Simulations Enhance Laparoscopic Surgery Training

Simulation-based laparoscopic surgery training presents major benefits when compared with no intervention, claims a new study.

Researchers at the Mayo Clinic College of Medicine (Rochester, MN, USA) and the University of Toronto (Ontario, Canada) conducted a systematic literature review through May 2011 for studies evaluating simulation, in comparison with no intervention, or to an alternate activity for training health professionals in laparoscopic surgery. Outcomes were classified as satisfaction, skills (in a test setting), time (to perform the task), process (e.g., performance rating), product (e.g., knot strength), and behaviors when caring for patients. The researchers used random effects to pool effect size (ES).

The results from 219 eligible studies enrolling 7,138 trainees showed that in comparison with no intervention, pooled ES favored simulation for outcomes of knowledge, skills time, skills process, skills product, behavior time, behavior process, and patient effects. When compared with nonsimulation instruction, simulation instruction significantly favored outcomes of skills time and skills process. The study was published ahead of print on March 12, 2013, in Annals of Surgery.

“Simulation-based laparoscopic surgery training of health professionals has large benefits when compared with no intervention and is moderately more effective than nonsimulation instruction,” concluded lead author Benjamin Zendejas, MD, of the Mayo Clinic, and colleagues. “For example, in comparison with virtual reality, box trainers have similar effects for process skills outcomes and seem to be superior for outcomes of satisfaction and skills time.”

The combination of advanced virtual reality (VR) simulation technology and comprehensive training and analysis tools has made simulation-based training for laparoscopic surgery a mainstay of surgical training. The advent of realistic haptic feedback devices that offer augmented reality (AR) tools has resulted in new laparoscopic simulation systems offering a combination of physical objects and VR simulation, allowing laparoscopic instruments to be used within a hybrid mannequin on tissue or objects while using video tracking.

Related Links:
Mayo Clinic College of Medicine
University of Toronto