The learning curve on the Xitact LS 500 laparoscopy simulator: profiles of performance

Schijven, Marlies P.; Jakimowicz, Jack J.

doi:10.1007/s00464-003-9040-x

Cited by 82 publications

(71 citation statements)

References 20 publications

(14 reference statements)

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“…In fact, we found a trend toward a negative effect, especially in the initial trial. As shown in past studies, we found evidence of a significant learning curve within the first five trials for all three groups [13,19]. The detrimental effect of activating music was strong during the first trial and accompanied by a significantly increased autonomic response (increased heart rate).…”

Section: Discussionsupporting

confidence: 84%

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Randomized controlled trial investigating the effect of music on the virtual reality laparoscopic learning performance of novice surgeons

et al. 2008

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Background Findings have shown that music affects cognitive performance, but little is known about its influence on surgical performance. The hypothesis of this randomized controlled trial was that arousing (activating) music has a beneficial effect on the surgical performance of novice surgeons in the setting of a laparoscopic virtual reality task. Methods For this study, 45 junior surgeons with no previous laparoscopic experience were randomly assigned to three equal groups. Group 1 listened to activating music; group 2 listened to deactivating music; and group 3 had no music (control) while each participant solved a surgical task five times on a virtual laparoscopic simulator. The assessed global task score, the total task time, the instrument travel distances, and the surgeons' heart rate were assessed. Results All surgical performance parameters improved significantly with experience (task repetition). The global score showed a trend for a between-groups difference, suggesting that the group listening to activating music had the worst performance. This observation was supported by a significant between-groups difference for the first trial but not subsequent trials (activating music, 35 points; deactivating music, 66 points; no music, 91 points; p = 0.002). The global score (p = 0.056) and total task time (p = 0.065) showed a trend toward improvement when participants considered the music pleasant rather than unpleasant. Conclusions Music in the operating theater may have a distracting effect on novice surgeons performing new tasks. Surgical trainers should consider categorically switching off music during teaching procedures.

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Section: Discussionsupporting

confidence: 84%

“…We also used the total task time as well as the left and right hand travel distances. These parameters represent most accurately the quality of task performance [18][19][20].…”

Section: Laparoscopy Simulator and Settingmentioning

confidence: 99%

Randomized controlled trial investigating the effect of music on the virtual reality laparoscopic learning performance of novice surgeons

et al. 2008

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“…A structured approach to this process has long been developed in other industries and has been applied extensively in laparoscopic surgery by Schijven et al [6,[11][12][13][14][15]. In accordance with this methodology, a number of basic skills trainers and complex task trainers have been validated to various degrees: Procedicus MIST (Mentice) [7,17], LapSim (Surgical Science) [21], and Promis (Haptica) [2,19].…”

Section: Motivation For This Studymentioning

confidence: 99%

“…It was systematically validated in combination with XitactÕs original software package [11][12][13]15], simulating basic skills exercises and phases of a laparoscopic cholecystectomy. As IBM did in the early 1980s, Xitact allows independent companies to develop software for its platform, thereby offering an open system with unprecedented versatility.…”

mentioning

confidence: 99%

Face validation of the Simbionix LAP Mentor virtual reality training module and its applicability in the surgical curriculum

et al. 2007

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Background: The goal of our study was to determine expert and referent face validity of the LAP Mentor, the first procedural virtual reality (VR) laparoscopy trainer. Methods: In the Netherlands 49 surgeons and surgical trainees were given a hands-on introduction to the Simbionix LAP Mentor training module. Subsequently, a standardized five-point Likert-scale questionnaire was administered. Respondents who had performed over 50 laparoscopic procedures were classified as ''experts.'' The others constituted the ''referent'' group, representing nonexperts such as surgical trainees. Results: Of the experts, 90.5% (n = 21) judge themselves to be average or above-average laparoscopic surgeons, while 88.5% of referents (n = 28) feel themselves to be less-than-average laparoscopic surgeons (p = 0.000). There is agreement between both groups on all items concerning the simulatorÕs performance and application. Respondents feel strongly about the necessity for training on basic skills before operating on patients and unanimously agree on the importance of procedural training. A large number (87.8%) of respondents expect the LAP Mentor to enhance a traineeÕs laparoscopic capability, 83.7% expect a shorter laparoscopic learning curve, and 67.3% even predict reduced complication rates in laparoscopic cholecystectomies among novice surgeons. The preferred stage for implementing the VR training module is during the surgeonÕs residency, and 59.2% of respondents feel the surgical curriculum is incomplete without VR training. Conclusion: Both potential surgical trainees and trainers stress the need for VR training in the surgical curriculum. Both groups believe the LAP Mentor to be a realistic VR module, with a powerful potential for training and monitoring basic laparoscopic skills as well as full laparoscopic procedures. Simulator training is perceived to be both informative and entertaining, and enthusiasm among future trainers and trainees is to be expected. Further validation of the system is required to determine whether the performance results agree with these favorable expectations.Key words: Training/courses -CholecystectomyEducation -Endoscopy -Imaging -Virtual realityThe apprenticeship model is historically used to teach surgery. In essence it consists of future surgeons training on actual patients in the operating room (OR). The apprenticeÕs inexperience results in prolonged OR time, incurring higher costs and higher risks of peroperative complications. In part, this phenomenon can be compensated for by training sufficiently preoperatively [1].The practice of training residents in real ORs also hinders the learning process itself by compromising educational opportunities: The learning environment is stressful and learning opportunities are as unpredictable as the availability of the patients on which to practice. Consequently, learning laparoscopy is an opportunistic enterprise. Until recently we lacked viable alternatives for surgical training beyond short introductory courses. Consequently, we had to tolerate...

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“…Performance of surgical tasks improves by standardized repetition. 13 Improvement is exponential at the start. Subsequently, it levels off over time until a steady state of performance is established.…”

Section: Methodsmentioning

confidence: 99%

Mapping the Maze of Minimally Invasive Surgery Simulators

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Rijssen

et al. 2012

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Background: Conforming to, among other considerations, legal and ethical concerns for patient safety, there is an increasing demand to assess a surgeon's skills prior to performance in the operating room in pursuit of higherquality treatment. Training in minimally invasive surgery (MIS) must therefore be intensified, including team training. New methods to train and assess minimally invasive surgical skills are gaining interest. The goal of this review is to provide instructors with an overview of available MIS training tools. In this review, we discuss currently available simulators for MIS training. Applicability, validity, and construction of simulators are reviewed. Also, some of the leading training programs and assessment methods in MIS are reviewed. Methods: A literature search was performed on studies evaluating surgical task performance on a simulator, reviewing satisfaction with laparoscopic training programs, or validating simulators or assessment methods. Results: Simulators may be divided into simple box trainers and computer-based systems, such as virtual and augmented simulators. All have advantages and disadvantages. An overview is provided of currently available training systems, validity, trainee assessment, and the importance of training programs in MIS. Conclusions:No simulator yet provides the ability to train the entire set of required psychomotor skills or procedures for MIS. A multiyear training program combining various simulators for multiple-level training, including team training, should be constructed.

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The learning curve on the Xitact LS 500 laparoscopy simulator: profiles of performance

Cited by 82 publications

References 20 publications

Randomized controlled trial investigating the effect of music on the virtual reality laparoscopic learning performance of novice surgeons

Randomized controlled trial investigating the effect of music on the virtual reality laparoscopic learning performance of novice surgeons

Face validation of the Simbionix LAP Mentor virtual reality training module and its applicability in the surgical curriculum

Mapping the Maze of Minimally Invasive Surgery Simulators

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