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Simulation training in laparoscopy using a computerized physical reality simulator.

Hasson HM - JSLS (2008 Oct-Dec)

Bottom Line: All were tested on the LTS.Satisfaction: LTS vs MISTELS 79.9 vs 70.4 (P=0.012).Study B: Posttest scores were significantly better in all tasks for both groups, P<0.0001.

View Article: PubMed Central - PubMed

Affiliation: University of New Mexico, Albuquerque, NM. drhasson@aol.com

ABSTRACT

Objective: To describe a new simulator, SurgicalSIM LTS, and summarize our preliminary experience with system.

Methods: LTS was evaluated in 3 studies: (1) 124 participants from 3 Canadian universities: 13 students; 30 residents, fellows, attendings from surgery; 59 gynecologists; 22 urologists were classified based on laparoscopic experience as novice, intermediate, competent, or expert. All were tested on the LTS. Seventy-four were tested on the LTS and MISTELS (McGill Inanimate System for Training and Evaluation of Laparoscopic Skills). Participants completed a satisfaction questionnaire. (2) Twenty-five international gynecologists in-training at Kiel Gynaecologic Endoscopy Center, and 15 students from the center pretested on LTS underwent voluntary additional trials and posttesting. (3) Seventeen experienced laparoscopic surgeons from 3 specialties were recruited to perform on randomly assigned simulators involving 5 commercial, computer-based systems. The surgeons practiced repetitively for 1.5 days. Efficient, error-free performance was measured and proficiency score formulas were developed.

Results: Study A: LTS showed a good correlation with level of experience (P=0.000) and MISTELS (0.79). Satisfaction: LTS vs MISTELS 79.9 vs 70.4 (P=0.012). Study B: Posttest scores were significantly better in all tasks for both groups, P<0.0001. Group mean scores with < or =5 trials were significantly better than with 2 or 3 trials (P<0.012, P<0.018). Study C: LTS had the highest effectiveness rating of the 5 simulators.

Conclusions: A new computerized physical reality simulator can be used to assess/train laparoscopic technical skills.

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Cover opened, monitor unfolded, sensor carousel exposed.
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Related In: Results  -  Collection

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Figure 2: Cover opened, monitor unfolded, sensor carousel exposed.

Mentions: The new simulator consists of an enclosure that can be folded so as to be stored and transported in a compact configuration. A series of simple steps transforms the system into an active configuration (Figure 1). The enclosure houses a revolving sensor carousel (Figure 2). A folding cover covers the carousel and contains ports through which laparoscopic instruments are inserted (Figure 3). The instruments shown in Figure 4 are used to perform procedures on physical models mounted on the carousel. The physical models have embedded sensors that sense and monitor the performance of each exercise. A computer is housed at the distal end of the enclosure with an electronic display mounted on the folding arm. A digital camera captures and records video. Live video of the performance is viewed on an integrated computer monitor. Rotating the sensor carousel provides access to 10 exercises arrayed on 6 stations (Figure 5). Some of the exercises are repeated with the nondominant hand. The validated exercises assess basic laparoscopic coordination skills, cannulation, cutting and suturing skills, including one that verifies knot integrity with a disruptive force of 1 kilogram. The administrative software supports enrolling users in a database, selecting and performing exercises, viewing and printing past and present test reports, watching tutorials and shutting down. The user survey and login functions make it possible to validate individual or group improvement in performance over time and to establish benchmark criteria for skill proficiency.


Simulation training in laparoscopy using a computerized physical reality simulator.

Hasson HM - JSLS (2008 Oct-Dec)

Cover opened, monitor unfolded, sensor carousel exposed.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3015993&req=5

Figure 2: Cover opened, monitor unfolded, sensor carousel exposed.
Mentions: The new simulator consists of an enclosure that can be folded so as to be stored and transported in a compact configuration. A series of simple steps transforms the system into an active configuration (Figure 1). The enclosure houses a revolving sensor carousel (Figure 2). A folding cover covers the carousel and contains ports through which laparoscopic instruments are inserted (Figure 3). The instruments shown in Figure 4 are used to perform procedures on physical models mounted on the carousel. The physical models have embedded sensors that sense and monitor the performance of each exercise. A computer is housed at the distal end of the enclosure with an electronic display mounted on the folding arm. A digital camera captures and records video. Live video of the performance is viewed on an integrated computer monitor. Rotating the sensor carousel provides access to 10 exercises arrayed on 6 stations (Figure 5). Some of the exercises are repeated with the nondominant hand. The validated exercises assess basic laparoscopic coordination skills, cannulation, cutting and suturing skills, including one that verifies knot integrity with a disruptive force of 1 kilogram. The administrative software supports enrolling users in a database, selecting and performing exercises, viewing and printing past and present test reports, watching tutorials and shutting down. The user survey and login functions make it possible to validate individual or group improvement in performance over time and to establish benchmark criteria for skill proficiency.

Bottom Line: All were tested on the LTS.Satisfaction: LTS vs MISTELS 79.9 vs 70.4 (P=0.012).Study B: Posttest scores were significantly better in all tasks for both groups, P<0.0001.

View Article: PubMed Central - PubMed

Affiliation: University of New Mexico, Albuquerque, NM. drhasson@aol.com

ABSTRACT

Objective: To describe a new simulator, SurgicalSIM LTS, and summarize our preliminary experience with system.

Methods: LTS was evaluated in 3 studies: (1) 124 participants from 3 Canadian universities: 13 students; 30 residents, fellows, attendings from surgery; 59 gynecologists; 22 urologists were classified based on laparoscopic experience as novice, intermediate, competent, or expert. All were tested on the LTS. Seventy-four were tested on the LTS and MISTELS (McGill Inanimate System for Training and Evaluation of Laparoscopic Skills). Participants completed a satisfaction questionnaire. (2) Twenty-five international gynecologists in-training at Kiel Gynaecologic Endoscopy Center, and 15 students from the center pretested on LTS underwent voluntary additional trials and posttesting. (3) Seventeen experienced laparoscopic surgeons from 3 specialties were recruited to perform on randomly assigned simulators involving 5 commercial, computer-based systems. The surgeons practiced repetitively for 1.5 days. Efficient, error-free performance was measured and proficiency score formulas were developed.

Results: Study A: LTS showed a good correlation with level of experience (P=0.000) and MISTELS (0.79). Satisfaction: LTS vs MISTELS 79.9 vs 70.4 (P=0.012). Study B: Posttest scores were significantly better in all tasks for both groups, P<0.0001. Group mean scores with < or =5 trials were significantly better than with 2 or 3 trials (P<0.012, P<0.018). Study C: LTS had the highest effectiveness rating of the 5 simulators.

Conclusions: A new computerized physical reality simulator can be used to assess/train laparoscopic technical skills.

Show MeSH