title: Simball Box for Laparoscopic Training With Advanced 4D Motion Analysis of Skills.
abstract: Background Laparoscopic skills training and evaluation outside the operating room is important for all surgeons learning new skills. To study feasibility, a video box trainer tracking 4-dimensional (4D) metrics was evaluated as a laparoscopic training tool. Method Simball Box is a video box trainer with authentic surgical instruments and camera with video recording, equipped with 4D motion analysis registered through trocars using machine vision technology. Residents attending a 3-day laparoscopy course were evaluated performing a laparoscopic surgical knot at start, middle, and end. Metrics were obtained. Feedback data were presented in reference to expert/tutorial performance. Results Ten right-handed residents were included. Median time (range) to finish the task was 359 (253-418), 129 (95-166), and 95 (52-156) seconds; 655%, 236%, and 174% of tutorial performance, with significance pre-/midcourse (P < .0001), pre-/postcourse (P < .0001), and mid-/postcourse (P = .0050). Combined median total instrument motion decreased pre-/midcourse from 1208 (845-1751) to 522 cm (411-810 cm); P = .042 to 405 cm (246-864 cm) postcourse; pre-/postcourse P < .0001; 673%, 291%, 225% of tutorial performance. Total angular distance in radians (range) was 150 (87-251), 65 (42-116), and 50 (33-136) with significance pre-/midcourse (P = .022) and pre-/postcourse (P = .0002). Right-handed average speed (cm/s) increased: 1.94 (1.11-2.27) pre-, 2.39 (1.56-2.83) mid-, 2.60 (1.67-3.19) postcourse with significance pre-/midcourse (P = .022) and pre-/postcourse (P = .002). Average acceleration (mm/s(2)) and motion smoothness (µm/s(3)) failed to show any difference. Conclusion For laparoscopic training and as a promising evaluation device, Simball Box obtained metrics mirroring progression well.
authors: Skåne University Hospital, Sweden Lund University, Lund, Sweden kristine.hagelsteen@med.lu.se.
authors: Kristine
authors: K
authors: Hagelsteen
authors: Skåne University Hospital, Sweden Lund University, Lund, Sweden.
authors: Dan
authors: D
authors: Sevonius
authors: Skåne University Hospital, Sweden Lund University, Lund, Sweden.
authors: Anders
authors: A
authors: Bergenfelz
authors: Skåne University Hospital, Sweden Lund University, Lund, Sweden.
authors: Mikael
authors: M
authors: Ekelund
mesh_terms: D000328:Adult; D002983:Clinical Competence; D004867:Equipment Design; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D010535:Laparoscopy / Q000193:education*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D000066908:Simulation Training / Q000379:methods*; D013647:Task Performance and Analysis; D014741:Video Recording / Q000295:instrumentation*
keywords: assessment; box trainer; evaluation; laparoscopy; medical education; motion tracking; simulation; skills; surgical education