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Surgical Endoscopy

Open Access 14-04-2025 | Minimally Invasive Surgery

Effects of training in pairs versus training alone on reaching proficiency in minimally invasive Roux-en-Y-gastric bypass on a virtual reality trainer in medical students: a randomized-controlled trial

Authors: Amila Cizmic, Paulina Reichert, Frida Häberle, Anas A. Preukschas, Frank Pianka, Arianeb Mehrabi, Anna Nießen, Beat P. Müller-Stich, Thilo Hackert, Rainer Grotelüschen, Felix Nickel

Published in: Surgical Endoscopy

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Abstract

Background

Minimally invasive surgery (MIS) is the standard approach in bariatric surgery. The most common bariatric procedures are sleeve gastrectomy and Roux-en-Y-Gastric Bypass (RYGB). Simulation training, including virtual reality (VR), is useful when learning MIS. Training in pairs has proven beneficial in acquiring basic MIS skills. However, this has not been tested on more complex procedures such as MIS RYGB. The study aimed to assess the learning effects of training MIS RYGB on a VR trainer in pairs compared to solo training.

Methods

Medical students (n = 60) were randomized into the intervention group, trained in pairs (n = 30), and the control group, trained solo (n = 30). Both groups needed to train MIS RYGB on a VR trainer under the supervision of trained tutors until proficiency was reached. The MIS RYGB proficiency was defined as 105/110 points according to the Bariatric Objective Structured Assessment of Technical Skills (BOSATS) score. The primary outcome was the number of exercise repetitions until proficiency was reached. Secondary outcomes compared the BOSATS scores, bleeding incidents, and the validated score on current motivation.

Results

The intervention group achieved proficiency with significantly fewer repetitions than the control group (p = 0.002). Most participants in the intervention group reached proficiency by the fifth repetition, and none required an eighth repetition. The intervention group had better BOSATS scores than the control group after the second, fourth, and fifth MIS RYGB (91.1 ± 6.4 vs. 87.1 ± 7.0 points, p = 0.025; 104.0 ± 4.7 vs. 100.3 ± 6.1 points, p = 0.014; 106.2 ± 2.8 vs. 101.9 ± 5.8 points, p = 0.026), respectively. Additionally, the intervention group experienced fewer bleeding complications in the fifth and sixth MIS RYGB repetitions than the control group (2 vs. 10, p = 0.001; 0 vs. 8, p < 0.001, respectively).

Conclusions

Training MIS RYGB on a VR trainer in pairs enables trainees to reach procedural proficiency with fewer exercise repetitions than training alone.
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Metadata
Title
Effects of training in pairs versus training alone on reaching proficiency in minimally invasive Roux-en-Y-gastric bypass on a virtual reality trainer in medical students: a randomized-controlled trial
Authors
Amila Cizmic
Paulina Reichert
Frida Häberle
Anas A. Preukschas
Frank Pianka
Arianeb Mehrabi
Anna Nießen
Beat P. Müller-Stich
Thilo Hackert
Rainer Grotelüschen
Felix Nickel
Publication date
14-04-2025
Publisher
Springer US
Published in
Surgical Endoscopy
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-025-11701-9
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