Virtual reality simulation to enhance laparoscopic salpingectomy skills.


Journal

Journal of gynecology obstetrics and human reproduction
ISSN: 2468-7847
Titre abrégé: J Gynecol Obstet Hum Reprod
Pays: France
ID NLM: 101701588

Informations de publication

Date de publication:
Mar 2020
Historique:
received: 11 02 2019
revised: 29 11 2019
accepted: 07 01 2020
pubmed: 14 1 2020
medline: 8 1 2021
entrez: 14 1 2020
Statut: ppublish

Résumé

To assess skill enhancement and maintenance by virtual-reality simulation of laparoscopic salpingectomy in gynecologic surgery fellows. Skill acquisition by virtual-reality surgical simulation is an active field of research and technological development. Salpingectomy is one of the first gynecologic surgery techniques taught to fellows that requires accompanied learning. A single-center prospective study was performed in the University of Lyon, France, including 26 junior fellows (≤ 3 semesters' internship) performing laparoscopic salpingectomy exercises on a LapSim® virtual reality simulator. Salpingectomy was performed and timed on 3 trials in session 1 and 3 trials in session 2, at a 3-month interval. Analysis was based on students' subjective assessments and a senior surgeon's objective assessment of skill. Progress between the 2 sessions was assessed on McNemar test and Wilcoxon test for matched series. 26 junior specialist trainees performed all trials. Most performed anterograde salpingectomy, both in session 1 (69 %) and session 2 (86 %). Mean procedure time was significantly shorter in session 2: 6.10min versus 7.82min (p=0.0003). There was a significant decrease in blood loss between the first trial in session 1 and the last trial in session 2: 167ml versus 70.3ml (p=0.02). Subjective assessment showed a significant decrease in anxiety and significant increase in perceived efficacy, eye-hand coordination and ergonomics. Efficacy, performance quality and speed of execution as assessed by the senior surgeon all improved significantly from trial to trial, while hesitation significantly decreased. The study showed that junior trainees improved their surgical skills on a short laparoscopic exercise using a virtual reality simulator. Virtual reality simulation is useful in the early learning curve, accelerating the acquisition of reflexes. Maintaining skill requires simulation sessions at shorter intervals.

Sections du résumé

BACKGROUND BACKGROUND
To assess skill enhancement and maintenance by virtual-reality simulation of laparoscopic salpingectomy in gynecologic surgery fellows. Skill acquisition by virtual-reality surgical simulation is an active field of research and technological development. Salpingectomy is one of the first gynecologic surgery techniques taught to fellows that requires accompanied learning.
METHODS METHODS
A single-center prospective study was performed in the University of Lyon, France, including 26 junior fellows (≤ 3 semesters' internship) performing laparoscopic salpingectomy exercises on a LapSim® virtual reality simulator. Salpingectomy was performed and timed on 3 trials in session 1 and 3 trials in session 2, at a 3-month interval. Analysis was based on students' subjective assessments and a senior surgeon's objective assessment of skill. Progress between the 2 sessions was assessed on McNemar test and Wilcoxon test for matched series.
RESULTS RESULTS
26 junior specialist trainees performed all trials. Most performed anterograde salpingectomy, both in session 1 (69 %) and session 2 (86 %). Mean procedure time was significantly shorter in session 2: 6.10min versus 7.82min (p=0.0003). There was a significant decrease in blood loss between the first trial in session 1 and the last trial in session 2: 167ml versus 70.3ml (p=0.02). Subjective assessment showed a significant decrease in anxiety and significant increase in perceived efficacy, eye-hand coordination and ergonomics. Efficacy, performance quality and speed of execution as assessed by the senior surgeon all improved significantly from trial to trial, while hesitation significantly decreased.
CONCLUSIONS CONCLUSIONS
The study showed that junior trainees improved their surgical skills on a short laparoscopic exercise using a virtual reality simulator. Virtual reality simulation is useful in the early learning curve, accelerating the acquisition of reflexes. Maintaining skill requires simulation sessions at shorter intervals.

Identifiants

pubmed: 31931145
pii: S2468-7847(20)30006-4
doi: 10.1016/j.jogoh.2020.101685
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

101685

Informations de copyright

Copyright © 2020 Elsevier Masson SAS. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no competing interests.

Auteurs

Gery Lamblin (G)

Department of Gynecology Surgery and Urogynecology, Femme Mère Enfant University Hospital, Hospices Civils de Lyon, Lyon-Bron, France; Claude Bernard Lyon 1 Medical Faculty, Lyon 1 University, 69008 Lyon, France; Surgery School, Claude Bernard Lyon 1 University, IDEFI Program, SAMSEI (ANR 11 IDFI 0034), Lyon, France. Electronic address: gery.lamblin@chu-lyon.fr.

Gabriel Thiberville (G)

Department of Gynecology Surgery and Urogynecology, Femme Mère Enfant University Hospital, Hospices Civils de Lyon, Lyon-Bron, France.

Loic Druette (L)

Surgery School, Claude Bernard Lyon 1 University, IDEFI Program, SAMSEI (ANR 11 IDFI 0034), Lyon, France.

Stéphanie Moret (S)

Department of Gynecology Surgery and Urogynecology, Femme Mère Enfant University Hospital, Hospices Civils de Lyon, Lyon-Bron, France.

Sébastien Couraud (S)

Lyon Sud Medical Faculty, Lyon 1 University, 69600 Oullins, France.

Xavier Martin (X)

Surgery School, Claude Bernard Lyon 1 University, IDEFI Program, SAMSEI (ANR 11 IDFI 0034), Lyon, France.

Gil Dubernard (G)

Department of Gynecology Surgery, Hôpital de la Croix Rousse, Hospices Civils de Lyon, 69004 Lyon, France.

Gautier Chene (G)

Department of Gynecology Surgery and Urogynecology, Femme Mère Enfant University Hospital, Hospices Civils de Lyon, Lyon-Bron, France; Claude Bernard Lyon 1 Medical Faculty, Lyon 1 University, 69008 Lyon, France.

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Classifications MeSH