Chirurgisches Training am Simulator

Abstract

Learning of laparoscopic operative skills is often complex and time consuming resulting in a learning curve especially for novices in surgery. Virtual reality (VR) simulation was developed as an alternative to conventional training, such as active assistance and conventional laparoscopic training with artificially perfused organs (Pop-Trainer). VR simulation enables a wide range of repeatable laparoscopic techniques in variable virtual scenarios. For abdominal surgery four different simulation systems (MIST-VR(R), LapSim, Simsurgery, Lap-Mentor) are currently available and the modules allow simulation of abstract exercises to more advanced laparoscopic procedures, such as laparoscopic sigmoid resection. The effect of VR training on laparoscopic performance and its impact on non-technical skills was evaluated using the simulator LapSim after a constructive validity study. Novices benefited most from VR training and performance in the operating room improved significantly after VR training. Good spatial perception and positive stress coping strategies also enhanced laparoscopic performance. VR simulation provides a tool to shift the laparoscopic learning curve outside the operating room and thus contributes to patient safety. It would be worthwhile to include VR training in the surgical curriculum. For economic reasons regional training centers seem to be an effective way to realize a broad implementation of VR simulation in surgical training. Application and development of VR simulators should be professionally promoted just as flight simulators in aviation.

Etablierung eines multidimensionalen, strukturierten Weiterbildungscurriculums in der Chirurgie

“…Für die mittlerweile immer wichtiger werdende minimalinvasive Chirurgie (MIC) sind neben den bereits etablierten Box-Trainern auch Virtual Reality Trainer (VRT, Laparoskopiesimulatoren) einsetzbar. Solche VRT eignen sich sehr gut für Anfänger zum Erlernen erster Basisfähigkeiten [20,21] und geben dem Anwender durch objektive Messparameter (Instrumentenausschlag, Gewebedehnung etc.) eine Rückmeldung zu seiner Leistung [6].…”

“…Bislang existieren nur limitierte Daten zur Untersuchung des notwendigen Zeitbedarfs zur Umsetzung eines solchen Programms im klinischen Alltag. Studien konnten zeigen, dass beim simulatorbasierten Training bereits wenige Wiederholungen einer Übung (2-7 Trainingseinheiten) zum Erreichen eines ersten Lernplateaus führen [8,20]. Es gibt jedoch Unterschiede in Abhängigkeit von Vorerfahrung und Schwierigkeitsgrad der Übungen.…”

Preparation for pyeloplasty for ureteropelvic junction obstruction using a patient-specific laparoscopic simulator: a case report

“…Some training systems that simulate a surgical procedure are available commercially. They are useful for basic training but are not suitable for training surgeons to respond to the specific conditions of a given patient [2,4-6]. Unlike other surgeries, urological surgeries need a great deal of information about vessels, ureters, and tumors hidden by other organs; this protects the organs and shortens the operation time.…”

Development of three-dimensional patient face model that enables real-time collision detection and cutting operation for a dental simulator

“…To overcome such problems, much attention has been paid to the virtual reality (VR) simulator, which has been recognized as a strong tool in the car industry [2][3][4] , airplane industry 5) , and medicine [6][7][8][9][10][11] . Haptic devices that make users feel force feedbacks are useful for acquiring hand skill efficiently in VR environments 12,13) .…”