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Procedural virtual reality simulation in minimally invasive surgery

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Abstract

Background

Simulation of procedural tasks has the potential to bridge the gap between basic skills training outside the operating room (OR) and performance of complex surgical tasks in the OR. This paper provides an overview of procedural virtual reality (VR) simulation currently available on the market and presented in scientific literature for laparoscopy (LS), flexible gastrointestinal endoscopy (FGE), and endovascular surgery (EVS).

Methods

An online survey was sent to companies and research groups selling or developing procedural VR simulators, and a systematic search was done for scientific publications presenting or applying VR simulators to train or assess procedural skills in the PUBMED and SCOPUS databases.

Results

The results of five simulator companies were included in the survey. In the literature review, 116 articles were analyzed (45 on LS, 43 on FGE, 28 on EVS), presenting a total of 23 simulator systems. The companies stated to altogether offer 78 procedural tasks (33 for LS, 12 for FGE, 33 for EVS), of which 17 also were found in the literature review. Although study type and used outcomes vary between the three different fields, approximately 90 % of the studies presented in the retrieved publications for LS found convincing evidence to confirm the validity or added value of procedural VR simulation. This was the case in approximately 75 % for FGE and EVS.

Conclusions

Procedural training using VR simulators has been found to improve clinical performance. There is nevertheless a large amount of simulated procedural tasks that have not been validated. Future research should focus on the optimal use of procedural simulators in the most effective training setups and further investigate the benefits of procedural VR simulation to improve clinical outcome.

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Acknowledgments

The authors thank Professor Jack Jakimowicz, Professor Ronald Mårvik, and Edmund Søvik for clinical expert advices. The authors equally thank the companies that have contributed to the survey: CAE Healthcare ( www.cae.com/en/healthcare/home.asp), Mentice AB (www.mentice.com), Simbionix Ltd (www.simbionix.com), SimSurgery AS (www.simsurgery.com), and Surgical Science AB (www.surgicalscience.com).

Disclosures

Cecilie Våpenstad and Sonja Buzink have no conflicts of interest or financial ties to disclose. The work of Cecilie Våpenstad was supported by the Centre for ultrasound- and image-guided therapy, the National Centre for Advanced Laparoscopic Surgery, and SINTEF (all Trondheim, Norway). The work of Sonja Buzink was supported by a TU Delft Fellowship Grant provided by the Executive Board of Delft University of Technology, The Netherlands.

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  1. Department of Medical Technology, SINTEF Technology and Society, PB 4760 Sluppen, 7465, Trondheim, Norway

    Cecilie Våpenstad

  2. Faculty of Industrial Design Engineering, Delft University of Technology, Landbergstraat 15, 2628 CE, Delft, The Netherlands

    Sonja N. Buzink

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  1. Cecilie Våpenstad
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  2. Sonja N. Buzink
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Correspondence to Sonja N. Buzink.

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Våpenstad, C., Buzink, S.N. Procedural virtual reality simulation in minimally invasive surgery. Surg Endosc 27, 364–377 (2013). https://doi.org/10.1007/s00464-012-2503-1

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