title: Objective evaluation of minimally invasive surgical skills for transplantation. Surgeons using a virtual reality simulator.
abstract: BACKGROUND
  The learning curve in laparoscopic surgery may be associated with higher patient risk, which is unacceptable in the setting of kidney donation. Virtual reality simulators may increase the safety and efficiency of training in laparoscopic surgery. The aim of this study was to investigate if the results of a training session reflect the actual skill level of transplantation surgeons and whether the simulator could differentiate laparoscopic experienced transplantation surgeon from advanced trainees.
  
  
  METHODS
  16 subjects were assigned to one of two groups: 5 experienced transplantation surgeon and 11 advanced residents, with only assistant role during transplantation. The level of performance was measured by a relative scoring system that combines single parameters assessed by the computer.
  
  
  RESULTS
  The higher the level of transplantation experience of a participant, the higher the laparoscopic performance. Experienced transplantation surgeons showed statistically significant better scores than the advanced group for time and precision parameters.
  
  
  CONCLUSIONS
  Our results show that performance of the various tasks on the simulator corresponds to the respective level of experience in transplantation surgery in our research groups. This study confirms construct validity for the LapSim. It thus measures relevant skills and can be integrated in an endoscopic training and assessment curriculum for transplantations surgeons.
authors.affiliation: Department of Visceral-, Thoracic- and Vascular Surgery, Philipps-University of Marburg, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Dănilă
authors.forename: B
authors.initials: B
authors.lastname: Gerdes
authors.forename: H
authors.initials: H
authors.lastname: Ulrike
authors.forename: E
authors.initials: E
authors.lastname: Domínguez Fernández
authors.forename: I
authors.initials: I
authors.lastname: Hassan
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000592:standards; D003198:Computer Simulation; D004502:Education, Medical, Continuing / Q000379:methods; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D016030:Kidney Transplantation / Q000193:education; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D014584:User-Computer Interface