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VALIDATION OF A VIRTUAL FLS INTRACORPOREAL SUTURING SIMULATOR

Yaoyu Fu1, Lora Cavuoto, PhD1, Trudi Qi, PhD2, Karthik Panneerselvam2, Venkata S Artikala, PhD3, Andinet Enquobahrie, PhD3, Suvranu De, PhD2, Steven D Schwaitzberg, MD4. 1University at Buffalo, 2Rensselaer Polytechnic Institute, 3Kitware, Inc., 4University at Buffalo Jacobs School of Medicine and Biomedical Sciences

INTRODUCTION: Intracorporeal suturing is one of the most important and difficult procedures in laparoscopic surgery. Practicing on a FLS trainer box is effective but requires large amount of consumables and is scored subjectively. The purpose of this study is to evaluate the face validity of the intracorporeal suturing task on a Virtual Fundamentals of Laparoscopic Surgery Simulator (Virtual FLS). We hypothesize that the Virtual FLS will demonstrate face validity.

METHODS AND PROCEDURES: After a video demonstration and a practice period, twenty-three medical students and residents completed an evaluation of the simulator. The participants were asked to perform the standard intracorporeal suturing task on each of the Virtual FLS and the traditional FLS box trainer. The presentation order of the devices was balanced. The performance scores on each device were calculated based on time (seconds), deviations to the black dots (mm), and incision gap (mm). The participants were then asked to finish a 13-question questionnaire regarding the face validity of the simulator. Participants answered questions with ratings from 1 (not realistic/useful) to 5 (very realistic/useful). A Wilcoxon signed ranks test was performed to identify differences in performance on the Virtual FLS compared to the traditional FLS box trainer.

RESULTS: Responses to 10 of the 13 questions (76.9%) averaged above a 3.0 out of 5. Those questions that rated the highest were the degree of realism of the target objects in the Virtual FLS compared to the FLS (3.87) and the usefulness of the Virtual FLS simulation in learning hand-eye coordination skills compared to the FLS (3.83). Those rated lowest were the quality of the force feedback in the Virtual FLS compared to the FLS (2.91) and the degree of realism of the instrument handling in the Virtual FLS compared to that in actual laparoscopic surgery (2.92). Average intracorporeal suturing completion time on the Virtual FLS was 441 (standard deviation = 167) seconds compared to 434 (164) seconds on the box trainer (p=0.903). There was also no significant difference for the incision gap (p=0.098). Deviation in needle insertion from the black dot was smaller for the box trainer than the virtual simulator (2.16 vs. 7.02, p<0.001).

CONCLUSIONS: Overall, participants showed comparable performance on the Virtual FLS and traditional box trainer. Differences in needle insertion deviation may result from limited depth perception in the virtual environment. The Virtual FLS system showed face validity and has the potential to support training on suturing skills. 


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

Abstract ID: 86655

Program Number: P342

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

52

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