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Surgical Endoscopy
Published in: Surgical Endoscopy 11/2020

Open Access 01-11-2020 | Hysterectomy

Simulator training and residents’ first laparoscopic hysterectomy: a randomized controlled trial

Authors: Ewa Jokinen, Tomi S. Mikkola, Päivi Härkki

Published in: Surgical Endoscopy | Issue 11/2020

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Abstract

Background

Hysterectomy rates are decreasing in many countries, and virtual reality simulators bring new opportunities into residents’ surgical education. The objective of this study was to evaluate the effect of training in laparoscopic hysterectomy module with virtual reality simulator on surgical outcomes among residents performing their first laparoscopic hysterectomy.

Methods

This randomized study was carried out at the Department of Obstetrics and Gynecology in Helsinki University Hospital and Hyvinkää Hospital. We recruited twenty residents and randomly signed half of them to train ten times with the laparoscopic hysterectomy module on a virtual reality simulator, while the rest represented the control group. Their first laparoscopic hysterectomy was video recorded and assessed later by using the Objective Structured Assessment of Technical Skills (OSATS) forms and Visual Analog Scale (VAS). The scores and surgical outcomes were compared between the groups.

Results

The mean OSATS score for the Global Rating Scale (GRS) was 17.0 (SD 3.1) in the intervention group and 11.2 (SD 2.4) in the control group (p = 0.002). The mean procedure-specific OSATS score was 20.0 (SD 3.3) and 16.0 (SD 2.8) (p = 0.012), and the mean VAS score was 55.0 (SD 14.8) and 29.9 (SD 14.9) (p = 0.001). Operative time was 144 min in the intervention group and 165 min in the control group, but the difference did not reach statistical significance (p = 0.205). There were no differences between the groups in blood loss or direct complications.

Conclusion

Residents training with a virtual reality simulator prior to the first laparoscopic hysterectomy seem to perform better in the actual live operation. Thus, a virtual reality simulator hysterectomy module could be considered as a part of laparoscopic training curriculum.
Literature
1.
Elbadrawy M, Majoko F, Gasson J (2008) Impact of Calman system and recent reforms on surgical training in gynaecology. J Obstet Gynaecol 28(5):474–477PubMedCrossRef
2.
Vitish-Sharma P, Knowles J, Patel B (2011) Acquisition of fundamental laparoscopic skills: is a box really as good as a virtual reality trainer? Int J Surg 9(8):659–661PubMedCrossRef
3.
Mettler LL, Dewan P (2009) Virtual reality simulators in gynecological endoscopy: a surging new wave. JSLS 13(3):279–286PubMedPubMedCentral
4.
Beyer-Berjot L, Aggarwal R (2013) Toward technology-supported surgical training: the potential of virtual simulators in laparoscopic surgery. Scand J Surg 102(4):221–226PubMedCrossRef
5.
Li L, Yu F, Shi D, Shi J, Tian Z, Yang J et al (2017) Application of virtual reality technology in clinical medicine. Am J Transl Res 9(9):3867–3880PubMedPubMedCentral
6.
7.
Grantcharov TP, Kristiansen VB, Bendix J, Bardram L, Rosenberg J, Funch-Jensen P (2004) Randomized clinical trial of virtual reality simulation for laparoscopic skills training. Br J Surg 91(2):146–150PubMedCrossRef
8.
Larsen CR, Soerensen JL, Grantcharov TP, Dalsgaard T, Schouenborg L, Ottosen C et al (2009) Effect of virtual reality training on laparoscopic surgery: randomised controlled trial. BMJ 338:b1802PubMedPubMedCentralCrossRef
9.
Thomsen AS, Bach-Holm D, Kjaerbo H, Hojgaard-Olsen K, Subhi Y, Saleh GM et al (2017) Operating room performance improves after proficiency-based virtual reality cataract surgery training. Ophthalmology 124(4):524–531PubMedCrossRef
10.
Yiannakopoulou E, Nikiteas N, Perrea D, Tsigris C (2015) Virtual reality simulators and training in laparoscopic surgery. Int J Surg 13:60–64PubMedCrossRef
11.
12.
Jokinen E, Mikkola TS, Harkki P (2017) Evaluation of a web course on the basics of gynecological laparoscopy in resident training. J Surg Educ 74(4):717–723PubMedCrossRef
13.
Jokinen E, Mikkola TS, Harkki P (2019) Effect of structural training on surgical outcomes of residents’ first operative laparoscopy: a randomized controlled trial. Surg Endosc 33(11):3688–3695PubMedPubMedCentralCrossRef
14.
Rosenthal R, von Websky MW, Hoffmann H, Vitz M, Hahnloser D, Bucher HC et al (2015) How to report multiple outcome metrics in virtual reality simulation. Eur Surg 47(4):202–205CrossRef
15.
Martin JA, Regehr G, Reznick R, MacRae H, Murnaghan J, Hutchison C et al (1997) Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg 84(2):273–278PubMed
16.
Crochet P, Aggarwal R, Knight S, Berdah S, Boubli L, Agostini A (2017) Development of an evidence-based training program for laparoscopic hysterectomy on a virtual reality simulator. Surg Endosc 31(6):2474–2482PubMedCrossRef
17.
Fahim C, Wagner N, Nousiainen MT, Sonnadara R (2018) Assessment of technical skills competence in the operating room: a systematic and scoping review. Acad Med 93(5):794–808PubMedCrossRef
18.
Goderstad JM, Sandvik L, Fosse E, Lieng M (2016) Assessment of surgical competence: development and validation of rating scales used for laparoscopic supracervical hysterectomy. J Surg Educ 73(4):600–608PubMedCrossRef
19.
Tremblay C, Grantcharov T, Urquia ML, Satkunaratnam A (2014) Assessment tool for total laparoscopic hysterectomy: a Delphi consensus survey among international experts. J Obstet Gynaecol Can 36(11):1014–1023PubMedCrossRef
20.
Knight S, Aggarwal R, Agostini A, Loundou A, Berdah S, Crochet P (2018) Development of an objective assessment tool for total laparoscopic hysterectomy: a Delphi method among experts and evaluation on a virtual reality simulator. PLoS ONE 13(1):e0190580PubMedPubMedCentralCrossRef
21.
Bilotta F, Titi L, Lanni F, Stazi E, Rosa G (2013) Training anesthesiology residents in providing anesthesia for awake craniotomy: learning curves and estimate of needed case load. J Clin Anesth 25(5):359–366PubMedCrossRef
22.
Milano A, Stankewicz H, Stoltzfus J, Salen P (2019) The impact of a standardized checklist on transition of care during emergency department resident physician change of shift. West J Emerg Med 20(1):29–34PubMedCrossRef
23.
Robertson RL, Vergis A, Gillman LM, Park J (2018) Effect of rater training on the reliability of technical skill assessments: a randomized controlled trial. Can J Surg 61(6):15917PubMedCrossRef
24.
Jayakumar N, Brunckhorst O, Dasgupta P, Khan MS, Ahmed K (2015) e-Learning in surgical education: a systematic review. J Surg Educ 72(6):1145–1157PubMedCrossRef
Metadata
Title
Simulator training and residents’ first laparoscopic hysterectomy: a randomized controlled trial
Authors
Ewa Jokinen
Tomi S. Mikkola
Päivi Härkki
Publication date
01-11-2020
Publisher
Springer US
Keyword
Hysterectomy
Published in
Surgical Endoscopy / Issue 11/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-019-07270-3

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