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Surgical Endoscopy
Published in:

19-09-2022 | Surgery | Review Article

Training and assessment using the LapSim laparoscopic simulator: a scoping review of validity evidence

Authors: Conor Toale, Marie Morris, Dara O. Kavanagh

Published in: Surgical Endoscopy | Issue 3/2023

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Abstract

Introduction

The LapSim (Surgical Science, Sweden) laparoscopic simulator is a high-fidelity virtual reality simulator for use in endoscopic surgical training. This review critiques the current validity evidence for the LapSim laparoscopic simulator, specifically with respect to its potential use as a tool and method of training and assessment in surgery.

Methods

A scoping review of the MEDLINE (PubMed), EMBASE, Cochrane and Web of Science databases was conducted in accordance with PRISMA guidelines (2020)—scoping review extension. Articles were included if they presented validity evidence for the use of the LapSim in operative skill training or assessment, in accordance with Messick’s validity framework. European Association of Endoscopic Surgeons (EAES) guidelines (2005) were used to provide recommendations for the use of the LapSim in operative performance training and assessments.

Results

Forty-nine articles were included. An EAES level 2 recommendation was provided with regard to the internal consistency reliability of automated performance metrics in assessing performance. An EAES recommendation of 2 was awarded with respect to the ability of the LapSim to discriminate based on case volume and overall laparoscopic experience (relationships with other variables). Performance assessment metrics on the LapSim correlate with improved performance in the operating room (EAES level of recommendation 1—consequential validity).

Conclusion

The LapSim has accumulated substantial evidence supporting the validity of its use in surgical training and assessment. Future studies should explore the relationship between the achievement of performance benchmarks on the LapSim and subsequent patient outcomes, and interrogate the benefits of implementing virtual reality simulation training and assessment curricula in post-graduate surgical training programmes.
Appendix
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Literature
1.
Hong M, Rozenblit JW, Hamilton AJ (2021) Simulation-based surgical training systems in laparoscopic surgery: a current review. Virtual Real 25:491–510CrossRef
2.
Toale C, Morris M, Kavanagh D (2021) Perceptions and experiences of simulation-based assessment of technical skill in surgery: a scoping review. Am J Surg 222:723–730PubMedCrossRef
3.
4.
Carter FJ, Schijven MP, Aggarwal R, Grantcharov T, Francis NK, Hanna GB, Jakimowicz JJ (2005) Consensus guidelines for validation of virtual reality surgical simulators. Surg Endosc 19:1523–1532PubMedCrossRef
5.
Fairhurst K, Strickland A, Maddern G (2011) The LapSim virtual reality simulator: promising but not yet proven. Surg Endosc 25:343–355PubMedCrossRef
6.
Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, Moher D, Peters MD, Horsley T, Weeks L (2018) PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med 169:467–473PubMedCrossRef
7.
Smyer P (2011) The medical education research study quality instrument (MERSQI)
8.
Hambleton RK, Arrasmith G, Sheehan DS, Grobe RP, Hathaway W, Doherty V, Forbes D, Houser R, Ingebo G, Kingsbury G (1986) Standards for educational and psychological testing: six reviews. JSTOR
9.
Cook DA, Lineberry M (2016) Consequences validity evidence: evaluating the impact of educational assessments. Acad Med 91:785–795PubMedCrossRef
10.
Cook DA, Hatala R (2016) Validation of educational assessments: a primer for simulation and beyond. Adv Simul 1:31CrossRef
11.
Doneza JA, Palvia V, Lerner VT, Overbey J, Levie M, Brodman M, Ascher-Walsh C (2021) Correlation of surgical case volume and fellowship training with performance on simulated procedural tasks. Am J Obstet Gynecol 225:548.e541-548.e510CrossRef
12.
Haidari TA, Bjerrum F, Hansen HJ, Konge L, Petersen RH (2022) Simulation-based VATS resection of the five lung lobes: a technical skills test. Surg Endosc 36:1234–1242PubMedCrossRef
13.
Jensen K, Hansen HJ, Petersen RH, Neckelmann K, Vad H, Møller LB, Pedersen JH, Konge L (2019) Evaluating competency in video-assisted thoracoscopic surgery (VATS) lobectomy performance using a novel assessment tool and virtual reality simulation. Surg Endosc 33:1465–1473PubMedCrossRef
14.
Våpenstad C, Hofstad EF, Bø LE, Kuhry E, Johnsen G, Mårvik R, Langø T, Hernes TN (2017) Lack of transfer of skills after virtual reality simulator training with haptic feedback. Minim Invasive Ther Allied Technol 26:346–354PubMedCrossRef
15.
Mathews S, Brodman M, D’Angelo D, Chudnoff S, McGovern P, Kolev T, Bensinger G, Mudiraj S, Nemes A, Feldman D, Kischak P, Ascher-Walsh C (2017) Predictors of laparoscopic simulation performance among practicing obstetrician gynecologists. Am J Obstet Gynecol 217:596.e591-596.e597CrossRef
16.
Bjerrum F, Strandbygaard J, Rosthøj S, Grantcharov T, Ottesen B, Sorensen JL (2017) Evaluation of procedural simulation as a training and assessment tool in general surgery-simulating a laparoscopic appendectomy. J Surg Educ 74:243–250PubMedCrossRef
17.
Jensen K, Bjerrum F, Hansen HJ, Petersen RH, Pedersen JH, Konge L (2017) Using virtual reality simulation to assess competence in video-assisted thoracoscopic surgery (VATS) lobectomy. Surg Endosc 31:2520–2528PubMedCrossRef
18.
Jensen K, Bjerrum F, Hansen HJ, Petersen RH, Pedersen JH, Konge L (2015) A new possibility in thoracoscopic virtual reality simulation training: development and testing of a novel virtual reality simulator for video-assisted thoracoscopic surgery lobectomy. Interact Cardiovasc Thorac Surg 21:420–426PubMedCrossRef
19.
Alwaal A, Al-Qaoud TM, Haddad RL, Alzahrani TM, Delisle J, Anidjar M (2015) Transfer of skills on LapSim virtual reality laparoscopic simulator into the operating room in urology. Urol Ann 7:172–176PubMedPubMedCentralCrossRef
20.
Lin D, Pena G, Field J, Altree M, Marlow N, Babidge W, Hewett P, Maddern G (2016) What are the demographic predictors in laparoscopic simulator performance? ANZ J Surg 86:983–989PubMedCrossRef
21.
Akdemir A, Sendağ F, Oztekin MK (2014) Laparoscopic virtual reality simulator and box trainer in gynecology. Int J Gynaecol Obstet 125:181–185PubMedCrossRef
22.
Khan MW, Lin D, Marlow N, Altree M, Babidge W, Field J, Hewett P, Maddern G (2014) Laparoscopic skills maintenance: a randomized trial of virtual reality and box trainer simulators. J Surg Educ 71:79–84PubMedCrossRef
23.
Akdemir A, Ergenoğlu AM, Yeniel A, Sendağ F (2013) Conventional box model training improves laparoscopic skills during salpingectomy on LapSim: a randomized trial. J Turk Ger Gynecol Assoc 14:157–162PubMedPubMedCentralCrossRef
24.
Xafis V, Babidge W, Field J, Altree M, Marlow N, Maddern G (2013) The efficacy of laparoscopic skills training in a Mobile Simulation Unit compared with a fixed site: a comparative study. Surg Endosc 27:2606–2612PubMedCrossRef
25.
Lehmann KS, Gröne J, Lauscher JC, Ritz JP, Holmer C, Pohlen U, Buhr HJ (2012) Simulation training in surgical education—application of virtual reality laparoscopic simulators in a surgical skills course. Zentralbl Chir 137:130–137PubMed
26.
Tan SC, Marlow N, Field J, Altree M, Babidge W, Hewett P, Maddern GJ (2012) A randomized crossover trial examining low- versus high-fidelity simulation in basic laparoscopic skills training. Surg Endosc 26:3207–3214PubMedCrossRef
27.
Shetty S, Panait L, Baranoski J, Dudrick SJ, Bell RL, Roberts KE, Duffy AJ (2012) Construct and face validity of a virtual reality-based camera navigation curriculum. J Surg Res 177:191–195PubMedCrossRef
28.
Kovac E, Azhar RA, Quirouet A, Delisle J, Anidjar M (2012) Construct validity of the LapSim virtual reality laparoscopic simulator within a urology residency program. Can Urol Assoc J 6:253–259PubMedPubMedCentralCrossRef
29.
Palter VN, Graafland M, Schijven MP, Grantcharov TP (2012) Designing a proficiency-based, content validated virtual reality curriculum for laparoscopic colorectal surgery: a Delphi approach. Surgery 151:391–397PubMedCrossRef
30.
Våpenstad C, Hofstad E, Bø LE, Chmarra M, Kuhry E, Johnsen G, Mårvik R, Langø T (2012) Limitations of haptic feedback devices on construct validity of the LapSim((R)) virtual reality simulator. Surg Endosc 27
31.
Panait L, Larios JM, Brenes RA, Fancher TT, Ajemian MS, Dudrick SJ, Sanchez JA (2011) Surgical skills assessment of applicants to general surgery residency. J Surg Res 170:189–194PubMedCrossRef
32.
Calatayud D, Arora S, Aggarwal R, Kruglikova I, Schulze S, Funch-Jensen P, Grantcharov T (2010) Warm-up in a virtual reality environment improves performance in the operating room. Ann Surg 251:1181–1185PubMedCrossRef
33.
van Dongen KW, Ahlberg G, Bonavina L, Carter FJ, Grantcharov TP, Hyltander A, Schijven MP, Stefani A, van der Zee DC, Broeders IA (2011) European consensus on a competency-based virtual reality training program for basic endoscopic surgical psychomotor skills. Surg Endosc 25:166–171PubMedCrossRef
34.
Gauger PG, Hauge LS, Andreatta PB, Hamstra SJ, Hillard ML, Arble EP, Kasten SJ, Mullan PB, Cederna PS, Minter RM (2010) Laparoscopic simulation training with proficiency targets improves practice and performance of novice surgeons. Am J Surg 199:72–80PubMedCrossRef
35.
Tanoue K, Uemura M, Kenmotsu H, Ieiri S, Konishi K, Ohuchida K, Onimaru M, Nagao Y, Kumashiro R, Tomikawa M, Hashizume M (2010) Skills assessment using a virtual reality simulator, LapSim, after training to develop fundamental skills for endoscopic surgery. Minim Invasive Ther Allied Technol 19:24–29PubMedCrossRef
36.
Maagaard M, Sorensen JL, Oestergaard J, Dalsgaard T, Grantcharov TP, Ottesen BS, Larsen CR (2011) Retention of laparoscopic procedural skills acquired on a virtual-reality surgical trainer. Surg Endosc 25:722–727PubMedCrossRef
37.
Schreuder HW, van Dongen KW, Roeleveld SJ, Schijven MP, Broeders IA (2009) Face and construct validity of virtual reality simulation of laparoscopic gynecologic surgery. Am J Obstet Gynecol 200:540.e541-548CrossRef
38.
Larsen CR, Soerensen JL, Grantcharov TP, Dalsgaard T, Schouenborg L, Ottosen C, Schroeder TV, Ottesen BS (2009) Effect of virtual reality training on laparoscopic surgery: randomised controlled trial. BMJ 338:b1802PubMedPubMedCentralCrossRef
39.
Sinha P, Hogle NJ, Fowler DL (2008) Do the laparoscopic skills of trainees deteriorate over time? Surg Endosc 22:2018–2025PubMedCrossRef
40.
Hogle NJ, Widmann WD, Ude AO, Hardy MA, Fowler DL (2008) Does training novices to criteria and does rapid acquisition of skills on laparoscopic simulators have predictive validity or are we just playing video games? J Surg Educ 65:431–435PubMedCrossRef
41.
Kundhal PS, Grantcharov TP (2009) Psychomotor performance measured in a virtual environment correlates with technical skills in the operating room. Surg Endosc 23:645–649PubMedCrossRef
42.
Salgado J, Grantcharov TP, Papasavas PK, Gagne DJ, Caushaj PF (2009) Technical skills assessment as part of the selection process for a fellowship in minimally invasive surgery. Surg Endosc 23:641–644PubMedCrossRef
43.
Panait L, Bell RL, Roberts KE, Duffy AJ (2008) Designing and validating a customized virtual reality-based laparoscopic skills curriculum. J Surg Educ 65:413–417PubMedCrossRef
44.
Botden SM, Buzink SN, Schijven MP, Jakimowicz JJ (2007) Augmented versus virtual reality laparoscopic simulation: what is the difference? A comparison of the ProMIS augmented reality laparoscopic simulator versus LapSim virtual reality laparoscopic simulator. World J Surg 31:764–772PubMedPubMedCentralCrossRef
45.
van Dongen KW, Tournoij E, van der Zee DC, Schijven MP, Broeders IA (2007) Construct validity of the LapSim: can the LapSim virtual reality simulator distinguish between novices and experts? Surg Endosc 21:1413–1417PubMedCrossRef
46.
Newmark J, Dandolu V, Milner R, Grewal H, Harbison S, Hernandez E (2007) Correlating virtual reality and box trainer tasks in the assessment of laparoscopic surgical skills. Am J Obstet Gynecol 197:546.e541–544CrossRef
47.
Hogle NJ, Briggs WM, Fowler DL (2007) Documenting a learning curve and test-retest reliability of two tasks on a virtual reality training simulator in laparoscopic surgery. J Surg Educ 64:424–430PubMedCrossRef
48.
Ahlberg G, Enochsson L, Gallagher AG, Hedman L, Hogman C, McClusky DA 3rd, Ramel S, Smith CD, Arvidsson D (2007) Proficiency-based virtual reality training significantly reduces the error rate for residents during their first 10 laparoscopic cholecystectomies. Am J Surg 193:797–804PubMedCrossRef
49.
Hassan I, Gerdes B, Koller M, Langer P, Rothmund M, Zielke A (2006) Clinical background is required for optimum performance with a VR laparoscopy simulator. Comput Aided Surg 11:103–106PubMedCrossRef
50.
Woodrum DT, Andreatta PB, Yellamanchilli RK, Feryus L, Gauger PG, Minter RM (2006) Construct validity of the LapSim laparoscopic surgical simulator. Am J Surg 191:28–32PubMedCrossRef
51.
Larsen CR, Grantcharov T, Aggarwal R, Tully A, Sørensen JL, Dalsgaard T, Ottesen B (2006) Objective assessment of gynecologic laparoscopic skills using the LapSimGyn virtual reality simulator. Surg Endosc 20:1460–1466PubMedCrossRef
52.
Aggarwal R, Grantcharov TP, Eriksen JR, Blirup D, Kristiansen VB, Funch-Jensen P, Darzi A (2006) An evidence-based virtual reality training program for novice laparoscopic surgeons. Ann Surg 244:310–314PubMedPubMedCentralCrossRef
53.
Aggarwal R, Tully A, Grantcharov T, Larsen CR, Miskry T, Farthing A, Darzi A (2006) Virtual reality simulation training can improve technical skills during laparoscopic salpingectomy for ectopic pregnancy. BJOG 113:1382–1387PubMedCrossRef
54.
Eriksen JR, Grantcharov T (2005) Objective assessment of laparoscopic skills using a virtual reality stimulator. Surg Endosc 19:1216–1219PubMedCrossRef
55.
Hassan I, Sitter H, Schlosser K, Zielke A, Rothmund M, Gerdes B (2005) A virtual reality simulator for objective assessment of surgeons’ laparoscopic skill. Chirurg 76:151–156PubMedCrossRef
56.
Langelotz C, Kilian M, Paul C, Schwenk W (2005) LapSim virtual reality laparoscopic simulator reflects clinical experience in German surgeons. Langenbecks Arch Surg 390:534–537PubMedCrossRef
57.
Sherman V, Feldman LS, Stanbridge D, Kazmi R, Fried GM (2005) Assessing the learning curve for the acquisition of laparoscopic skills on a virtual reality simulator. Surg Endosc 19:678–682PubMedCrossRef
58.
Duffy AJ, Hogle NJ, McCarthy H, Lew JI, Egan A, Christos P, Fowler DL (2005) Construct validity for the LAPSIM laparoscopic surgical simulator. Surg Endosc 19:401–405PubMedCrossRef
59.
Hassan I, Sitter H, Schlosser K, Zielke A, Rothmund M, Gerdes B (2005) Laparoskopiesimulator. Chirurg 76:151–156PubMedCrossRef
60.
Cosman PH, Hugh TJ, Shearer CJ, Merrett ND, Biankin AV, Cartmill JA (2007) Skills acquired on virtual reality laparoscopic simulators transfer into the operating room in a blinded, randomised, controlled trial. Stud Health Technol Inform 125:76–81PubMed
61.
Mazzone E, Puliatti S, Amato M, Bunting B, Rocco B, Montorsi F, Mottrie A, Gallagher AG (2021) A systematic review and meta-analysis on the impact of proficiency-based progression simulation training on performance outcomes. Ann Surg 274:281–289PubMedCrossRef
62.
Zevin B, Aggarwal R, Grantcharov TP (2014) Surgical simulation in 2013: why is it still not the standard in surgical training? J Am Coll Surg 218:294–301PubMedCrossRef
63.
Metadata
Title
Training and assessment using the LapSim laparoscopic simulator: a scoping review of validity evidence
Authors
Conor Toale
Marie Morris
Dara O. Kavanagh
Publication date
19-09-2022
Publisher
Springer US
Keyword
Surgery
Published in
Surgical Endoscopy / Issue 3/2023
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-022-09593-0

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