Learning curves, potential and speed in training of laparoscopic skills: a randomised comparative study in a box trainer

Abstract

Background The effectiveness of practical surgical training is characterised by an inherent learning curve. Decisive are individual initial starting capabilities, learning speed, ideal learning plateaus, and resulting learning potentials. The quantification of learning curves requires reproducible tasks with varied levels of difficulty. The hypothesis of this study is that the use of three-dimensional (3D) vision is more advantageous than two-dimensional vision (2D) for the learning curve in laparoscopic training. Methods Forty laparoscopy novices were recruited and randomised to a 2D Group and a 3D Group. A laparoscopy box trainer with two standardised tasks was used for training of surgical tasks. Task 1 was a positioning task, while Task 2 called for laparoscopic knotting as a more complex process. Each task was repeated at least ten times. Performance time and the number of predefined errors were recorded. 2D performance after 3D training was assessed in an additional final 2D cycle undertaken by the 3D Group. Results The calculated learning plateaus of both performance times and errors were lower for 3D. Independent of the vision mode the learning curves were smoother (exponential decay) and efficiency was learned faster than precision. The learning potentials varied widely depending on the corresponding initial values and learning plateaus. The final 2D performance time of the 3D-trained group was not significantly better than that of the 2D Group. The final 2D error numbers were similar for all groups. Conclusions Stereoscopic vision can speed up laparoscopic training. The 3D learning curves resulted in better precision and efficiency. The 3D-trained group did not show inferior performance in the final 2D cycle. Consequently, we encourage the training of surgical competences like suturing and knotting under 3D vision, even if it is not available in clinical routine.

Effect of the Fundamentals of Laparoscopic Surgery Curriculum on Skills of Operating Room Technology Students: An Interventional Study

“…The study showed that after practicing laparoscopic skills in the training box, the skill performance quality of novices without any previous experience in laparoscopic surgery improved with a gentle slope. Of course, other studies should consider the quality of skills performed in they concluded that the administration of simulated training of skills in a safe environment would accelerate the learning process and give people a better understanding of three-dimensional space (25,26). According to the study results, by practicing and performing skills repeatedly in the simulation environment, the accuracy and speed of students in doing skills increased gradually.…”

Associations Between Binocular Depth Perception and Performance Gains in Laparoscopic Skill Acquisition

“…When considering the time of operation as the primary outcome, systems that provide 3D vision have been shown to be advantageous in some clinical settings (e.g., Itatani et al, 2019). Results from experimental settings (e.g., using a standardized laparoscopic box trainer) have thus far also shown that, when trained with 3D display, learning speed and precision can be improved, at least in some studies (e.g., Beattie et al, 2020;Kunert et al, 2020). However, the transfer of performance trained under 3D display to actual operative situations and longterm clinical outcomes is still equivocal (Yim et al, 2017;Beattie et al, 2020).…”

Study on augmented reality for robotic surgery bedside assistants

“…Currently, this must all be performed with a traditional laparoscopic two-dimensional (2D) monitor, while accommodating the physical presence of the robot as a potential obstruction to the video display. It has previously been reported that laparoscopic task performance significantly improves when the laparoscopic view is straight in front of the operator's head and forearms [2], that laparoscopic learning curves are faster under 3D vision [3], and that novices perform laparoscopic tasks better under 3D vision [4]. Thus, the ability of the robotic surgery bedside assistant to view the laparoscopic surgical field in 3D while in proper ergonomic position could significantly impact the operative time and success of the procedure.…”