Virtual coach: the next tool in functional endoscopic sinus surgery education

Abstract

BackgoundFunctional endoscopic sinus surgery (FESS) can be challenging as novices become accustomed to handling endoscopes and instruments while navigating complex sinonasal anatomy. Experts demonstrate fluid and efficient motions when addressing pathology. The training process from novice to expert relies on hands‐on experience in cadaveric laboratories and preceptorship models that require significant time and expense. This study aims to validate the use of a virtual coach to guide users step‐by‐step through a basic FESS.MethodsSeventeen surgeons were grouped into novice (n = 10) and expert (n = 7) based on self‐reported levels of surgical experience. Users were trained using the maxillary antrostomy module in the Neurorhinological Surgery (NRS) simulator combining the physical craniofacial model with virtual reality (VR)‐tracked surgical instruments in the VR operating room. The virtual coach guided the user using surgical videos, auditory, and visual cues. The coach recorded data for each subject including the number of times borders of the nasal cavity were encountered and time to completion. Users graded the usefulness of the virtual coach on a Likert questionnaire.ResultsFace validity of our NRS simulator was replicated by user questionnaires, and construct validity replicated by differentiation between novice and expert level surgeons (p < 0.01). Novices contacted a significantly higher number of anatomic borders (n = 17) and had a longer operative time (t = 370 seconds). All users reported high scores on the benefit and usefulness of the virtual coach.ConclusionThe virtual coach provides a useful tool to enhance FESS education by providing objective real‐time data in a novel mixed‐reality surgical environment.

Effects of Endoscopic Sinus Surgery Combined with Budesonide Treatment on Nasal Cavity Function and Serum Inflammatory Factors in Patients with Chronic Sinusitis

“…The incidence of chronic sinusitis is relatively high. Thus, in the clinical treatment of this disease, nasal endoscopic surgery is often used as the local anatomical structure can be clearly observed, meanwhile, the diseased tissue can be understood and targeted in time to effectively restore the basic functions of the sinuses and nasal cavity [ 14 ]. Although nasal endoscopic surgery could effectively improve the therapeutic effect, it will inevitably increase the secretion of inflammatory mediators due to invasive operations.…”

Use of high‐fidelity 3‐dimensional–printed models for training novice residents in basic nasal endoscopic skills

“…real-time data to users has been reported. 15,16 A mixedreality surgical simulator that could mimic tissue reactions, such as oozing or bleeding, could yield promising results. Additionally, it is worth noting that in teaching-related studies, there is a concern that the results may always be positive because the trainees are taught for the exam.…”

“…However, the unnecessary damage to tissue that was observed to be a common weakness among the residents also suggested that we should help them by improving the simulator in the future. A training tool based on virtual reality technology, which provides immediate haptic feedback and objective real‐time data to users has been reported 15,16 . A mixed‐reality surgical simulator that could mimic tissue reactions, such as oozing or bleeding, could yield promising results.…”

Pharmacological, Technological, and Digital Innovative Aspects in Rhinology

“…Today, the VR can be used in the surgical simulation, allowing modernization of training and its transition from the practice of simple exercises into a fully-immersive environment experience. In a recent study, the use of a virtual coach was tried guiding a group of surgeons using surgical videos, auditory, and visual cues ( 70 ). In AuR, the real-world environments are combined with computer-generated sounds, text, and graphics.…”