Virtual Reality Simulators Improve Surgical Skills

Researchers at University Hospital Rigshospitalet (Copenhagen, Denmark) conducted a prospective randomized controlled and blinded trial that assessed the effect of virtual reality training on an actual laparoscopic operation, in seven gynecological departments in the Zeeland region of Denmark. The study, which took place between September 2006 and August 2007, included 24 first and second year registrars specializing in gynecology and obstetrics, with no previous clinical experience of laparoscopic surgery. Participants were randomly allocated to either virtual reality simulator training or to traditional clinical training. The simulator group received seven hours of training and then performed their first supervised laparoscopic operation on an actual patient. The registrars were scored according to their technical performance by two independent assessors, and their operation time was also recorded.

The results showed that the simulator trained group reached a median total score of 33 points, equivalent to the experience gained after 20-50 laparoscopic procedures, whereas the control group reached a median total score of 23 points, equivalent to the experience gained from fewer than five procedures. The median total operation time in the simulator trained group was 12 minutes and in the control group was 24 minutes. The authors stress that surgical performance also involves nontechnical skills, such as communication, teamwork, and decision-making, and that therefore simulator training should only be considered as a supplement to real operations. The study was published online on May 14, 2009, in BMJ.

"These findings clearly show that skills in laparoscopic surgery can be increased in a clinically relevant manner by virtual reality simulator training,” concluded lead author Christian Larsen, M.D., and colleagues. "Simulator training should be incorporated into the curriculum for all surgical trainees before they embark on patient procedures. This can potentially improve patient safety and improve operation room efficiency.”

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University Hospital Rigshospitalet