title: Assessment of comparative skills between hand-assisted and straight laparoscopic colorectal training on an augmented reality simulator.
abstract: OBJECTIVE
  The aim of this study was to compare skills sets during a hand-assisted and straight laparoscopic colectomy on an augmented reality simulator.
  
  
  METHODS
  Twenty-nine surgeons, assigned randomly in 2 groups, performed laparoscopic sigmoid colectomies on a simulator: group A (n = 15) performed hand-assisted then straight procedures; group B (n = 14) performed straight then hand-assisted procedures. Groups were compared according to prior laparoscopic colorectal experience, performance (time, instrument path length, and instrument velocity changes), technical skills, and operative error.
  
  
  RESULTS
  Prior laparoscopic colorectal experience was similar in both groups. Both groups had better performances with the hand-assisted approach, although technical skill scores were similar between approaches. The error rate was higher with the hand-assisted approach in group A, but similar between both approaches in group B.
  
  
  CONCLUSIONS
  These data define the metrics of performance for hand-assisted and straight laparoscopic colectomy on an augmented reality simulator. The improved scores with the hand-assisted approach suggest that with this simulator a hand-assisted model may be technically easier to perform, although it is associated with increased intraoperative errors.
authors: Division of Colorectal Surgery, University Hospitals Case Medical Center, Cleveland, Ohio 44106-5047, USA.
authors: F
authors: F
authors: Leblanc
authors: C P
authors: CP
authors: Delaney
authors: P C
authors: PC
authors: Neary
authors: J
authors: J
authors: Rose
authors: K M
authors: KM
authors: Augestad
authors: A J
authors: AJ
authors: Senagore
authors: C N
authors: CN
authors: Ellis
authors: B J
authors: BJ
authors: Champagne
mesh_terms: D002983:Clinical Competence; D003082:Colectomy / Q000592:standards*; D003107:Colorectal Surgery / Q000193:education* / Q000592:standards*; D003198:Computer Simulation; D003194:Computer-Assisted Instruction; D006801:Humans; D010535:Laparoscopy / Q000592:standards*; D011597:Psychomotor Performance; D018709:Statistics, Nonparametric; D013647:Task Performance and Analysis; D014584:User-Computer Interface