Assessment parameters for a novel simulator in minimally invasive spine surgery

Abstract

Surgical simulators provide a safe environment where novice surgeons can acquire their surgical skills. Although the number of patients with diseases of the musculoskeletal system is growing, the development of orthopedic simulators is still in it's infancy. The aim of this work was to identify simulation-based assessment parameters for a novel simulator in minimally invasive spine surgery. Apart from parameters targeting the duration and the surgeon's economy of motion during percutaneous bone access, parameters characterizing the movement smoothness were also examined with respect to their suitability. The results indicated, that the overall duration, the number of instrument movements, the number of velocity peaks and the Movement Arrest Period Ratio are the most promising predictors of expertise. Targeting performance improvement, the overall duration (p = 0.001), the number of instrument movements (p = 0.003) and the traveled instrument path length (p = 0.009) detected significant differences between subsequent trials. Using these parameters, a study can be designed targeting the validity and reliability of the simulation-based assessment.

A review of computer‐assisted orthopaedic surgery systems

“…One spine‐oriented surgery training system 30 can distinguish novices and experts in transpedicular bone access procedure surgery training. One system 37 has a lower cost and is more suitable for medical students to train basic skills of spine surgery than other systems.…”

“…Fuerst et al 30 developed a high‐fidelity simulator for minimally invasive spine surgery. The purpose of their study was to identify simulation‐based assessment parameters, and the emphasis of simulation was on percutaneous bone access for minimally invasive surgery approaches.…”

Teaching Training and Surgical Education in Minimally Invasive Surgery (MIS) of the Spine: What Are the Best Teaching and Learning Strategies for MIS? Do We Have Any Experience and Data?

“…Dexterity: can be assessed by different methods, such as the objective structured assessment of technical skills (OSATS), the Imperial College surgical assessment device (ICSAD), minimally invasive surgical trainer (virtual reality), or combinations of the above. 9,10…”

“…The simulators are appropriate to measure performance, that is, the number of movements made by each hand, the distance covered by each hand movement, duration of the procedure, and time used for each task. 10,11…”

“…The simulators are appropriate to measure performance, that is, the number of movements made by each hand, the distance covered by each hand movement, duration of the procedure, and time used for each task. 10,11 An artificial lumbar spine prototype is available for MISS training that includes skin, muscles, bone, ligaments, and dura mater to make the training more realistic. Tubing systems simulate bone bleeding and cerebrospinal fluid leakage if the trainee could not perform an appropriate bone homeostasis or had a dural opening 12 (see Figure 1).…”