Does training laparoscopic skills in a virtual reality simulator improve surgical performance?
OBJECTIVE
Several different methods of teaching laparoscopic skills have been advocated, with virtual reality surgical simulation (VRSS) being the most popular. Its effectiveness in improving surgical performance is not a consensus yet, however. The purpose of this study was to determine whether practicing surgical skills in a virtual reality simulator results in improved surgical performance.


METHODS
Fifteen medical students recruited for the study were divided into three groups. Group I (control) did not receive any VRSS training. For 10 weeks, group II trained basic laparoscopic skills (camera handling, cutting skill, peg transfer skill, and clipping skill) in a VRSS laparoscopic skills simulator. Group III practiced the same skills and, in addition, performed a simulated cholecystectomy. All students then performed a cholecystectomy in a swine model. Their performance was reviewed by two experienced surgeons. The following parameters were evaluated: Gallbladder pedicle dissection time, clipping time, time for cutting the pedicle, gallbladder removal time, total procedure time, and blood loss.


RESULTS
With practice, there was improvement in most of the evaluated parameters by each of the individuals. There were no statistical differences in any of evaluated parameters between those who did and did not undergo VRSS training, however.


CONCLUSIONS
VRSS training is assumed to be an effective tool for learning and practicing laparoscopic skills. In this study, we could not demonstrate that VRSS training resulted in improved surgical performance. It may be useful, however, in familiarizing surgeons with laparoscopic surgery. More effective methods of teaching laparoscopic skills should be evaluated to help in improving surgical performance.
Urology Department, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
José Arnaldo Shiomi
JA
da Cruz
Natascha Silva
NS
Sandy
Carlo Camargo
CC
Passerotti
Hiep
H
Nguyen
Alberto Azoubel
AA
Antunes
Sabrina Thalita
ST
Dos Reis
Marcos Francisco
MF
Dall'Oglio
Ricardo Jordao
RJ
Duarte
Miguel
M
Srougi
D000818:Animals; D016063:Blood Loss, Surgical; D002983:Clinical Competence; D003198:Computer Simulation; D005704:Gallbladder / Q000601:surgery; D006801:Humans; D007430:Intraoperative Care; D010535:Laparoscopy / Q000193:education* / Q000592:standards*; D013337:Students, Medical; D034421:Sus scrofa; D013997:Time Factors; D014584:User-Computer Interface