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Evaluation of surgical skills in new developed VR simulator for laparoscopic sigma resection.

Koji Ikeda, Nobuyoshi Takeshita, Koichi Teramura, Masaaki Ito. National Cancer Center East

Background: While conventional VR simulators have been useful to learn the surgery process seeing surgical anatomy, dissection procedures performed in real surgery could not be reproduced in these VR systems. We developed a new model of VR simulator, Lap-PASS LP-100, in collaboration with a company. This includes the similar human plane structure in which laparoscopic trainings for dissection and exposure are possible

Objective: The objective of this study is to evaluate whether surgical performance tried in this VR can reflect actual surgical skills.

Methods: Fifty subjects including 44 surgeons and 6 medical non-professional were asked to undergo a surgical procedure in a certain step of laparoscopic sigma resection in VR and the procedures were scored. In the step, they dissected the meso-sigmoid colon three times to be scored. Two expert endoscopic surgeons having case experiences of more than 100 laparoscopic surgery, evaluated their surgical procedures performed in the VR simulator in a blind manner, using GOALS, global operative assessment of laparoscopic skills. This includes five evaluationitems as follows; 1. Depth perception, 2. Bimanual dexterity, 3.Efficiency and 4. Tissue handling. Each item counts for 5 points, and so the total score is 20 points.

Results: Among fifty subjects, 11 were colorectal surgeons and 18 had surgical experiences with more than 100 laparoscopic surgeries. Total score evaluated in surgeons with more than 100 experiences of laparoscopic surgery was significantly superior to the others (15.0±0.86 vs 10.3±2.08, p=0.032). Especially, two items of Bimanual dexterity (p=0.0022) and Efficiency (p=0.0045) in GOALS were found to be the great difference between two groups.  .

Conclusion: The current VR simulator succeeded in distinguishing between expert surgery and others. This can include real surgical plane anatomy in laparoscopic colectomy, which can be the effective tools leading to actual exercise for dissection skills in laparoscopic surgery.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 94003

Program Number: P406

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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