Prospective Cohort Study of Haptic Virtual Reality Laparoscopic Appendicectomy Learning Curve Trajectory

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a
Chris BrownWyn G Lewis

Abstract

Background: Simulation training is strongly advocated by 24/7 risk-rich professions because swift learning curve inflection point attainment delivers earlier competence; the left-shift effect. The aim of this study was to determine the value of haptic laparoscopic virtual reality simulation, by iterative benchmark exercise (n = 8), before simulated laparoscopic appendicectomy (SLA); the hypothesis was that favorable benchmark learning curve trajectories would be associated with improved SLA competence when compared with consultant expert performance. Methods: A 28-trainee cohort completed 1349 Laparoscopic Haptic Virtual Reality Skills (LHVRS) tasks, during which 19 ergonomic variables were assessed by virtual interface, including force feedback (Surgicalscience.com), before 153 SLAs. Primary outcome measure was SLA composite competence score related to six consultant trainer experts. Results: Of the eight LHVRS tasks, the three with the steepest learning curve trajectories correlated with better median overall SLA competence scores, namely tissue grasping/lifting (rho = 0.362, P = .049), fine dissection (rho = 0.388, P = .028), and camera navigation (rho = 0.518, P = .007); fine dissection was the only haptic laparoscopic...Continue Reading

References

Jan 1, 1950·Cancer·W J YOUDEN
Feb 24, 2006·Annals of Surgery·Leanne M SutherlandGuy J Maddern
Dec 7, 2007·Postgraduate Medical Journal·A N HopperW G Lewis
May 20, 2008·BJOG : an International Journal of Obstetrics and Gynaecology·C R LarsenB Ottesen
Aug 28, 2013·The Cochrane Database of Systematic Reviews·Myura NagendranBrian R Davidson
Mar 10, 2015·JAMA Pediatrics·Adam ChengMarc Auerbach
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Jun 16, 2016·Lancet· The Lancet
Jul 19, 2017·The British Journal of Surgery·C BrownW G Lewis
Aug 8, 2018·Journal of Surgical Education·Evelien M OvertoomHenk W R Schreuder

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Methods Mentioned

BETA
dissection

Software Mentioned

LapSim Basic Skills
SPSS
LapSim
LapSim Appendicectomy
Windows

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