Effect of virtual reality training on laparoscopic surgery: randomised controlled trial.
OBJECTIVE
To assess the effect of virtual reality training on an actual laparoscopic operation.


METHODS
Prospective randomised controlled and blinded trial.


METHODS
Seven gynaecological departments in the Zeeland region of Denmark.


METHODS
24 first and second year registrars specialising in gynaecology and obstetrics.


METHODS
Proficiency based virtual reality simulator training in laparoscopic salpingectomy and standard clinical education (controls).


METHODS
The main outcome measure was technical performance assessed by two independent observers blinded to trainee and training status using a previously validated general and task specific rating scale. The secondary outcome measure was operation time in minutes.


RESULTS
The simulator trained group (n=11) reached a median total score of 33 points (interquartile range 32-36 points), equivalent to the experience gained after 20-50 laparoscopic procedures, whereas the control group (n=10) reached a median total score of 23 (22-27) points, equivalent to the experience gained from fewer than five procedures (P<0.001). The median total operation time in the simulator trained group was 12 minutes (interquartile range 10-14 minutes) and in the control group was 24 (20-29) minutes (P<0.001). The observers' inter-rater agreement was 0.79.


CONCLUSIONS
Skills in laparoscopic surgery can be increased in a clinically relevant manner using proficiency based virtual reality simulator training. The performance level of novices was increased to that of intermediately experienced laparoscopists and operation time was halved. Simulator training should be considered before trainees carry out laparoscopic procedures.


BACKGROUND
ClinicalTrials.gov NCT00311792.
Larsen
Christian R
CR
Department of Gynecology, Juliane Marie Centre for Children, Women and Reproduction, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, DK-2100 OE, Copenhagen, Denmark. crl@dadlnet.dk [corrected]
Soerensen
Jette L
JL
Grantcharov
Teodor P
TP
Dalsgaard
Torur
T
Schouenborg
Lars
L
Ottosen
Christian
C
Schroeder
Torben V
TV
Ottesen
Bent S
BS
D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D003198:Computer Simulation; D003718:Denmark; D004503:Education, Medical, Graduate; D005260:Female; D013502:General Surgery / Q000193:education*; D006176:Gynecology / Q000193:education*; D006801:Humans; D010535:Laparoscopy / Q000592:standards*; D008297:Male; D011446:Prospective Studies; D013663:Teaching / Q000379:methods; D013997:Time Factors