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Objective assessment of gynecologic laparoscopic skills using the LapSimGyn virtual reality simulator

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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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References

  1. Aggarwal R, Moorthy K, Darzi A (2004) Laparoscopic skills training and assessment. Br J Surg 91: 1549–1558

    Article  PubMed  CAS  Google Scholar 

  2. Brunner WC, Korndorffer JR Jr., Sierra R, Massarweh NN, Dunne JB, Yau JB, Scott DJ (2004) Laparoscopic virtual reality training: are 30 repetitions enough? J Surg Res 122: 150–156

    Article  PubMed  Google Scholar 

  3. Duffy AJ, Hogle NJ, McCarthy H, Lew JI, Egan A, Christos P, Fowler DL (2005) Construct validity for the LAPSIM laparoscopic surgical simulator. Surg Endosc 19: 401–405

    Article  PubMed  CAS  Google Scholar 

  4. Eriksen JR, Grantcharov T (2005) Objective assessment of laparoscopic skills using a virtual reality stimulator. Surg Endosc 19: 1216–1219

    Article  PubMed  CAS  Google Scholar 

  5. Gallagher AG, Ritter EM, Satava RM (2003) Fundamental principles of validation and reliability: rigorous science for the assessment of surgical education and training. Surg Endosc 17: 1525–1529

    Article  PubMed  CAS  Google Scholar 

  6. Grantcharov TP, Bardram L, Funch-Jensen P, Rosenberg J (2002) Assessment of technical surgical skills. Eur J Surg 168: 139–144

    Article  PubMed  Google Scholar 

  7. Grantcharov TP, Bardram L, Funch-Jensen P, Rosenberg J (2003) Learning curves and impact of previous operative experience on performance on a virtual reality simulator to test laparoscopic surgical skills. Am J Surg 185: 146–149

    Article  PubMed  Google Scholar 

  8. Grantcharov TP, Rosenberg J, Pahle E, Funch-Jensen P (2001) Virtual reality computer simulation. Surg Endosc 15: 242–244

    Article  PubMed  CAS  Google Scholar 

  9. Grober ED, Hamstra SJ, Wanzel KR, Reznick RK, Matsumoto ED, Sidhu RS, Jarvi KA (2004) The educational impact of bench model fidelity on the acquisition of technical skill: the use of clinically relevant outcome measures. Ann Surg 240: 374–381

    Article  PubMed  Google Scholar 

  10. Hyltander A, Liljegren E, Rhodin PH, Lonroth H (2002) The transfer of basic skills learned in a laparoscopic simulator to the operating room. Surg Endosc 16: 1324–1328

    Article  PubMed  CAS  Google Scholar 

  11. Lidegaard O, Hammerum MS (2002) The National Patient Registry as a tool for continuous production and quality control. Ugeskr Laeger 164: 4420–4423

    PubMed  Google Scholar 

  12. Moorthy K, Munz Y, Sarker SK, Darzi A (2003) Objective assessment of technical skills in surgery. BMJ 327: 1032–1037

    Article  PubMed  Google Scholar 

  13. Munz Y, Kumar BD, Moorthy K, Bann S, Darzi A (2004) Laparoscopic virtual reality and box trainers: is one superior to the other? Surg Endosc 18: 485–494

    Article  PubMed  CAS  Google Scholar 

  14. Reznick RK (2005) Surgical simulation: a vital part of our future. Ann Surg 242: 640–641

    Article  PubMed  Google Scholar 

  15. Sherman V, Feldman LS, Stanbridge D, Kazmi R, Fried GM (2005) Assessing the learning curve for the acquisition of laparoscopic skills on a virtual reality simulator. Surg Endosc 19: 678–682

    Article  PubMed  CAS  Google Scholar 

  16. Wanzel KR, Ward M, Reznick RK (2002) Teaching the surgical craft: from selection to certification. Curr Probl Surg 39: 573–659

    Article  PubMed  Google Scholar 

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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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Correspondence to C. R. Larsen.

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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

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