Virtual reality training in laparoscopic surgery: A systematic review &amp; meta-analysis

Alaker, Medhat; Wynn, Greg; Arulampalam, Tan

doi:10.1016/j.ijsu.2016.03.034

Cited by 283 publications

(200 citation statements)

References 31 publications

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“…Over time, extensive clinical research on VR simulators and the integration of new technologies have resulted in the development of increasingly effective and versatile models. For example, the Minimally Invasive Surgery Trainer Virtual Reality (MIST-VR) and other VR simulators for laparoscopic surgeries have been shown to improve performance in the operating room (15,16). Today, VR simulators combine actual surgical tools used in the operating room with extremely realistic computerized images.…”

Section: History Of Surgical Simulationmentioning

confidence: 99%

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Innovations in surgery simulation: a review of past, current and future techniques

Badash¹,

Burtt²,

Solorzano³

et al. 2016

Ann. Transl. Med.

249

165

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As a result of recent work-hours limitations and concerns for patient safety, innovations in extraclinical surgical simulation have become a desired part of residency education. Current simulation models, including cadaveric, animal, bench-top, virtual reality (VR) and robotic simulators are increasingly used in surgical training programs. Advances in telesurgery, three-dimensional (3D) printing, and the incorporation of patient-specific anatomy are paving the way for simulators to become integral components of medical training in the future.Evidence from the literature highlights the benefits of including simulations in surgical training; skills acquired through simulations translate into improvements in operating room performance. Moreover, simulations are rapidly incorporating new medical technologies and offer increasingly high-fidelity recreations of procedures. As a result, both novice and expert surgeons are able to benefit from their use. As dedicated, structured curricula are developed that incorporate simulations into daily resident training, simulated surgeries will strengthen the surgeon's skill set, decrease hospital costs, and improve patient outcomes.

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Section: History Of Surgical Simulationmentioning

confidence: 99%

“…There is substantial evidence supporting the use of VR simulators in surgical training (15,16). VR simulation has been found to reduce operative time and to improve the performance of surgical trainees (16).…”

Section: Vr Simulatorsmentioning

confidence: 99%

Innovations in surgery simulation: a review of past, current and future techniques

Badash¹,

Burtt²,

Solorzano³

et al. 2016

Ann. Transl. Med.

249

165

View full text Add to dashboard Cite

show abstract

“…When comparing VR to the traditional training methods, a meta-analysis of 30 studies demonstrated that VR simulation is as good as box trainers and significantly more effective than video trainers [1]. Hence, multiple medical specialties have already started to incorporate these innovations into their daily practice, mostly in surgery, resulting in many positive outcomes for surgical planning and simulation.…”

mentioning

confidence: 99%

“…Up to now, only pilot studies have been published about the use of VR in general surgery. These studies have shown that VR training tools improve the laparoscopic skills of both inexperienced and experienced surgeons [1]. The experience gained from other procedures indicates unequivocally that gastrointestinal surgery can benefit from VR training both in the preoperative and the intraoperative setting, especially in technically challenging procedures such as transanal total mesorectal excision (taTME) [6][7][8].…”

mentioning

confidence: 99%

“…Proficiency-based training, with optimal provision of immediate feedback and on the spot instructions, the motivation for deliberate practice and the availability of practicing varying levels of difficulty all seem to enhance the learning outcomes of VR simulation [1,2,5]. Different settings should be proposed for the surgeon, from simple laparoscopic cholecystectomy to more demanding procedures such as gastrectomies or total mesorectal excision.…”

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confidence: 99%

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Virtual reality simulation for surgery: from video games to transanal total mesorectal excision

2017

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Intense Simulation-Based Surgical Education for Manual Small-Incision Cataract Surgery

et al. 2021

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IMPORTANCE Cataracts account for 40% of cases of blindness globally, with surgery the only treatment. OBJECTIVE To determine whether adding simulation-based cataract surgical training to conventional training results in improved acquisition of surgical skills among trainees. DESIGN, SETTING, AND PARTICIPANTS A multicenter, investigator-masked, parallel-group, randomized clinical educational-intervention trial was conducted at 5 university hospital training institutions in Kenya, Tanzania, Uganda, and Zimbabwe from October 1, 2017, to September 30, 2019, with a follow-up of 15 months. Fifty-two trainee ophthalmologists were assessed for eligibility (required no prior cataract surgery as primary surgeon); 50 were recruited and randomized. Those assessing outcomes of surgical competency were masked to group assignment. Analysis was performed on an intention-to-treat basis. INTERVENTIONS The intervention group received a 5-day simulation-based cataract surgical training course, in addition to standard surgical training. The control group received standard training only, without a placebo intervention; however, those in the control group received the intervention training after the initial 12-month follow-up period. MAIN OUTCOMES AND MEASURES The primary outcome measure was overall surgical competency at 3 months, which was assessed with a validated competency assessment rubric. Secondary outcomes included surgical competence at 1 year and quantity and outcomes (including visual acuity and posterior capsule rupture) of cataract surgical procedures performed during a 1-year period. RESULTS Among the 50 participants (26 women [52.0%]; mean [SD] age, 32.3 [4.6] years), 25 were randomized to the intervention group, and 25 were randomized to the control group, with 1 dropout. Forty-nine participants were included in the final intention-to-treat analysis. Baseline characteristics were balanced. The participants in the intervention group had higher scores at 3 months compared with the participants in the control group, after adjusting for baseline assessment rubric score. The participants in the intervention group were estimated to have scores 16.6 points (out of 40) higher (95% CI, 14.4-18.7; P < .001) at 3 months than the participants in the control group. The participants in the intervention group performed a mean of 21.5 cataract surgical procedures in the year after the training, while the participants in the control group performed a mean of 8.5 cataract surgical procedures (mean difference, 13.0; 95% CI, 3.9-22.2; P < .001). Posterior capsule rupture rates (an important complication) were 7.8% (42 of 537) for the intervention group and 26.6% (54 of 203) for the control group (difference, 18.8%; 95% CI, 12.3%-25.3%; P < .001). CONCLUSIONS AND RELEVANCE This randomized clinical trial provides evidence that intense simulation-based cataract surgical education facilitates the rapid acquisition of surgical competence and maximizes patient safety.

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Virtual reality training in laparoscopic surgery: A systematic review & meta-analysis

Cited by 283 publications

References 31 publications

Innovations in surgery simulation: a review of past, current and future techniques

Innovations in surgery simulation: a review of past, current and future techniques

Virtual reality simulation for surgery: from video games to transanal total mesorectal excision

Intense Simulation-Based Surgical Education for Manual Small-Incision Cataract Surgery

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