The development of laparoscopic skills using virtual reality simulations: A systematic review

Abstract

Background Teaching based on virtual reality simulators in medicine has expanded in recent years due to the limitations of more traditional methods, especially for surgical procedures such as laparoscopy. Purpose of review To analyze the effects of using virtual reality simulations on the development of laparoscopic skills in medical students and physicians. Data sources The literature screening was done in April 2020 through Medline (PubMed), EMBASE and Database of the National Institute of Health. Eligibility criteria Randomized clinical trials that subjected medical students and physicians to training in laparoscopic skills in virtual reality simulators. Study appraisal Paired reviewers independently identified 1529 articles and included 7 trials that met the eligibility criteria. Findings In all studies, participants that trained in virtual simulators showed improvements in laparoscopic skills, although the articles that also had a physical model training group did not show better performance of one model compared to the other. Limitations No article beyond 2015 met the eligibility criteria, and the analyzed simulators have different versions and models, which might impact the results. Conclusion Virtual reality simulators are useful educational tools, but do not show proven significant advantages over traditional models. The lack of standardization and a scarcity of articles makes comparative analysis between simulators difficult, requiring more research in the area, according to the model suggested in this review. Systematic review registration number Registered by the Prospective Register of Systematic Reviews (PROSPERO), identification code CRD42020176479.

Training residents in minimally invasive surgery; confirming competence or hoping for the best?

“…However, structured training with video demonstrations and clearly stated performance goals seem to be able to replace expert supervision 16 . Despite all the limitations with traditional box‐training, systematic reviews have not been able to demonstrate clear inferiority of this type of training compared to the much more technologically advanced, and thus expensive, virtual reality trainers 17,18 …”

“…16 Despite all the limitations with traditional box-training, systematic reviews have not been able to demonstrate clear inferiority of this type of training compared to the much more technologically advanced, and thus expensive, virtual reality trainers. 17,18 Virtual reality (VR) training includes both basic skills in low fidelity (not lifelike) simulations, as well as high fidelity simulation of entire surgical procedures. VR can simulate complications such as bleeding, bile leakage and slipping of clips.…”

The importance of simulation training in surgical sciences

“…27,28 Training has been shown to reduce operating time and error while improving performance and confidence. 10,23,29,30 However, structured training is needed, as formal training programs are still lacking. 11,18…”

“…These can be physical models, 3-D printed, simulators with virtual reality, augmented reality, or a combination of these for hybrid simulation. [8][9][10][11] These allow for a greater number of trainees to participate, and the repetition of maneuvers. However, the models do not depend only on their design.…”

Biometric analysis of induced stress and learning during the performance of pericardiocentesis in a virtual reality simulated scenario: a before and after study

“…Additionally, effective simulation training requires highly specialized instructors and presents a steep learning curve. [9,10] In this evolving landscape, virtual reality (VR) emerges as a potentially revolutionary solution [11] [12,13]. VR offers several key advantages over traditional simulation methods, including deeper immersion in clinical scenarios, near-perfect reproducibility, standardization of training scenarios, the incorporation of an emotional component, and scalability.…”