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Alsowaina KN, Atashzar SF, Pur DR, Eagleson R, Patel RV, Elnahas AI, Hawel JD, Alkhamesi NA, Schlachta CM. Video Context Improves Performance in Identifying Operative Planes on Static Surgical Images. JOURNAL OF SURGICAL EDUCATION 2022; 79:492-499. [PMID: 34702691 DOI: 10.1016/j.jsurg.2021.10.004] [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: 06/25/2021] [Revised: 09/10/2021] [Accepted: 10/03/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Correct identification of the surgical tissue planes of dissection is paramount at the operating room, and the needed skills seem to be improved with realistic dynamic models rather than mere still images. The objective is to assess the role of adding video prequels to still images taken from operations on the precision and accuracy of tissue plane identification using a validated simulation model, considering various levels of surgeons' experience. METHODS A prospective observational study was conducted involving 15 surgeons distributed to three equal groups, including a consultant group [C], a senior group [S], and a junior group [J]. Subjects were asked to identify and draw ideal tissue planes in 20 images selected at suitable operative moments of identification before and after showing a 10- second videoclip preceding the still image. A validated comparative metric (using a modified Hausdorff distance [%Hdu] for object matching) was used to measure the distance between lines. A precision analysis was carried out based on the difference in %Hdu between lines drawn before and after watching the videos, and between-group comparisons were analyzed using a one-way analysis of variance (ANOVA). The analysis of accuracy was done on the difference in %Hdu between lines drawn by the subjects and the ideal lines provided by an expert panel. The impact of videos on accuracy was assessed using a repeated-measures ANOVA. RESULTS The C group showed the highest preciseness as compared to the S and J groups (mean Hdu 9.17±11.86 versus 12.1±15.5 and 20.0±18.32, respectively, p <0.001) and significant differences between groups were found in 14 images (70%). Considering the expert panel as a reference, the interaction between time and experience level was significant ( F (2, 597) = 4.52, p <0.001). Although the subjects of the J group were significantly less accurate than other surgeons, only this group showed significant improvements in mean %Hdu values after watching the lead-in videos ( F (1, 597) = 6.04, p = 0.014). CONCLUSIONS Adding video context improved the ability of junior trainees to identify tissue planes of dissection. A realistic model is recommended considering experience-based differences in precision in training programs.
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Affiliation(s)
- Khalid N Alsowaina
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), London, Ontario, Canada; Department of Surgery, Western University, London, Ontario, Canada
| | - Seyed F Atashzar
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), London, Ontario, Canada; Department of Electrical and Computer Engineering, Western University, London, Ontario, Canada
| | - Daiana R Pur
- Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
| | - Roy Eagleson
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), London, Ontario, Canada; Department of Surgery, Western University, London, Ontario, Canada
| | - Rajni V Patel
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), London, Ontario, Canada; Department of Electrical and Computer Engineering, Western University, London, Ontario, Canada
| | - Ahmad I Elnahas
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), London, Ontario, Canada; Department of Surgery, Western University, London, Ontario, Canada
| | - Jeffrey D Hawel
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), London, Ontario, Canada; Department of Surgery, Western University, London, Ontario, Canada
| | - Nawar A Alkhamesi
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), London, Ontario, Canada; Department of Surgery, Western University, London, Ontario, Canada
| | - Christopher M Schlachta
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), London, Ontario, Canada; Department of Surgery, Western University, London, Ontario, Canada
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Sommer GM, Broschewitz J, Huppert S, Sommer CG, Jahn N, Jansen-Winkeln B, Gockel I, Hau HM. The role of virtual reality simulation in surgical training in the light of COVID-19 pandemic: Visual spatial ability as a predictor for improved surgical performance: a randomized trial. Medicine (Baltimore) 2021; 100:e27844. [PMID: 34918632 PMCID: PMC8677906 DOI: 10.1097/md.0000000000027844] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 10/25/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Due to the current COVID-19 pandemic, surgical training has become increasingly challenging due to required social distancing. Therefore, the use of virtual reality (VR)-simulation could be a helpful tool for imparting surgical skills, especially in minimally invasive environments. Visual spatial ability (VSA) might influence the learning curve for laparoscopic surgical skills. However, little is known about the influence of VSA for surgical novices on VR-simulator training regarding the complexity of different tasks over a long-term training period. Our study evaluated prior VSA and VSA development in surgical trainees during VR-simulator training, and its influence on surgical performance in simulator training. METHODS In our single-center prospective two-arm randomized trial, VSA was measured with a tube figure test before curriculum training. After 1:1 randomization, the training group (TG) participated in the entire curriculum training consisting of 48 different VR-simulator tasks with varying difficulty over a continuous nine-day training session. The control group (CG) performed two of these tasks on day 1 and 9. Correlation and regression analyses were used to assess the influence of VSA on VR-related surgical skills and to measure procedural abilities. RESULTS Sixty students (33 women) were included. Significant improvements in the TG in surgical performance and faster completion times were observed from days 1 to 9 for the scope orientation 30° right-handed (SOR), and cholecystectomy dissection tasks after the structured 9-day training program. After training, the TG with pre-existing low VSA scores achieved performance levels similar to those with pre-existing high VSA scores for the two VR simulator tasks. Significant correlations between VSA and surgical performance on complex laparoscopic camera navigation SOR tasks were found before training. CONCLUSIONS Our study revealed that that all trainees improved their surgical skills irrespective of previous VSA during structured VR simulator training. An increase in VSA resulted in improvements in surgical performance and training progress, which was more distinct in complex simulator tasks. Further, we demonstrated a positive relationship between VSA and surgical performance of the TG, especially at the beginning of training. Our results identified pre-existing levels of VSA as a predictor of surgical performance.
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Affiliation(s)
- Guillermo Marcos Sommer
- Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital of Leipzig, Germany
| | - Johannes Broschewitz
- Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital of Leipzig, Germany
| | - Sabine Huppert
- Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital of Leipzig, Germany
| | - Christina Gesine Sommer
- Department of National Competency Center for Shared Decision Making, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Nora Jahn
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Boris Jansen-Winkeln
- Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital of Leipzig, Germany
| | - Ines Gockel
- Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital of Leipzig, Germany
| | - Hans-Michael Hau
- Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital of Leipzig, Germany
- Department of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Mason EM, Deal MJ, Richey BP, Baker A, Zeini IM, Service BC, Osbahr DC. Innate Arthroscopic & Laparoscopic Surgical Skills: A Systematic Review of Predictive Performance Indicators Within Novice Surgical Trainees. JOURNAL OF SURGICAL EDUCATION 2021; 78:178-200. [PMID: 32591323 DOI: 10.1016/j.jsurg.2020.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 05/11/2020] [Accepted: 06/04/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To query the literature for predictive factors for performance on arthroscopic and laparoscopic surgical simulators in novice surgical trainees. These predictive factors may prove a valuable tool in identifying certain innate potential to becoming a future skilled surgeon that could benefit both surgical residency candidates and program directors alike, while also improving patient care. DESIGN Systematic Review. RESULTS The initial searches yielded 249 articles. After screening titles/abstracts and implementing inclusion and exclusion criteria, 36 studies were included in the final systematic review. CONCLUSIONS Current literature suggests that video game experience/frequency, psychomotor and visuospatial aptitude, and perceptual ability are among the most promising predictive indicators of baseline simulator performance. Study limitations include utilization of different standards for characterizing predictive factors. Future studies should aim to utilize standard guidelines for accurate quantification of innate predictive factors. Future research should also focus on utilizing standardized simulator platforms and aptitude tests to allow for more accurate cross-study comparisons and meta-analyses with larger sample sizes.
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Affiliation(s)
- Eric M Mason
- University of Central Florida College of Medicine, Orlando, Florida
| | | | - Bradley P Richey
- University of Central Florida College of Medicine, Orlando, Florida
| | - Alexandra Baker
- University of Central Florida College of Medicine, Orlando, Florida
| | | | - Benjamin C Service
- Sports Medicine Division, Orlando Health Orthopedic Institute, Orlando, Florida
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Kalun P, Dunn K, Wagner N, Pulakunta T, Sonnadara R. Recent evidence on visual-spatial ability in surgical education: A scoping review. CANADIAN MEDICAL EDUCATION JOURNAL 2020; 11:e111-e127. [PMID: 33349760 PMCID: PMC7749687 DOI: 10.36834/cmej.69051] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Understanding the relationships between structures is critical for surgical trainees. However, the heterogeneity of the literature on visual-spatial ability (VSA) in surgery makes it challenging for educators to make informed decisions on incorporating VSA into their programs. We conducted a scoping review of the literature on VSA in surgery to provide a map of the literature and identify where gaps still exist for future research. METHODS We searched databases until December 2019 using keywords related to VSA and surgery. The resulting articles were independently screened by two researchers for inclusion in our review. RESULTS We included 117 articles in the final review. Fifty-nine articles reported significant correlations between VSA tests and surgical performance, and this association is supported by neuroimaging studies. However, it remains unclear whether VSA should be incorporated into trainee selection and whether there is a benefit of three-dimensional (3D) over two-dimensional (2D) training. CONCLUSIONS It appears that VSA correlates with surgical performance in the simulated environment, particularly for novice learners. Based on our findings, we make suggestions for how surgical educators may use VSA to support novice learners. Further research should determine whether VSA remains correlated to surgical performance when trainees move into the operative environment.
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Affiliation(s)
- Portia Kalun
- Department of Surgery, McMaster University, Ontario, Canada
| | - Krista Dunn
- Faculty of Medicine, Dalhousie University, Nova Scotia, Canada
| | - Natalie Wagner
- Department of Surgery, McMaster University, Ontario, Canada
- Office of Professional Development & Educational Scholarship, Faculty of Health Sciences, Queen’s University, Ontario, Canada
| | | | - Ranil Sonnadara
- Department of Surgery, McMaster University, Ontario, Canada
- Department of Surgery, University of Toronto, Ontario, Canada
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Hedman LR, Felländer-Tsai L. Simulation-based skills training in non-performing orthopedic surgeons: skills acquisition, motivation, and flow during the COVID-19 pandemic. Acta Orthop 2020; 91:520-522. [PMID: 32573303 PMCID: PMC8023967 DOI: 10.1080/17453674.2020.1781413] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- Leif Rune Hedman
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Orthopedics and Biotechnology, Karolinska Institutet, Stockholm, Sweden, and Center for Advanced Medical Simulation and Training (CAMST), Karolinska University Hospital, Stockholm
- Department of Psychology, Umeå University, Umeå, Sweden
| | - Li Felländer-Tsai
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Orthopedics and Biotechnology, Karolinska Institutet, Stockholm, Sweden, and Center for Advanced Medical Simulation and Training (CAMST), Karolinska University Hospital, Stockholm
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Alvarez-Lopez F, Maina MF, Saigí-Rubió F. Use of a Low-Cost Portable 3D Virtual Reality Gesture-Mediated Simulator for Training and Learning Basic Psychomotor Skills in Minimally Invasive Surgery: Development and Content Validity Study. J Med Internet Res 2020; 22:e17491. [PMID: 32673217 PMCID: PMC7388055 DOI: 10.2196/17491] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 02/26/2020] [Accepted: 02/29/2020] [Indexed: 02/06/2023] Open
Abstract
Background Simulation in virtual environments has become a new paradigm for surgeon training in minimally invasive surgery (MIS). However, this technology is expensive and difficult to access. Objective This study aims first to describe the development of a new gesture-based simulator for learning skills in MIS and, second, to establish its fidelity to the criterion and sources of content-related validity evidence. Methods For the development of the gesture-mediated simulator for MIS using virtual reality (SIMISGEST-VR), a design-based research (DBR) paradigm was adopted. For the second objective, 30 participants completed a questionnaire, with responses scored on a 5-point Likert scale. A literature review on the validity of the MIS training-VR (MIST-VR) was conducted. The study of fidelity to the criterion was rated using a 10-item questionnaire, while the sources of content-related validity evidence were assessed using 10 questions about the simulator training capacity and 6 questions about MIS tasks, and an iterative process of instrument pilot testing was performed. Results A good enough prototype of a gesture-based simulator was developed with metrics and feedback for learning psychomotor skills in MIS. As per the survey conducted to assess the fidelity to the criterion, all 30 participants felt that most aspects of the simulator were adequately realistic and that it could be used as a tool for teaching basic psychomotor skills in laparoscopic surgery (Likert score: 4.07-4.73). The sources of content-related validity evidence showed that this study’s simulator is a reliable training tool and that the exercises enable learning of the basic psychomotor skills required in MIS (Likert score: 4.28-4.67). Conclusions The development of gesture-based 3D virtual environments for training and learning basic psychomotor skills in MIS opens up a new approach to low-cost, portable simulation that allows ubiquitous learning and preoperative warm-up. Fidelity to the criterion was duly evaluated, which allowed a good enough prototype to be achieved. Content-related validity evidence for SIMISGEST-VR was also obtained.
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Affiliation(s)
| | - Marcelo Fabián Maina
- Faculty of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
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Walbron P, Common H, Thomazeau H, Sirveaux F. Evaluation of arthroscopic skills with a virtual reality simulator in first-year orthopaedic residents. INTERNATIONAL ORTHOPAEDICS 2020; 44:821-827. [PMID: 32219495 DOI: 10.1007/s00264-020-04520-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 03/04/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE This study of residents' initial performance was performed to determine which factors predisposed residents for success in demonstrating the best arthroscopic skills. METHODS Each orthopaedic first-year resident was officially invited to take part in a one hour evaluation on a VirtaMed™ ArthroS™ simulator. On the FAST module, the Periscoping exercise was chosen to test for use of angled optics. The Shoulder Module was chosen to test their ability to extract intra-articular foreign bodies using the Catch the Stars exercise. The variables such as time, camera alignment, camera path length, and grasper path length were analysed. Residents completed a questionnaire prior to the evaluation. Their results were analysed according to gender, orientation assessment, and surgical history. RESULTS A total of 34 women and 82 men were included in the study. In the Periscoping exercise, a significant difference between women and men in the time variables was noticed (275 ± 82 and 195 ± 71; p < 0.00001) and camera path length (207 ± 60 and 170 ± 66; p = 0.00094). For the Catch the Stars exercise, there was a significant difference between women and men for the time values (249 ± 114 and 201 ± 99; p = 0.01246) and grasper path length (290 ± 130 and 229 ± 108; p = 0.00493). After multivariate analysis, no influence of self-assessed spatial perception (p=0.1), number of arthroscopic procedures (p=0.39), or laparoscopic procedures (p=0.43) to which they had already assisted was found. CONCLUSIONS This study shows a significant difference in skills regarding spatial recognition and triangulation related to gender at the beginning of specialization training. It also demonstrates that male medical students are more attracted by surgical departments during their medical training.
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Affiliation(s)
- P Walbron
- Orthopaedics Department, Nancy University Hospital, Centre Chiurgical Emile Gallé, 49 rue Hermite, 54000, Nancy, France.
| | - H Common
- Rennes University Hospital, 2 rue Henri le Guilloux, 35000, Rennes, France
| | - H Thomazeau
- Rennes University Hospital, 2 rue Henri le Guilloux, 35000, Rennes, France
| | - F Sirveaux
- Orthopaedics Department, Nancy University Hospital, Centre Chiurgical Emile Gallé, 49 rue Hermite, 54000, Nancy, France
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Langlois J, Bellemare C, Toulouse J, Wells GA. Spatial abilities training in the field of technical skills in health care: A systematic review. Heliyon 2020; 6:e03280. [PMID: 32190751 PMCID: PMC7068633 DOI: 10.1016/j.heliyon.2020.e03280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 08/24/2019] [Accepted: 01/06/2020] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To conduct a systematic review of the effect of interventions on spatial abilities in the field of technical skills in health care. METHODS A literature search was conducted up to November 14, 2017 in Scopus and in several databases on EBSCOhost platform. Citations were obtained, articles related to retained citations were reviewed and a final list of included studies was identified. Methods in the field of technical skills relating an intervention to spatial abilities test scores between intervention groups or obtained before and after the intervention were identified as eligible. The quality of included studies was assessed and data were extracted in a systematic way. RESULTS A series of 5513 citations was obtained. Ninety-nine articles were retained and fully reviewed, yielding four included studies. No difference in the Hidden Figure Test score after one year was observed after residency training in General Surgery of at least nine months. A first-year dental curriculum was not found to elevate the Novel Object Cross-Sections Test score (P = 0.07). A two-semester learning period of abdominal sonography was found to increase the Revised Minnesota Paper Form Board Test score (P < 0.05). A hands-on radiology course using interactive three-dimensional image post-processing software consisting of seven two-hour long seminars on a weekly basis was found to amplify the Cube Perspective Test score (P < 0.001). CONCLUSION Spatial abilities tests scores were enhanced by courses in abdominal sonography and hands-on radiology, but were not improved by residency training in General Surgery and first-year dental curriculum.
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Affiliation(s)
- Jean Langlois
- Department of Emergency Medicine, CIUSSS de l’Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Christian Bellemare
- Department of Multidisciplinary Services, Clinical Quality Division, CIUSSS de l’Estrie – Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Josée Toulouse
- Librairies and Archives Services, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - George A. Wells
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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The utility of virtual reality surgical simulation in the undergraduate otorhinolaryngology curriculum. The Journal of Laryngology & Otology 2018; 132:1072-1076. [PMID: 30457086 DOI: 10.1017/s0022215118002025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To examine the impact of temporal bone virtual reality surgical simulator use in the undergraduate otorhinolaryngology curriculum. METHODS Medical students attended a workshop involving the use of a temporal bone virtual reality surgical simulator. Students completed a pre-workshop questionnaire on career interests. A post-workshop questionnaire evaluated the perceived usefulness and enjoyment of the virtual reality surgical simulator experience, and assessed changes in their interest in ENT. RESULTS Thirty-two fifth-year University of Auckland medical students were recruited. The majority of students (53.1 per cent) had already chosen their career path. The simulator experience was useful for: stimulating thoughts around career plans (71.9 per cent), providing hands-on experience (93.8 per cent) and teaching disease processes (93.8 per cent). After the workshop, 53.1 per cent of students were more interested in a career in ENT. CONCLUSION Virtual reality may be a fun and engaging way of teaching ENT. Furthermore, it could help guide student career planning.
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Vajsbaher T, Schultheis H, Francis NK. Spatial cognition in minimally invasive surgery: a systematic review. BMC Surg 2018; 18:94. [PMID: 30404634 PMCID: PMC6223063 DOI: 10.1186/s12893-018-0416-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 09/20/2018] [Indexed: 02/08/2023] Open
Abstract
Background Spatial cognition is known to play an important role in minimally invasive surgery (MIS), as it was found to enable faster surgical skill acquisition, reduce surgical time and errors made and significantly improve surgical performance. No prior research attempted to summarize the available literature, to indicate the level of importance of the individual spatial abilities and how they impact surgical performance and skill acquisition in MIS. Methods Psychological and medical databases were systematically searched to identify studies directly exploring spatial cognition in MIS learning and performance outcomes. Articles written in the English language articles, published between 2006 and 2016, investigating any and all aspect of spatial cognition in direct relation to influence over performance or learning of MIS, were deemed eligible. Results A total of 26 studies satisfied this criterion and were included in the review. The studies were very heterogeneous and the vast majority of the participants were novice trainees but with variable degree of skills. There were no clinical studies as almost all studies were conducted on either box trainers or virtual reality simulators. Mental rotation ability was found to have a clear impact on operative performance and mental practice was identified as an effective tool to enhance performance, pre-operatively. Ergonomic set-up of the MIS equipment has a marked influence on MIS performance and learning outcomes. Conclusions Spatial cognition was found to play an important role in MIS, with mental rotation showing a specific significance. Future research is required to further confirm and quantify these findings in the clinical settings.
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Affiliation(s)
- Tina Vajsbaher
- Bremen Spatial Cognition Center & Department of Human and Health Sciences, University of Bremen, Enrique-Schmidt-Str.5, 28359, Bremen, Germany. .,Department of Human and Health Sciences, University of Bremen, Bremen, Germany.
| | - Holger Schultheis
- Bremen Spatial Cognition Center & Department of Human and Health Sciences, University of Bremen, Enrique-Schmidt-Str.5, 28359, Bremen, Germany
| | - Nader K Francis
- Department of General Surgery, Yeovil District Hospital NHS Foundation Trust, Yeovil, UK.,Faculty of Health and Life Sciences, University of Liverpool, Brownlow Hill, Liverpool, L69 7ZX, UK
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Roch PJ, Rangnick HM, Brzoska JA, Benner L, Kowalewski KF, Müller PC, Kenngott HG, Müller-Stich BP, Nickel F. Impact of visual-spatial ability on laparoscopic camera navigation training. Surg Endosc 2017; 32:1174-1183. [PMID: 28840317 DOI: 10.1007/s00464-017-5789-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 07/28/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Technical limitations of minimally invasive surgery challenge both surgeons and camera assistants. Current research indicates that visual-spatial ability (VSA) has impact on learning of laparoscopic camera navigation (LCN). However, it remains unclear if complexity of LCN tasks influences the impact of VSA. The aim of this study was to examine the influence of VSA on LCN training within tasks of different complexity levels. METHODS The present study was conducted as a monocentric prospective trial. VSA was assessed with a cube comparison test before participants underwent LCN training. LCN training consisted of three tasks with increasing complexity. Each task was performed four times and performance was assessed each time. Correlations and multivariate regression analysis were used to assess the influence of VSA on LCN skills. RESULTS Seventy-one participants were included (35 males). Significant performance improvement and faster completion times were observed from the first to fourth trial of all three LCN training tasks. Significant positive correlations between VSA and performance on LCN task 3 were found (performance: r s = 0.47; p < 0.001, time: r s = -0.43; p < 0.001). Multivariate regression revealed that higher VSA resulted in greater reduction of time between the first trials of LCN training task 3 (B = -1.67, p = 0.031). CONCLUSION In the present study, all trainees improved LCN performance during the training. VSA seems to have impact on LCN performance and training progress particularly for complex LCN tasks. The relation of VSA and LCN performance was stronger for less experienced participants and in the beginning of the learning phase.
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Affiliation(s)
- Paul J Roch
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Henriette M Rangnick
- Department for Visceral, Thoracic and Vascular Surgery at the University Hospital, Technical University Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Julia A Brzoska
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Laura Benner
- Institute for Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Karl-Friedrich Kowalewski
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Philip C Müller
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Hannes G Kenngott
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Beat-Peter Müller-Stich
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Felix Nickel
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
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