Surgical Endoscopy

, Volume 25, Issue 2, pp 423–428 | Cite as

Construct validity of the LapVR virtual-reality surgical simulator

  • Naoki Iwata
  • Michitaka Fujiwara
  • Yasuhiro Kodera
  • Chie Tanaka
  • Norifumi Ohashi
  • Goro Nakayama
  • Masahiko Koike
  • Akimasa Nakao
Article

Abstract

Background

Laparoscopic surgery requires fundamental skills peculiar to endoscopic procedures such as eye–hand coordination. Acquisition of such skills prior to performing actual surgery is highly desirable for favorable outcome. Virtual-reality simulators have been developed for both surgical training and assessment of performance. The aim of the current study is to show construct validity of a novel simulator, LapVR (Immersion Medical, San Jose, CA, USA), for Japanese surgeons and surgical residents.

Methods

Forty-four subjects were divided into the following three groups according to their experience in laparoscopic surgery: 14 residents (RE) with no experience in laparoscopic surgery, 14 junior surgeons (JR) with little experience, and 16 experienced surgeons (EX). All subjects executed “essential task 1” programmed in the LapVR, which consists of six tasks, resulting in automatic measurement of 100 parameters indicating various aspects of laparoscopic skills.

Results

Time required for each task tended to be inversely correlated with experience in laparoscopic surgery. For the peg transfer skill, statistically significant differences were observed between EX and RE in three parameters, including total time and average time taken to complete the procedure and path length for the nondominant hand. For the cutting skill, similar differences were observed between EX and RE in total time, number of unsuccessful cutting attempts, and path length for the nondominant hand. According to the programmed comprehensive evaluation, performance in terms of successful completion of the task and actual experience of the participants in laparoscopic surgery correlated significantly for the peg transfer (P = 0.007) and cutting skills (P = 0.026).

Conclusions

The peg transfer and cutting skills could best distinguish between EX and RE. This study is the first to provide evidence that LapVR has construct validity to discriminate between novice and experienced laparoscopic surgeons.

Keywords

Laparoscopic surgery Virtual reality Simulation training Assessment 

References

  1. 1.
    Zhang A, Hunerbein M, Dai Y, Schlag PM, Beller S (2008) Construct validity testing of a laparoscopic surgery simulator (Lap Mentor) (2008) evaluation of surgical skill with a virtual laparoscopic training simulator. Surg Endosc 22:1440–1444CrossRefPubMedGoogle Scholar
  2. 2.
    van Dongen KW, Tournoij E, van der Zee DC, Schijven MP, Broeders I (2007) Construct validity of the LapSim: can the LapSim virtual reality simulator distinguish between novices and experts? Surg Endosc 21:1413–1417CrossRefPubMedGoogle Scholar
  3. 3.
    Eriksen JR, Grantcharov T (2005) Objective assessment of laparoscopic skills using a virtual reality stimulator. Surg Endosc 19:1216–1219CrossRefPubMedGoogle Scholar
  4. 4.
    Yamaguchi S, Konishi K, Yasunaga T, Yoshida D, Kinjo N, Kobayashi K, Ieiri S, Okazaki K, Nakashima H, Tanoue K, Maehara Y, Hashizume M (2007) Construct validity for eye-hand coordination skill on a virtual reality laparoscopic surgical simulator. Surg Endosc 21:2253–2257CrossRefPubMedGoogle Scholar
  5. 5.
    McDougall EM, Corica FA, Boker JR, Sala LG, Stoliar G, Borin JF, Chu FT, Clayman RV (2006) Construct validity testing of a laparoscopic surgical simulator. J Am Coll Surg 202:779–787CrossRefPubMedGoogle Scholar
  6. 6.
    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 19:1523–1532CrossRefPubMedGoogle Scholar
  7. 7.
    Satava RM (1993) Virtual reality surgical simulator. The first steps. Surg Endosc 7:203–205CrossRefPubMedGoogle Scholar
  8. 8.
    Reznick RK, MacRae H (2006) Medical education—teaching surgical skills—changes in the wind. N Engl J Med 355:2664–2669CrossRefPubMedGoogle Scholar
  9. 9.
    Gallagher AG, Ritter EM, Champion H, Higgins G, Fried MP, Moses G, Smith CD, Satava RM (2005) Virtual reality simulation for the operating room—proficiency-based training as a paradigm shift in surgical skills training. Ann Surg 241:364–372CrossRefPubMedGoogle Scholar
  10. 10.
    Kundhal PS, Grantcharov TP (2009) Psychomotor performance measured in a virtual environment correlates with technical skills in the operating room. Surg Endosc 23:645–649CrossRefPubMedGoogle Scholar
  11. 11.
    Seymour NE, Gallagher AG, Roman SA, O’Brien MK, Bansal VK, Andersen DK, Satava RM (2002) Virtual reality training improves operating room performance—results of a randomized, double-blinded study. Ann Surg 236:458–464CrossRefPubMedGoogle Scholar
  12. 12.
    Aggarwal R, Ward J, Balasundaram I, Sains P, Athanasiou T, Darzi A (2007) Proving the effectiveness of virtual reality simulation for training in laparoscopic surgery. Ann Surg 246:771–779CrossRefPubMedGoogle Scholar
  13. 13.
    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 91:146–150CrossRefPubMedGoogle Scholar
  14. 14.
    Sturm LP, Windsor JA, Cosman PH, Cregan P, Hewett PJ, Maddern GJ (2008) A systematic review of skills transfer after surgical simulation training. Ann Surg 248:166–179CrossRefPubMedGoogle Scholar
  15. 15.
    Schijven M, Jakimowicz J (2003) Construct validity—experts and novices performing on the Xitact LS500 laparoscopy simulator. Surg Endosc 17:803–810CrossRefPubMedGoogle Scholar
  16. 16.
    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 19:401–405CrossRefPubMedGoogle Scholar
  17. 17.
    Woodrum DT, Andreatta PB, Yellamanchilli RK, Feryus L, Gauger PG, Minter RM (2006) Construct validity of the LapSim laparoscopic surgical simulator. Am J Surg 191:28–32CrossRefPubMedGoogle Scholar
  18. 18.
    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 19:678–682CrossRefPubMedGoogle Scholar
  19. 19.
    Pellen MGC, Horgan LF, Barton JR, Attwood SE (2009) Construct validity of the ProMIS laparoscopic simulator. Surg Endosc 23:130–139CrossRefPubMedGoogle Scholar
  20. 20.
    Andreatta PB, Woodrum DT, Birkmeyer JD, Yellamanchilli RK, Doherty GM, Gauger PG, Minter RM (2006) Laparoscopic skills are improved with LapMentor (TM) training—results of a randomized, double-blinded study. Ann Surg 243:854–863CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Naoki Iwata
    • 1
  • Michitaka Fujiwara
    • 1
  • Yasuhiro Kodera
    • 1
  • Chie Tanaka
    • 1
  • Norifumi Ohashi
    • 1
  • Goro Nakayama
    • 1
  • Masahiko Koike
    • 1
  • Akimasa Nakao
    • 1
  1. 1.Department of Surgery IINagoya University Graduate School of MedicineNagoyaJapan

Personalised recommendations