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Erschienen in: Surgical Endoscopy 9/2012

01.09.2012

The virtual reality simulator dV-Trainer® is a valid assessment tool for robotic surgical skills

verfasst von: Cyril Perrenot, Manuela Perez, Nguyen Tran, Jean-Philippe Jehl, Jacques Felblinger, Laurent Bresler, Jacques Hubert

Erschienen in: Surgical Endoscopy | Ausgabe 9/2012

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Abstract

Background

Exponential development of minimally invasive techniques, such as robotic-assisted devices, raises the question of how to assess robotic surgery skills. Early development of virtual simulators has provided efficient tools for laparoscopic skills certification based on objective scoring, high availability, and lower cost. However, similar evaluation is lacking for robotic training. The purpose of this study was to assess several criteria, such as reliability, face, content, construct, and concurrent validity of a new virtual robotic surgery simulator.

Methods

This prospective study was conducted from December 2009 to April 2010 using three simulators dV-Trainers® (MIMIC Technologies®) and one Da Vinci S® (Intuitive Surgical®). Seventy-five subjects, divided into five groups according to their initial surgical training, were evaluated based on five representative exercises of robotic specific skills: 3D perception, clutching, visual force feedback, EndoWrist® manipulation, and camera control. Analysis was extracted from (1) questionnaires (realism and interest), (2) automatically generated data from simulators, and (3) subjective scoring by two experts of depersonalized videos of similar exercises with robot.

Results

Face and content validity were generally considered high (77 %). Five levels of ability were clearly identified by the simulator (ANOVA; p = 0.0024). There was a strong correlation between automatic data from dV-Trainer and subjective evaluation with robot (r = 0.822). Reliability of scoring was high (r = 0.851). The most relevant criteria were time and economy of motion. The most relevant exercises were Pick and Place and Ring and Rail.

Conclusions

The dV-Trainer® simulator proves to be a valid tool to assess basic skills of robotic surgery.
Literatur
1.
Zurück zum Zitat Amodeo A, Linares Quevedo A, Joseph JV, Belgrano E, Patel HRH (2009) Robotic laparoscopic surgery: cost and training. Minerva Urol Nefrol 61(2):121–128PubMed Amodeo A, Linares Quevedo A, Joseph JV, Belgrano E, Patel HRH (2009) Robotic laparoscopic surgery: cost and training. Minerva Urol Nefrol 61(2):121–128PubMed
2.
Zurück zum Zitat Callery MP, Strasberg SM, Soper NJ (1996) Complications of laparoscopic general surgery. Gastrointest Endosc Clin N Am 6(2):423–444PubMed Callery MP, Strasberg SM, Soper NJ (1996) Complications of laparoscopic general surgery. Gastrointest Endosc Clin N Am 6(2):423–444PubMed
3.
Zurück zum Zitat Bruynzeel H, de Bruin AF, Bonjer HJ, Lange JF, Hop WC, Ayodeji ID, Kazemier G (2007) Desktop simulator: key to universal training? Surg Endosc 21(9):1637–1640PubMedCrossRef Bruynzeel H, de Bruin AF, Bonjer HJ, Lange JF, Hop WC, Ayodeji ID, Kazemier G (2007) Desktop simulator: key to universal training? Surg Endosc 21(9):1637–1640PubMedCrossRef
4.
Zurück zum Zitat Van Dongen KW, Tournoij E, van der Zee DC, Schijven MP, Broeders IA (2007) Construct validity of the LapSim: can the LapSim virtual reality simulator distinguish between novices and experts? Surg Endosc 21(8):1413–1417PubMedCrossRef Van Dongen KW, Tournoij E, van der Zee DC, Schijven MP, Broeders IA (2007) Construct validity of the LapSim: can the LapSim virtual reality simulator distinguish between novices and experts? Surg Endosc 21(8):1413–1417PubMedCrossRef
5.
Zurück zum Zitat Kroeze SGC, Mayer EK, Chopra S, Aggarwal R, Darzi A, Patel A (2009) Assessment of laparoscopic suturing skills of urology residents: a pan-European study. Eur Urol 56(5):865–873PubMedCrossRef Kroeze SGC, Mayer EK, Chopra S, Aggarwal R, Darzi A, Patel A (2009) Assessment of laparoscopic suturing skills of urology residents: a pan-European study. Eur Urol 56(5):865–873PubMedCrossRef
6.
Zurück zum Zitat Fried GM (2008) FLS assessment of competency using simulated laparoscopic tasks. J Gastrointest Surg 12(2):210–212PubMedCrossRef Fried GM (2008) FLS assessment of competency using simulated laparoscopic tasks. J Gastrointest Surg 12(2):210–212PubMedCrossRef
7.
Zurück zum Zitat Xeroulis G, Dubrowski A, Leslie K (2009) Simulation in laparoscopic surgery: a concurrent validity study for FLS. Surg Endosc 23(1):161–165PubMedCrossRef Xeroulis G, Dubrowski A, Leslie K (2009) Simulation in laparoscopic surgery: a concurrent validity study for FLS. Surg Endosc 23(1):161–165PubMedCrossRef
8.
Zurück zum Zitat Sroka G, Feldman LS, Vassiliou MC, Kaneva PA, Fayez R, Fried GM (2010) Fundamentals of laparoscopic surgery simulator training to proficiency improves laparoscopic performance in the operating room-a randomized controlled trial. Am J Surg 199(1):115–120PubMedCrossRef Sroka G, Feldman LS, Vassiliou MC, Kaneva PA, Fayez R, Fried GM (2010) Fundamentals of laparoscopic surgery simulator training to proficiency improves laparoscopic performance in the operating room-a randomized controlled trial. Am J Surg 199(1):115–120PubMedCrossRef
9.
Zurück zum Zitat Feldman LS, Sherman V, Fried GM (2004) Using simulators to assess laparoscopic competence: ready for widespread use? Surgery 135(1):28–42PubMedCrossRef Feldman LS, Sherman V, Fried GM (2004) Using simulators to assess laparoscopic competence: ready for widespread use? Surgery 135(1):28–42PubMedCrossRef
10.
Zurück zum Zitat Sweet RM, Hananel D, Lawrenz F (2010) A unified approach to validation, reliability, and education study design for surgical technical skills training. Arch Surg 145(2):197–201PubMedCrossRef Sweet RM, Hananel D, Lawrenz F (2010) A unified approach to validation, reliability, and education study design for surgical technical skills training. Arch Surg 145(2):197–201PubMedCrossRef
11.
Zurück zum Zitat Van Nortwick SS, Lendvay TS, Jensen AR, Wright AS, Horvath KD, Kim S (2010) Methodologies for establishing validity in surgical simulation studies. Surgery 147(5):622–630PubMedCrossRef Van Nortwick SS, Lendvay TS, Jensen AR, Wright AS, Horvath KD, Kim S (2010) Methodologies for establishing validity in surgical simulation studies. Surgery 147(5):622–630PubMedCrossRef
12.
Zurück zum Zitat Chipman JG, Schmitz CC (2009) Using objective structured assessment of technical skills to evaluate a basic skills simulation curriculum for first-year surgical residents. J Am Coll Surg 209(3):364–370PubMedCrossRef Chipman JG, Schmitz CC (2009) Using objective structured assessment of technical skills to evaluate a basic skills simulation curriculum for first-year surgical residents. J Am Coll Surg 209(3):364–370PubMedCrossRef
13.
Zurück zum Zitat Hogle NJ, Briggs WM, Fowler DL (2007) Documenting a learning curve and test-retest reliability of two tasks on a virtual reality training simulator in laparoscopic surgery. J Surg Educ 64(6):424–430PubMedCrossRef Hogle NJ, Briggs WM, Fowler DL (2007) Documenting a learning curve and test-retest reliability of two tasks on a virtual reality training simulator in laparoscopic surgery. J Surg Educ 64(6):424–430PubMedCrossRef
14.
Zurück zum Zitat Gallagher AG, Ritter EM, Satava RM (2003) Fundamental principles of validation, and reliability: rigorous science for the assessment of surgical education and training. Surg Endosc 17(10):1525–1529PubMedCrossRef Gallagher AG, Ritter EM, Satava RM (2003) Fundamental principles of validation, and reliability: rigorous science for the assessment of surgical education and training. Surg Endosc 17(10):1525–1529PubMedCrossRef
15.
Zurück zum Zitat Kenney PA, Wszolek MF, Gould JJ, Libertino JA, Moinzadeh A (2009) Face, content, and construct validity of dV-Trainer: a novel virtual reality simulator for robotic surgery. Urology 73(6):1288–1292PubMedCrossRef Kenney PA, Wszolek MF, Gould JJ, Libertino JA, Moinzadeh A (2009) Face, content, and construct validity of dV-Trainer: a novel virtual reality simulator for robotic surgery. Urology 73(6):1288–1292PubMedCrossRef
16.
Zurück zum Zitat Sethi AS, Peine WJ, Mohammadi Y, Sundaram CP (2009) Validation of a novel virtual reality robotic simulator. J Endourol 23(3):503–508PubMedCrossRef Sethi AS, Peine WJ, Mohammadi Y, Sundaram CP (2009) Validation of a novel virtual reality robotic simulator. J Endourol 23(3):503–508PubMedCrossRef
17.
Zurück zum Zitat Lendvay TS, Casale P, Sweet R, Peters C (2008) VR robotic surgery: randomized blinded study of the dV-Trainer robotic simulator. Stud Health Technol Inform 132:242–244PubMed Lendvay TS, Casale P, Sweet R, Peters C (2008) VR robotic surgery: randomized blinded study of the dV-Trainer robotic simulator. Stud Health Technol Inform 132:242–244PubMed
18.
Zurück zum Zitat Lerner MA, Ayalew M, Peine WJ, Sundaram CP (2010) Does training on a virtual reality robotic simulator improve performance on the da Vinci surgical system? J Endourol 24(3):467–472PubMedCrossRef Lerner MA, Ayalew M, Peine WJ, Sundaram CP (2010) Does training on a virtual reality robotic simulator improve performance on the da Vinci surgical system? J Endourol 24(3):467–472PubMedCrossRef
19.
Zurück zum Zitat Hogle NJ, Chang L, Strong VEM, Welcome AOU, Sinaan M, Bailey R, Fowler DL (2009) Validation of laparoscopic surgical skills training outside the operating room: a long road. Surg Endosc 23(7):1476–1482PubMedCrossRef Hogle NJ, Chang L, Strong VEM, Welcome AOU, Sinaan M, Bailey R, Fowler DL (2009) Validation of laparoscopic surgical skills training outside the operating room: a long road. Surg Endosc 23(7):1476–1482PubMedCrossRef
20.
Zurück zum Zitat Grover S, Tan GY, Srivastava A, Leung RA, Tewari AK (2010) Residency training program paradigms for teaching robotic surgical skills to urology residents. Curr Urol Rep 1(2):87–92CrossRef Grover S, Tan GY, Srivastava A, Leung RA, Tewari AK (2010) Residency training program paradigms for teaching robotic surgical skills to urology residents. Curr Urol Rep 1(2):87–92CrossRef
21.
Zurück zum Zitat Seixas-Mikelus SA, Stegemann AP, Kesavadas T, Srimathveeravalli G, Sathyaseelan G, Chandrasekhar R, Wilding GE, Peabody JO, Guru KA (2011) Content validation of a novel robotic robotic surgical simulator. BJU Int 107(7):1130–1135PubMedCrossRef Seixas-Mikelus SA, Stegemann AP, Kesavadas T, Srimathveeravalli G, Sathyaseelan G, Chandrasekhar R, Wilding GE, Peabody JO, Guru KA (2011) Content validation of a novel robotic robotic surgical simulator. BJU Int 107(7):1130–1135PubMedCrossRef
22.
Zurück zum Zitat Seixas-Mikelus SA, Kesavadas T, Srimathveeravalli G, Chandrasekhar R, Wilding GE, Guru KA (2010) Face Validation of a novel surgical simulator. Urology 76(2):357–360PubMedCrossRef Seixas-Mikelus SA, Kesavadas T, Srimathveeravalli G, Chandrasekhar R, Wilding GE, Guru KA (2010) Face Validation of a novel surgical simulator. Urology 76(2):357–360PubMedCrossRef
23.
Zurück zum Zitat Hung AJ, Zehnder P, Patil MB, Cai J, Ng CK, Aron M, Gill IS, Desai MM (2011) Face, content and construct validity of a novel robotic surgery simulator. J Urol 186(3):1019–1025PubMedCrossRef Hung AJ, Zehnder P, Patil MB, Cai J, Ng CK, Aron M, Gill IS, Desai MM (2011) Face, content and construct validity of a novel robotic surgery simulator. J Urol 186(3):1019–1025PubMedCrossRef
24.
Zurück zum Zitat Gallagher AG, Ritter EM, Satava RM (2003) Fundamental principles of validation, and reliability: rigorous science for the assessment of surgical education and training. Surg Endosc 17(10):1525–1529PubMedCrossRef Gallagher AG, Ritter EM, Satava RM (2003) Fundamental principles of validation, and reliability: rigorous science for the assessment of surgical education and training. Surg Endosc 17(10):1525–1529PubMedCrossRef
Metadaten
Titel
The virtual reality simulator dV-Trainer® is a valid assessment tool for robotic surgical skills
verfasst von
Cyril Perrenot
Manuela Perez
Nguyen Tran
Jean-Philippe Jehl
Jacques Felblinger
Laurent Bresler
Jacques Hubert
Publikationsdatum
01.09.2012
Verlag
Springer-Verlag
Erschienen in
Surgical Endoscopy / Ausgabe 9/2012
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-012-2237-0

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