title: Validated robotic laparoscopic surgical training in a virtual-reality environment.
abstract: BACKGROUND
  A robotic virtual-reality (VR) simulator has been developed to improve robot-assisted training for laparoscopic surgery and to enhance surgical performance in laparoscopic skills. The simulated VR training environment provides an effective approach to evaluate and improve surgical performance. This study presents our findings of the VR training environment for robotic laparoscopy.
  
  
  METHODS
  Eight volunteers performed two inanimate tasks in both the VR and the actual training environment. The tasks were bimanual carrying (BC) and needle passing (NP). For the BC task, the volunteers simultaneously transferred two plastic pieces in opposite directions five times consecutively. The same volunteers passed a surgical needle through six pairs of holes in the NP task. Both tasks require significant bimanual coordination that mimics actual laparoscopic skills. Data analysis included time to task completion, speed and distance traveled of the instrument tip, as well as range of motion of the subject's wrist and elbow of the right arm. Electromyography of the right wrist flexor and extensor were also analyzed. Paired t-tests and Pearson's r were used to explore the differences and correlations between the two environments.
  
  
  RESULTS
  There were no significant differences between the actual and the simulated VR environment with respect to the BC task, while there were significant differences in almost all dependent parameters for the NP task. Moderate to high correlations for most dependent parameters were revealed for both tasks.
  
  
  CONCLUSIONS
  Our data shows that the VR environment adequately simulated the BC task. The significant differences found for the NP task may be attributed to an oversimplification in the VR environment. However, they do point to the need for improvements in the complexity of our VR simulation. Further research work is needed to develop effective and reliable VR environments for robotic laparoscopic training.
authors.affiliation: HPER Biomechanics Lab, University of Nebraska at Omaha, Omaha, NE 68182-0216, USA.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Katsavelis
authors.forename: Ka-Chun
authors.initials: KC
authors.lastname: Siu
authors.forename: Bernadette
authors.initials: B
authors.lastname: Brown-Clerk
authors.forename: Irene H
authors.initials: IH
authors.lastname: Lee
authors.forename: Yong Kwon
authors.initials: YK
authors.lastname: Lee
authors.forename: Dmitry
authors.initials: D
authors.lastname: Oleynikov
authors.forename: Nick
authors.initials: N
authors.lastname: Stergiou
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003194:Computer-Assisted Instruction; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009048:Motor Skills / Q000502:physiology*; D011214:Practice, Psychological; D015203:Reproducibility of Results; D012371:Robotics; D025321:Surgery, Computer-Assisted / Q000193:education*; D014584:User-Computer Interface; D055815:Young Adult