Abstract
Background
Safe realistic training and unbiased quantitative assessment of technical skills are required for laparoscopy. Virtual reality (VR) simulators may be useful tools for training and assessing basic and advanced surgical skills and procedures. This study aimed to investigate the construct validity of the LapSimGyn VR simulator, and to determine the learning curves of gynecologists with different levels of experience.
Methods
For this study, 32 gynecologic trainees and consultants (juniors or seniors) were allocated into three groups: novices (0 advanced laparoscopic procedures), intermediate level (>20 and <60 procedures), and experts (>100 procedures). All performed 10 sets of simulations consisting of three basic skill tasks and an ectopic pregnancy program. The simulations were carried out on 3 days within a maximum period of 2 weeks. Assessment of skills was based on time, economy of movement, and error parameters measured by the simulator.
Results
The data showed that expert gynecologists performed significantly and consistently better than intermediate and novice gynecologists. The learning curves differed significantly between the groups, showing that experts start at a higher level and more rapidly reach the plateau of their learning curve than do intermediate and novice groups of surgeons.
Conclusion
The LapSimGyn VR simulator package demonstrates construct validity on both the basic skills module and the procedural gynecologic module for ectopic pregnancy. Learning curves can be obtained, but to reach the maximum performance for the more complex tasks, 10 repetitions do not seem sufficient at the given task level and settings. LapSimGyn also seems to be flexible and widely accepted by the users.
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Acknowledgments
The authors thank TrygFonden and The Juliane Marie Centre for financial support, and Dr. Christian Ottosen, Dr. Lars Schouenborg, and Professor Torben V. Schroeder for inspiration and criticism. Finally, they thank the gynecologic departments at the Rigshospitalet, Frederiksberg, Hillerød, Glostrup, Hvidovre, Holbæk, and Herlev hospitals for recruiting test persons.
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Larsen, C.R., Grantcharov, T., Aggarwal, R. et al. Objective assessment of gynecologic laparoscopic skills using the LapSimGyn virtual reality simulator. Surg Endosc 20, 1460–1466 (2006). https://doi.org/10.1007/s00464-005-0745-x
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DOI: https://doi.org/10.1007/s00464-005-0745-x