title: Development of the McGill simulator for endoscopic sinus surgery: a new high-fidelity virtual reality simulator for endoscopic sinus surgery.
abstract: BACKGROUND
  The technical challenges of endoscopic sinus surgery (ESS) and the high risk of complications support the development of alternative modalities to train residents in these procedures. Virtual reality simulation is becoming a useful tool for training the skills necessary for minimally invasive surgery; however, there are currently no ESS virtual reality simulators available with valid evidence supporting their use in resident education. Our aim was to develop a new rhinology simulator, as well as to define potential performance metrics for trainee assessment.
  
  
  METHODS
  The McGill simulator for endoscopic sinus surgery (MSESS), a new sinus surgery virtual reality simulator with haptic feedback, was developed (a collaboration between the McGill University Department of Otolaryngology-Head and Neck Surgery, the Montreal Neurologic Institute Simulation Lab, and the National Research Council of Canada). A panel of experts in education, performance assessment, rhinology, and skull base surgery convened to identify core technical abilities that would need to be taught by the simulator, as well as performance metrics to be developed and captured.
  
  
  RESULTS
  The MSESS allows the user to perform basic sinus surgery skills, such as an ethmoidectomy and sphenoidotomy, through the use of endoscopic tools in a virtual nasal model. The performance metrics were developed by an expert panel and include measurements of safety, quality, and efficiency of the procedure.
  
  
  CONCLUSIONS
  The MSESS incorporates novel technological advancements to create a realistic platform for trainees. To our knowledge, this is the first simulator to combine novel tools such as the endonasal wash and elaborate anatomic deformity with advanced performance metrics for ESS.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Canada.
authors.forename: Rickul
authors.initials: R
authors.lastname: Varshney
authors.forename: Saul
authors.initials: S
authors.lastname: Frenkiel
authors.forename: Lily H P
authors.initials: LH
authors.lastname: Nguyen
authors.forename: Meredith
authors.initials: M
authors.lastname: Young
authors.forename: Rolando
authors.initials: R
authors.lastname: Del Maestro
authors.forename: Anthony
authors.initials: A
authors.lastname: Zeitouni
authors.forename: Marc A
authors.initials: MA
authors.lastname: Tewfik
mesh_terms: D002983:Clinical Competence; D003198:Computer Simulation; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D007396:Internship and Residency; D010036:Otolaryngology / Q000193:education*; D010256:Paranasal Sinuses / Q000601:surgery*