Simulator training and residents’ first laparoscopic hysterectomy: a randomized controlled trial

Abstract

Background Hysterectomy rates are decreasing in many countries, and virtual reality simulators bring new opportunities into residents' surgical education. The objective of this study was to evaluate the effect of training in laparoscopic hysterectomy module with virtual reality simulator on surgical outcomes among residents performing their first laparoscopic hysterectomy. Methods This randomized study was carried out at the Department of Obstetrics and Gynecology in Helsinki University Hospital and Hyvinkää Hospital. We recruited twenty residents and randomly signed half of them to train ten times with the laparoscopic hysterectomy module on a virtual reality simulator, while the rest represented the control group. Their first laparoscopic hysterectomy was video recorded and assessed later by using the Objective Structured Assessment of Technical Skills (OSATS) forms and Visual Analog Scale (VAS). The scores and surgical outcomes were compared between the groups. Results The mean OSATS score for the Global Rating Scale (GRS) was 17.0 (SD 3.1) in the intervention group and 11.2 (SD 2.4) in the control group (p = 0.002). The mean procedure-specific OSATS score was 20.0 (SD 3.3) and 16.0 (SD 2.8) (p = 0.012), and the mean VAS score was 55.0 (SD 14.8) and 29.9 (SD 14.9) (p = 0.001). Operative time was 144 min in the intervention group and 165 min in the control group, but the difference did not reach statistical significance (p = 0.205). There were no differences between the groups in blood loss or direct complications. Conclusion Residents training with a virtual reality simulator prior to the first laparoscopic hysterectomy seem to perform better in the actual live operation. Thus, a virtual reality simulator hysterectomy module could be considered as a part of laparoscopic training curriculum. Keywords Surgical education · Resident education · Virtual reality simulator · OSATS · VASAlthough the number of live operations in residents' training has diminished [1], technology offers new solutions for surgical training in the form of lap trainers and virtual reality simulators [2][3][4][5]. With these training tools, it is possible to acquire fundamental laparoscopic skills [2], and they may be used as a part of the procedural training curriculum [6], as well. Though procedural skills have been proven to be transferred into the operating room after virtual reality simulator modules in laparoscopic cholecystectomy [7], in laparoscopic salpingectomy [8], and in cataract surgery [9], no data exists on the effect of virtual reality simulators on advanced major surgical procedures [10].Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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