The impact of external feedback on computer-assisted learning for surgical technical skill training

Rogers, David A.; Regehr, Glenn; Howdieshell, Thomas R.; Yeh, Karen A.; Palm, Ellen

doi:10.1016/s0002-9610(00)00341-x

Cited by 93 publications

(61 citation statements)

References 3 publications

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“…As such, these technologic advancements are having an ever-increasing influence on the way surgery is planned and performed. [1][2][3][4][5] We and others have previously reported preoperative liver imaging studies that show computer translation of conventional computed tomography scans into three-dimensional virtual reality images that sharply delineate the patient's anatomical structures as well as the presence of any pathology. 6 -8 By using this model, the surgeon can choose dissection planes before and during surgery.…”

Section: Discussionmentioning

confidence: 99%

Telerobotic Laparoscopic Cholecystectomy: Initial Clinical Experience With 25 Patients

et al. 2001

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ObjectiveTo determine the safety and feasibility of performing telerobotic laparoscopic cholecystectomies. This will serve as a preliminary step toward the integration of computer-rendered three-dimensional preoperative imaging studies of anatomy and pathology onto the patient's own anatomy during surgery. Summary Background DataComputer-assisted surgery (CAS) increases the surgeon's dexterity and precision during minimally invasive surgery, especially when using microinstruments. Clinical trials have shown the improved microsurgical precision afforded by CAS in the minimally invasive setting in cardiac and gynecologic surgery. Future applications would allow integration of preoperative data and augmented-reality simulation onto the actual procedure. MethodsBeginning in September 1999, CAS was used to perform cholecystectomies on 25 patients at a single medical center in this nonrandomized, prospective study. The operations were performed by one of two surgeons who had previous laboratory experience using the computer interface. The entire dissection was performed by the surgeon, who remained at a distance from the patient but in the same operating room. The operation was evaluated according to time of dissection, time of assembly/disassembly of robot, complications, immediate postoperative course, and short-term follow-up. ResultsTwenty of the 25 patients had symptomatic cholelithiasis, 1 had a gallbladder polyp, and 4 had acute cholecystitis. Twenty-four of the 25 laparoscopic cholecystectomies were successfully completed by CAS. There was one conversion to conventional laparoscopic cholecystectomy. Set-up and takedown of the robotic arms took a median of 18 minutes. The median operative time for dissection and the overall operative time were 25 and 108 minutes, respectively. There were no intraoperative complications. There was one postoperative complication of a suspected pulmonary embolus, which was treated with anticoagulation. All patients were tolerating diet at discharge. ConclusionsLaparoscopic cholecystectomy performed by CAS is safe and feasible, with operative times and patient recovery similar to those of conventional laparoscopy. At present, CAS cholecystectomy offers no obvious advantages to patients, but the potential advantages of CAS lie in its ability to convert the surgical act into digitized data. This digitized format can then interface with other forms of digitized data, such as pre-or intraoperative imaging studies, or be transmitted over a distance. This has the potential to revolutionize the way surgery is performed.Computers and technology are increasingly interacting with surgeons both inside and outside of the operating room, as exemplified by the rapid adoption of laparoscopy into routine use. The computer's ability to enhance, modify, or transform electronic data is changing patient management before, during, and after surgery. As such, these technologic advancements are having an ever-increasing influence on the way surgery is planned and performed.

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Section: Discussionmentioning

confidence: 99%

Telerobotic Laparoscopic Cholecystectomy: Initial Clinical Experience With 25 Patients

et al. 2001

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“…Furthermore many educational theories address the need for expert feedback [1]. Any kind of motor skill learning can be divided into three phases [1,7,8]: the cognitive phase, where the trainee tries to understand the different steps of the task; the associative phase where he/she practices the skill, integrating the knowledge of the task into the appropriate motor behavior; and finally the autonomous phase, where the skill is performed without cognitive awareness. It is especially during the associative phase that feedback is felt to play a major role.…”

Section: Introductionmentioning

confidence: 99%

How much do we need experts during laparoscopic suturing training?

Bruwaene¹,

Win²,

Miserez

2009

Surg Endosc

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“…This might be one of the reasons why some authors doubt that scientific evidence could persuade surgeons to change their technique [5]. However, it is interesting to know that if there would be one preferred knot tying technique, there are already randomized trials and even systematic reviews available describing how to teach this particular technique in a way to have the optimal learning success [4,[31][32][33].…”

Section: Introductionmentioning

confidence: 99%