Validation of NOViSE.
The goal of this study was to establish face, content, and construct validity of NOViSE-the first force-feedback enabled virtual reality (VR) simulator for natural orifice transluminal endoscopic surgery (NOTES). Fourteen surgeons and surgical trainees performed 3 simulated hybrid transgastric cholecystectomies using a flexible endoscope on NOViSE. Four of them were classified as "NOTES experts" who had independently performed 10 or more simulated or human NOTES procedures. Seven participants were classified as "Novices" and 3 as "Gastroenterologists" with no or minimal NOTES experience. A standardized 5-point Likert-type scale questionnaire was administered to assess the face and content validity. NOViSE showed good overall face and content validity. In 14 out of 15 statements pertaining to face validity (graphical appearance, endoscope and tissue behavior, overall realism), ≥50% of responses were "agree" or "strongly agree." In terms of content validity, 85.7% of participants agreed or strongly agreed that NOViSE is a useful training tool for NOTES and 71.4% that they would recommend it to others. Construct validity was established by comparing a number of performance metrics such as task completion times, path lengths, applied forces, and so on. NOViSE demonstrated early signs of construct validity. Experts were faster and used a shorter endoscopic path length than novices in all but one task. The results indicate that NOViSE authentically recreates a transgastric hybrid cholecystectomy and sets promising foundations for the further development of a VR training curriculum for NOTES without compromising patient safety or requiring expensive animal facilities.
1 Imperial College London, London, UK.
Przemyslaw
P
Korzeniowski
1 Imperial College London, London, UK.
Daniel C
DC
Brown
1 Imperial College London, London, UK.
Mikael H
MH
Sodergren
1 Imperial College London, London, UK.
Alastair
A
Barrow
1 Imperial College London, London, UK.
Fernando
F
Bello
D000328:Adult; D002763:Cholecystectomy / Q000193:education*; D002983:Clinical Competence; D003198:Computer Simulation; D005260:Female; D000068156:Formative Feedback; D006801:Humans; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000193:education*; D015203:Reproducibility of Results; D000066908:Simulation Training; D014584:User-Computer Interface
NOTES; flexible endoscopy; natural orifice surgery; transgastric cholecystectomy; virtual reality simulator
BJU Int. 2013 Jan;111(1):11-6
23323699
Surg Endosc. 2006 Feb;20(2):329-33
16402290
Surg Innov. 2013 Dec;20(6):631-8
23493565
Gastrointest Endosc. 2010 Feb;71(2):357-64
19922914
Simul Healthc. 2013 Oct;8(5):324-8
23598862
Surg Endosc. 2016 Jan;30(1):190-8
25840893
Surg Endosc. 2008 May;22(5):1294-7
17972136
Surg Endosc. 2013 May;27(5):1607-16
23247736
Surg Endosc. 2011 Aug;25(8):2441-8
21359881
Surg Endosc. 2016 Jan;30(1):73-7
25801110
Minim Invasive Ther Allied Technol. 2010 Oct;19(5):281-6
20868301
Ann Surg. 2017 Mar;265(3):534-538
27058950