Virtual Reality in Laparoscopic Surgery - Does Training with a Simulator Improve Skills?
Abstracts
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Background: For surgical training in laparoscopic surgery, new training methods have to be developed which allow surgeons to first practice handling instruments and the sequential steps of an operation on a dummy before operating on real patients. A virtual laparoscopic operation simulator has been developed within the framework of a joint project. The current study served to test whether training using this device provided results which are comparable to those obtained using the conventional pelvitrainer (PT). Study design: Devices used were the Lap-SimOne system (LS1) and a PT equipped with conventional instruments. Three basic tasks (camera direction, left-/ right-handed instrument direction) were constructed identically (a) as virtual tasks and (b) as a model for the PT. Test persons were divided into 2 groups each consisting of 10 novices and 4 experts (> 100 lap. operations). Each group carried out a defined training program over the course of 5 consecutive days. One group trained with LS1, the other with PT. As a control measure, the groups switched devices on the 5th day. The main parameter was the time needed to complete a given task. Results: The novices in both groups showed similar learning curves. The mean task completion times decreased significantly over the first 3 days of the study, after which, a plateau phase could be observed. The task completion times for the control task on day 5 were significantly lower than on day 1. The experts learning curves were very flat and their task completion times were much lower than those of the novices. Conclusions: The study showed that training with computer simulation, just as with the PT, resulted in a reproducible training effect. It can be concluded from the parallel-running learning curves on both training systems that the same learning mechanism is involved. The control task showed that skills learned on the simulator are applicable to real situations. The fact that the experts showed little improvement demonstrates that the simulation trains those skills learned in years of practice. In this sense, the simulator seems to be well-suited for use in laparoscopic training. |
