Assessment of laparoscopic surgical skills acquired on laparoscopic virtual reality simulator compared to box trainer: an analysis of obstetrics-gynaecology residents

Διπλωματική Εργασία uoadl:1314677 273 Αναγνώσεις

Μονάδα:
ΠΜΣ Ελάχιστα Επεμβατική Χειρουργική, Ρομποτική Χειρουργική & Τηλεχειρουργική
Βιβλιοθήκη Επιστημών Υγείας
Ημερομηνία κατάθεσης:
2015-06-25
Έτος εκπόνησης:
2015
Συγγραφέας:
Βάρρας Μιχαήλ
Στοιχεία επιβλεπόντων καθηγητών:
Νικόλαος Νικητέας
Πρωτότυπος Τίτλος:
Assessment of laparoscopic surgical skills acquired on laparoscopic virtual reality simulator compared to box trainer: an analysis of obstetrics-gynaecology residents
Γλώσσες εργασίας:
Αγγλικά
Περίληψη:
Background: Laparoscopic surgery requires very different set of psychomotor
skills compared to open surgery, such as working in three-dimensional
environment with two-dimensional view, four instead of six degrees of freedom,
eye-hand coordination, depth perception and bimanual manipulation. Laparoscopic
surgical training using laparoscopic simulators overcomes these inherent
differences and improves efficiency of learning and patient safety. The aim of
this study was to compare the effectiveness of virtual reality (VR) simulator
and box-trainer and determine whether one has advantages over the other as
training tool for relatively simple laparoscopic procedures.
Methods: A prospective, randomized, blinded, comparative trial enrolled 20
residents in Obstetrics and Gynaecology with minimal laparoscopic experiences
to participate in practical exercises with either virtual reality (LapVR)
simulator (group-A), or laparoscopic Box-Trainer (group-B). The candidates
acted as their own control. Subjects within one group were not allowed to
practice, on the opposing trainers. Initial teaching session was given to
obtain all participants familiarization with the virtual reality simulator and
they carried out laparoscopic salpingotomy and laparoscopic salpingectomy for
ectopic pregnancy on LapVR (pretest). Performance was recorded by LapVR for
parameters of total time taken, time of cautery used, total blood loss and
economy of motion. The subjects were then randomized to either group-A or
group-B for series of laparoscopic exercises. The residents of group-A were
practiced on LapVR in laparoscopic peg transfer, clipping and cutting and
certain parameters were assessed by LapVR. The practical exercises on
laparoscopic Trainer-Box were based in the tasks of “ovarian cystectomy” and
“salpingotomy” for ectopic pregnancy and they were captured on DVD and scored
for time and accuracy by a blinded expert investigator. After 2-day sessions
lasting one and half hours each, all subjects were reassessed on the initial
same procedures on LapVR (post-test).
Results: Both groups showed improvement after their training tasks. Performance
of two groups was comparable before and after training for both laparoscopic
ectopic pregnancy procedures on LapVR. The participants’ satisfaction according
to post-training questionnaire was high for the training modality as a whole
and showed no differences between groups.
Conclusions: Neither LapVR nor Box-Trainer simulator showed any superiority
over other for training laparoscopic skills to novice learners. Laparoscopic
training laboratories in laparoscopic training hospitals could include virtual
reality simulators as reasonable alternative to Box-Trainer simulators for
laparoscopic training of inexperienced residents in laparoscopy.
Λέξεις-κλειδιά:
Προσομοιωτής, Εκπαιδευτικό-κουτί, Εικονική πραγματικότητα, Λαπαροσκοπική χειρουργική, Γυναικολογικές επεμβάσεις
Ευρετήριο:
Όχι
Αρ. σελίδων ευρετηρίου:
0
Εικονογραφημένη:
Ναι
Αρ. βιβλιογραφικών αναφορών:
156
Αριθμός σελίδων:
203