brachetti G, Cannavale G, Chierici AP, Cioffi SPB, Cirelli R, Colletti G, D’abrosca V, Danelli P, Del Prete L, Di Capua F, Di Vittorio F, Ferrari D, Ferrario L, Fiore L, Frattaruol C, Froiio C, Gibelli L, Giusti I, Giustizieri U, Grandi S, Granieri S, Iacob G, Kersik A, Lombardi P, Longhi M, Lorusso L, Manara M, Manzo E, Marin JN, Maspero M, Messina V, Milito P, Molteni M, Monti E, Nicastro V, Novelli G, Paleino S, Pavesi S, Perali C, Pezzoli I, Ragozzino R, Santolamazza G, Scaravilli L, Spota A, Tornatore G, Toti F, Tripodi V, Vaterlini E, Vignati B. Surgeons' attitudes during laparoscopic appendectomy: do subjective intraoperative assessments affect the choice of peritoneal irrigation? A spin-off analysis from the REsiDENT-1 multicentre prospective observational trial. Surg Endosc 2023; 37:729-740. [PMID: 36307601 DOI: 10.1007/s00464-022-09674-0] [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: 05/12/2022] [Accepted: 09/24/2022] [Indexed: 01/18/2023]
Abstract
AIMS Laparoscopic appendectomy (LA) for acute appendicitis (AA) is one of the most performed procedures. The effects of peritoneal lavage (PL) and the reasons to perform it have not been cleared and all meta-analyses didn't show a statistical advantage to prevent infectious complications. This study aims to investigate surgeons' perceptions during LA, comparing intraoperative findings with histological results, and exploring how surgeons' subjectivity influences the decision-making process on PL. METHODS Data were extracted from the two-year data lock from REsiDENT-1 registry, a prospective resident-led multicentre observational trial. This study investigates the relationships between PL and postoperative intraabdominal abscesses (pIAA) introducing a classification for AA to standardize the intraoperative grading. We included pre, intra, and postoperative variables. We applied our classification proposal, used a five-point Likert scale (Ls) to assess subjective LA difficulty and ran a concordance analysis between the assessment of AA and histology. Subsequently, a multivariate logistic regression model was built to find factors influencing PL. RESULTS 561 patients were enrolled from twenty-one hospitals and 51 residents. 542 procedures were included in the logistic regression analysis and 441 in the concordance analysis, due to missing data. PL was used in 222 LA (39, 6%). We discovered a moderate positive monotonic relationship between surgical evaluation and histology, p < 0.001. Despite this, the reliability of the surgeon's assessment of appendicitis is progressively lower for gangrenous and perforated forms. The increasing grade of contamination, the increasing grade of subjective difficulty and the intraoperative finding of a gangrenous or perforated appendicitis were independent predictors of PL. CONCLUSION This study shows how surgeons' evaluation of AA severity overestimated more than half of gangrenous or perforated appendices with the perception of a challenging procedure. These perceptions influenced the choice of PL. We proved that the evaluation during LA could be affected by subjectivity with a non-negligible impact on the decision-making process.
Collapse
Affiliation(s)
- Stefano Piero Bernardo Cioffi
- General Surgery and Trauma Team, ASST GOM Niguarda, Milano, Piazza Ospedale Maggiore 3, 20162, Milan, Italy. .,Department of Surgical Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
| | - Stefano Granieri
- General Surgery Unit, ASST Vimercate, Via Santi Cosma e Damiano 16, 20871, Vimercate, Italy
| | - Luca Scaravilli
- General Surgery and Trauma Team, ASST GOM Niguarda, Milano, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.,General Surgery Residency Program, University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy
| | - Mattia Molteni
- General Surgery and Trauma Team, ASST GOM Niguarda, Milano, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.,General Surgery Residency Program, San Raffaele Hospital University, Via Olgettina 60, 20132, Milan, Italy
| | - Michele Altomare
- General Surgery and Trauma Team, ASST GOM Niguarda, Milano, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.,Department of Surgical Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Andrea Spota
- General Surgery and Trauma Team, ASST GOM Niguarda, Milano, Piazza Ospedale Maggiore 3, 20162, Milan, Italy
| | - Francesco Virdis
- General Surgery and Trauma Team, ASST GOM Niguarda, Milano, Piazza Ospedale Maggiore 3, 20162, Milan, Italy
| | - Roberto Bini
- General Surgery and Trauma Team, ASST GOM Niguarda, Milano, Piazza Ospedale Maggiore 3, 20162, Milan, Italy
| | - Federica Renzi
- General Surgery and Trauma Team, ASST GOM Niguarda, Milano, Piazza Ospedale Maggiore 3, 20162, Milan, Italy
| | - Elisa Reitano
- IRCAD Research Institute Against Digestive Cancer, Strasbourg, France
| | - Roberta Ragozzino
- General Surgery and Trauma Team, ASST GOM Niguarda, Milano, Piazza Ospedale Maggiore 3, 20162, Milan, Italy
| | - Shailvi Gupta
- University of Maryland, Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - Osvaldo Chiara
- General Surgery and Trauma Team, ASST GOM Niguarda, Milano, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.,Department of Pathophysiology and Transplants, University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy
| | - Stefania Cimbanassi
- General Surgery and Trauma Team, ASST GOM Niguarda, Milano, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.,Department of Pathophysiology and Transplants, University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Leitzke FB, Teivelis MP, Matos LL, Wolosker N, Szor DJ. Evaluation of laparoscopic skills in medical students. EINSTEIN-SAO PAULO 2022; 20:eAO0091. [DOI: 10.31744/einstein_journal/2022ao0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/23/2022] [Indexed: 11/13/2022] Open
|
15
|
Virtual Immersion into a Poorly-Managed Medical Crisis Worsens Subsequent Performance: A Randomized, Controlled Trial. Clin Simul Nurs 2022. [DOI: 10.1016/j.ecns.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
16
|
Khatkar H, Ferro A, Kotecha S, Prokopenko M, Evans A, Kyriakides J, Botterill J, Sangha MS, See A, Kerstein R. Assessing the attitude of surgical trainees towards virtual reality simulation: A national cross-sectional questionnaire study. Scott Med J 2022; 67:87-92. [PMID: 35637548 DOI: 10.1177/00369330221103279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND We performed a cross sectional study to determine the attitudes of surgical trainees and medical students towards virtual reality (VR) simulation in surgical training. A survey was devised through an iterative process before distribution to surgical trainees, foundation year doctors and medical students through online platforms. METHODS The survey was disseminated within the United Kingdom through social media and email correspondence, in co-operation with national surgical organisations. 91 trainees responded from a variety of clinical specialities. RESULTS VR technology in surgical training was viewed positively, with 91.3% of trainees agreeing that VR should be both an adjunct in surgical training as well as a competency-based assessment tool. Barriers to access were present, with access notably more challenging for senior surgeons. CONCLUSION Virtual reality surgical simulation in surgical training is beginning to emerge as a genuine high-fidelity, low-risk solution to the lack of surgical case volume trainees are currently experiencing.
Collapse
Affiliation(s)
- Harman Khatkar
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, Oxford, UK
| | - Ashley Ferro
- 8948Kings College Hospital NHS Trust, London, UK
| | | | | | - Ashish Evans
- 6397Oxford University Hospitals NHS Trust, Oxford, UK
| | | | | | | | - Abbas See
- 6084Northampton NHS Trust, Northampton, UK
| | - Ryan Kerstein
- 156485Queen Victoria Hospital NHS Trust, East Grinstead, UK
| |
Collapse
|
17
|
Mantica G, Leonardi R, Diaz R, Malinaric R, Parodi S, Tappero S, Paraboschi I, Álvarez-Maestro M, Yuen-Chun Teoh J, Garriboli M, Ortega Polledo LE, Soriero D, Pertile D, De Marchi D, Pini GL, Rigatti L, Ghosh SK, Akanji Onigbinde O, Tafuri A, M Carrion D, Nikles S, Antoni A, Fransvea P, Esperto F, Herbella FA, Oxley da Rocha A, Vanaclocha V, Sánchez-Guillén L, Wainman B, Quiroga-Garza A, Fregatti P, Murelli F, Van der Merwe A, Rivas JG, Terrone C. Reporting ChAracteristics of cadaver training and sUrgical studies: The CACTUS guidelines. Int J Surg 2022; 101:106619. [DOI: 10.1016/j.ijsu.2022.106619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/17/2022] [Accepted: 04/08/2022] [Indexed: 11/10/2022]
|
18
|
Bordeleau M, Stamenkovic A, Tardif PA, Thomas J. The Use of Virtual Reality in Back Pain Rehabilitation: A Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2021; 23:175-195. [PMID: 34425250 DOI: 10.1016/j.jpain.2021.08.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/08/2021] [Accepted: 08/11/2021] [Indexed: 12/14/2022]
Abstract
This systematic review aimed to synthesize the existing evidence of extended reality (XR) on pain and motor function outcomes in patients with back pain. Following the Cochrane guidelines, relevant articles of any language were selected by 2 independent reviewers from CINAHL, Cochrane, Embase, Medline and Web of Knowledge databases. Of 2,050 unique citations, 24 articles were included in our review. These studies included a total of 900 back pain patients. Despite broader XR search, all interventions were virtual reality (VR) based and involved physical exercises (n = 17, 71%), hippotherapy (n = 4, 17%), motor imagery (n = 1, 4%), distraction (n = 1, 4%), and cognitive-behavior therapy (n = 1, 4%). Sixteen controlled studies were included in a meta-analysis which suggested that VR provides a significant improvement in terms of back pain intensity over control interventions (Mean Difference: -0.67; 95% CI: -1.12 to -0.23; I2 = 85%). Almost all included studies presented high risk of bias, highlighting the need to improve methodology in the examination of VR interventions. While the specific set of studies showed high heterogeneity across several methodological factors, a tentative conclusion could be drawn that VR was effective improving back pain intensity and tends to have a positive effect on improving other pain outcomes and motion function. PERSPECTIVE: Extended reality technologies have appeared as interesting nonpharmacological options for the treatment of back pain, with the potential to minimise the need for opioid medications. Our systematic review summarised existing applications of extended reality for back pain and proposed a few recommendations to direct further studies in the field.
Collapse
Affiliation(s)
- Martine Bordeleau
- Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre hospitalier universitaire de Sherbrooke (CIUSSS de l'Estrie - CHUS), Sherbrooke, Quebec, Canada.
| | - Alexander Stamenkovic
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, Virginia
| | - Pier-Alexandre Tardif
- Population Health and Optimal Health Practices Unit, Trauma-Emergency-Critical Care Medicine, CHU de Québec-Université Laval Research Center, Université Laval, Quebec City, Quebec, Canada
| | - James Thomas
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, Virginia
| |
Collapse
|
19
|
Taba JV, Cortez VS, Moraes WA, Iuamoto LR, Hsing WT, Suzuki MO, do Nascimento FS, Pipek LZ, de Mattos VC, D’Albuquerque EC, Carneiro-D’Albuquerque LA, Meyer A, Andraus W. The development of laparoscopic skills using virtual reality simulations: A systematic review. PLoS One 2021; 16:e0252609. [PMID: 34138901 PMCID: PMC8211221 DOI: 10.1371/journal.pone.0252609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 05/18/2021] [Indexed: 11/30/2022] Open
Abstract
Background Teaching based on virtual reality simulators in medicine has expanded in recent years due to the limitations of more traditional methods, especially for surgical procedures such as laparoscopy. Purpose of review To analyze the effects of using virtual reality simulations on the development of laparoscopic skills in medical students and physicians. Data sources The literature screening was done in April 2020 through Medline (PubMed), EMBASE and Database of the National Institute of Health. Eligibility criteria Randomized clinical trials that subjected medical students and physicians to training in laparoscopic skills in virtual reality simulators. Study appraisal Paired reviewers independently identified 1529 articles and included 7 trials that met the eligibility criteria. Findings In all studies, participants that trained in virtual simulators showed improvements in laparoscopic skills, although the articles that also had a physical model training group did not show better performance of one model compared to the other. Limitations No article beyond 2015 met the eligibility criteria, and the analyzed simulators have different versions and models, which might impact the results. Conclusion Virtual reality simulators are useful educational tools, but do not show proven significant advantages over traditional models. The lack of standardization and a scarcity of articles makes comparative analysis between simulators difficult, requiring more research in the area, according to the model suggested in this review. Systematic review registration number Registered by the Prospective Register of Systematic Reviews (PROSPERO), identification code CRD42020176479.
Collapse
Affiliation(s)
- João Victor Taba
- Faculty of Medicine FMUSP, University of São Paulo, São Paulo, SP, Brazil
| | | | | | - Leandro Ryuchi Iuamoto
- Center of Acupuncture, Department of Orthopaedics and Traumatology, University of São Paulo, São Paulo, SP, Brazil
| | - Wu Tu Hsing
- Center of Acupuncture, Department of Orthopaedics and Traumatology, University of São Paulo, São Paulo, SP, Brazil
| | | | | | | | | | | | | | - Alberto Meyer
- Department of Gastroenterology, Hospital das Clínicas, HCFMUSP, São Paulo, SP, Brazil
- * E-mail:
| | - Wellington Andraus
- Department of Gastroenterology, Hospital das Clínicas, HCFMUSP, São Paulo, SP, Brazil
| |
Collapse
|
20
|
Andrés de León Caez K, García Paredes JJ, Escobar Pacheco CA, Ortega Sierra MG, Lozada-Martínez ID. A commentary on "The application of virtual reality in the training of laparoscopic surgery: A systematic review and meta-analysis" (Int J Surg; 87:105859). Int J Surg 2021; 89:105959. [PMID: 33930568 DOI: 10.1016/j.ijsu.2021.105959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 10/21/2022]
Affiliation(s)
| | | | | | | | - Ivan David Lozada-Martínez
- Medical and Surgical Research Center, School of Medicine, University of Cartagena, Cra. 50 #24-120, Cartagena, Colombia.
| |
Collapse
|
21
|
A commentary on "The application of virtual reality in the training of laparoscopic surgery: A systematic review and meta-analysis" [Int. J. Surg. Epub ahead of print]. Int J Surg 2021; 87:105905. [PMID: 33647450 DOI: 10.1016/j.ijsu.2021.105905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 02/19/2021] [Indexed: 11/22/2022]
|