Virtual reality training in laparoscopic surgery: a preliminary assessment of minimally invasive surgical trainer virtual reality (MIST VR).
BACKGROUND
The "fulcrum effect" of the body wall on surgical instrument manipulation is a major hurdle for novice endoscopic surgeons. Virtual reality training has not previously been evaluated as a means to overcome this problem.


METHODS
16 participants with no experience of endoscopy were required to make multiple defined incisions under laparoscopic laboratory conditions within 2-minute periods. Half of the subjects were randomized to receive initial training on the Minimally Invasive Surgical Trainer, Virtual Reality (MIST VR) computer programme.


RESULTS
Participants with MIST VR training made significantly more correct incisions (P = 0.0001) than the control group on test trial 1, and even after extended practice by both groups (P = 0.0001). They were also significantly more likely to actively use both hands to perform the endoscopic evaluation task (P = 0.01).


CONCLUSIONS
Virtual reality training represents a potential, viable solution for junior endoscopists, for overcoming the "fulcrum effect", in a replicable, safe learning environment which allows objective and reliable quantification of skill levels by trainers.
Gallagher
A G
AG
Queen's University Centre for Endoscopic Training and Research, Queen's University, Belfast, Northern Ireland. ag.gallagher@qub.ac.uk
McClure
N
N
McGuigan
J
J
Crothers
I
I
Browning
J
J
D000328:Adult; D004501:Education, Medical; D013502:General Surgery / Q000193:education*; D006801:Humans; D010535:Laparoscopy; D011597:Psychomotor Performance; D014584:User-Computer Interface