Toward technology-supported surgical training: the potential of virtual simulators in laparoscopic surgery

Abstract

Background and Aims: The mastery of manual skills that are indispensable for the performance of surgical tasks is a competence specific to surgery. one way of facilitating this acquisition is to move the training out of the operating room and all of its restrictions. Surgical training out of the operating room, also called simulation, has spread widely in the past decade, especially in laparoscopic and endoscopic surgery. Material and Methods: This review assesses the role of virtual reality (Vr) simulators in laparoscopic surgery and their actual impact on technical skills.Results and Conclusions: There is a wealth of simulators, ranging from low-to highfidelity simulators incorporating haptic feedback. They comprise basic tasks, procedural modules, and full procedures. Virtual reality simulators have shown acceptable fidelity and validity evidence. moreover, training out of the operating room on virtual reality simulators has demonstrated its positive impact on basic skills during real laparoscopic procedures in patients. The benefit of virtual reality over simple video trainers remains unclear for teaching basic skills. however, virtual reality simulators provide automatic feedback that permitted to design structured competency-based curricula and allow deliberate practice. finally, advanced procedures and patient-specific models have been designed on virtual reality simulators, and further investigations are still awaited to appraise their educational value.

Virtual and Augmented Reality in Medical Education

“…It is a low-fidelity simulator that does not support force-feedback function [18,20]. It has demonstrated construct validity but controversial transferability of skills [21,22].…”

“…Information on handling tissue, handling tools, time, and movement efficiency are obtained during the simulation and are processed to produce metrics [2,20]. It has demonstrated construct validity, predictive validity, and transferability of technical skills, especially when combined with supervision by the instructors [21,23].…”

“…It has shown good construct and predictive validity and transferability of some skills [2,18,20,21].…”

“…The skills acquired with VR training were maintained for at least 9 months [33]. GI Mentor™, EndoVR™ (CAE Healthcare, the old AccuTouch ® , Immersion) and Olympus Endo TS-1 (Olympus) are among the simulators that have been studied and have showed construct and predictive validity [21,33]. GI Mentor™ has been chosen by SAGES as the platform for the Fundamentals of Endoscopic Surgery™ (FES™) examination [34].…”

“…More randomized control trials, comparing the effect of VR training against no training, other simulation-based training, or different VR training systems, are needed. The samples must be larger to strengthen the results and the designs of different studies similar [5,7,8,21]. Moreover, the extent of the decay of the skills over time must be elucidated.…”