Laparoscopic Virtual Reality Simulation Combined with Live Animal Model Training: A Clinical Experience

Ulrika Johannesson1*, Sophia Ehrstrom2, Tomas Askerud3 and Magnus Kjellman4

1Department of Clinical Sciences, Division of Obstetrics and Gynecology, Danderyd Hospital, Karolinska Institute, Sweden
2Department of Gynecology, Ultragyn Sophiahemmet Private Hospital, Sweden
3Clinical Skills Center, Karolinska University Hospital, Stockholm, Sweden
4Department of Molecular Medicine and Surgery, Karolinska Institute, Sweden

^*Correspondance to: Ulrika Johannesson 

 PDF  Full Text DOI: 10.25107/2474-1647.2729

Abstract

Objective: Does virtual reality simulation combined with animal model training improve psychomotor skills over time? Background: The advantages of laparoscopy are well known. An increase in 80% of emergency gynecological patients at Danderyd Hospital resulted in more surgical cases during nights and weekends. The doctors covering the shifts were residents and specialists either with an obstetric or gynecological profile. To ensure patient safety a clinical education model focusing on basic laparoscopic skills was needed. Design: Fifty-three doctors were invited to a five step curriculum in laparoscopy consisting of (1) a two hour interactive lecture on laparoscopy, (2) a two hour box training and training of open entry technique, (3) a Virtual Reality (VR) simulator program of 16 different psychomotor skills (LapSim®), (4) a one day laparoscopic training on a live animal model, (5) six months later a repetition of step 3. Measurements on step 3 were compared to step 5 and analyzed by Wilcoxon Matched Pairs test and Sign test. Ethical permission was obtained. Setting: Danderyd University Hospital and Karolinska University Hospital Solna, Stockholm, Sweden. Participants: All fifty-three doctors working at the clinic were invited to the study. Results: Thirty-nine doctors completed the curriculum. There was a significant improvement in psychomotor skills measuring camera navigation (p=0.001), coordination (p=0.03), grasping (p=0.02), lifting and grasping (p=0.02), cutting and clip applying (p<0.05) at step 5 compared to step 3. Conclusion: Virtual reality simulation combined with animal model training can significantly improve psychomotor skills after 6 months. Patient safety may increase in larger clinics where there is a need for emergency gynecological laparoscopy. Further studies are required to measure the duration and quality of improvement.

Keywords

Laparoscopy; Surgical training; Virtual reality simulation

Cite the article

Johannesson U, Ehrstrom S, Askerud T, Kjellman M. Laparoscopic Virtual Reality Simulation Combined with Live Animal Model Training: A Clinical Experience. Clin Surg. 2020; 5: 2729..