LaparoscopyProficiency-based virtual reality training significantly reduces the error rate for residents during their first 10 laparoscopic cholecystectomies
Section snippets
Subjects
Thirteen surgical residents (6 men, 7 women) from 9 different institutions in Sweden participated in this study. The introduction to laparoscopy training in the Swedish education system varies and the subjects therefore differed with respect to their experience from postgraduate year 1 to 2. They all had experience in assisting with laparoscopic procedures but had no previous experience in performing an LC. All residents were scheduled to start with laparoscopic training and each supervisor
Results
A total of 120 cholecystectomies were registered within the frame of this study. Eleven trainees performed 10 procedures each and 1 trainee in each group performed 5 each for local logistical reasons. For these latter 2 trainees, surgeries 1 and 5 were assessed. In total, 37 procedures were reviewed. Three observed procedures in the control group were converted to open surgeries.
There was no significant difference between the 2 groups concerning baseline parameters (ie, sex, age, postgraduate
Comments
In this study we objectively assessed, in a prospective blinded fashion, the intraoperative errors of 13 residents who performed 120 LCs. Half of these procedures were performed by residents who had first shown laparoscopic technical proficiency on the LapSim VR simulator before performing surgery. The results of this study indicate that the VR-trained group performed to a significantly higher degree during their first 10 LCs, as compared with the control group. Subjects in the control group
Conclusions
In conclusion, we believe that the results in this study show that skills acquired in the LapSim simulator improve the initial learning curve in LCs, and that the system is clinically validated for this purpose. It also is clear that all new laparoscopists should train on the simulator until they reach the established proficiency level, before performing laparoscopically on patients. Furthermore, our results support the ongoing implementation of simulation technology into the medical training
Acknowledgment
The authors thank Jakob Bergström at the Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, for all help with the statistical analysis.
References (23)
- et al.
Complications of laparoscopic cholecystectomy: a national study of 4,292 hospitals and an analysis of 77,604 cases
Am J Surg
(1993) - et al.
Errors enacted during endoscopic surgery—a human reliability analysis
Appl Ergon
(1998) - et al.
Skills assessment of surgeons
Surgery
(2002) - et al.
Assessing competency in surgery: where to begin?
Surgery
(2004) - et al.
A redrawn Vendenberg and Kuse mental rotation test: different versions and factors that affect performance
Brain Cogn
(1995) - et al.
Is the learning curve for laparoscopic fundoplication determined by the teacher or the pupil?
Am J Surg
(2005) - et al.
The impact of minimal invasive surgical techniques
Annu Rev Med
(2004) - et al.
The learning curve for laparoscopic cholecystectomy
Am J Surg
(1995) - et al.
To Err Is Human: Building a Safer Health System
(1999) Surgical safety and overwork
Br J Surg
(2004)
What do master surgeons think of surgical competence and revalidation?
Am J Surg
Cited by (489)
Can an Orthopedic Hip Fracture Simulator Advance Orthopedic Residents’ Hip Fracture Fixation Skills to an Expert Level?
2024, Journal of Surgical EducationValidation of a Simulation Model for Robotic Myomectomy
2024, Journal of Minimally Invasive GynecologyIn Situ Simulation and Clinical Outcomes in Infants Born Preterm
2023, Journal of PediatricsAutomated analysis of intraoperative phase in laparoscopic cholecystectomy: A comparison of one attending surgeon and their residents
2023, Journal of Surgical Education