Laparoscopic Skills, Like Riding a Bike or You Lose What You Do Not Use!?

Amina Bouhelal, Dr, Walid Elbakbak, Dr, Badriya Alaraimi, Dr, Bijendra Patel, Mr. Barts Cancer Institute Queen Mary University of London.

Background: The validity of virtual reality training has been repeatedly proven, However, The ideal time to start training remains a question that still needs to be answered. Is learning laparoscopic skills like riding a bike or you lose what you do not use?

Aim: To investigate the learning curves toward proficiency in laparoscopic cholecystectomy using virtual reality and the to test the retainability of skills after a significant time of no training and no laparoscopic exposure

Methods: We randomly recruited and progressively trained 30 novices toward full laparoscopic cholecystectomy procedure, on a high-fidelity, commercially available Virtual Reality simulator (Lap Mentor, Simbionix) using a validated training curriculum with expert performance used as proficiency criteria. We re-tested the novices one year after the initial training to investigate the skills retainability.

Results: All novices reached proficiency level in all tasks, (P<0.000) Time taken to finish the full procedure decreased from 9:57 to 7:10 min in MTST of 30:04 minute. Economy of movement improved from 551 to 363 and the Total path length improved from 1368 – 807 cm number in of 3.4 trials. One year after the initial training with no further exposure to laparoscopy or simulation we investigated the retainability of the skills. 90% of the participants kept their time proficiency, 80% kept the economy of movement and 60% remained within the TPL proficiency.

Conclusion: The role of Virtual reality is evident and more prominently the skills obtained using VR were kept even after significant time of no training and no exposure.

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