Surgical Endoscopy

, Volume 28, Issue 9, pp 2547–2554 | Cite as

Short-duration virtual reality simulation training positively impacts performance during laparoscopic colectomy in animal model: results of a single-blinded randomized trial

VR warm-up for laparoscopic colectomy
  • Sergio E. A. AraujoEmail author
  • Conor P. Delaney
  • Victor E. Seid
  • Antonio R. Imperiale
  • Alexandre B. Bertoncini
  • Sergio C. Nahas
  • Ivan Cecconello



Several studies have demonstrated skills transfer after virtual reality (VR) simulation training in laparoscopic surgery. However, the impact of VR simulation training on transfer of skills related to laparoscopic colectomy remains not investigated. The present study aimed at determining the impact of VR simulation warm-up on performance during laparoscopic colectomy in the porcine model.


Fourteen residents naive to laparoscopic colectomy as surgeons were randomly assigned in block to two groups. Seven trainees completed a 2-h VR simulator training in the laparoscopic sigmoid colectomy module (study group). The remaining seven surgeons (control group) underwent no intervention. On the same day, all participants performed a sigmoid colectomy with anastomosis on a pig. All operations were video recorded. Two board-certified expert colorectal surgeons independently assessed performance during the colectomy on the swine. Examiners were blinded to group assignment. The two examiners used a previously validated clinical instrument specific to laparoscopic colectomy. The primary outcome was the generic and specific skills score values.


Surgeons undergoing short-duration training on the VR simulator performed significantly better during laparoscopic colectomy on the pig regarding general and specific technical skills evaluation. The average score of generic skills was 17.2 (16.5–18) for the control group and 20.1 (16.5–22) for the study group (p = 0.002). The specific skills average score for the control group was 20.2 (19–21.5) and 24.2 (21–27.5) for the study group (p = 0.001). There was acceptable concordance (Kendall’s W) regarding the video assessment of generic (W = 0.78) and specific skills (W = 0.84) between the two examiners.


A single short-duration VR simulator practice positively impacted surgeons’ generic and specific skills performance required to accomplish laparoscopic colectomy in the swine model.


Laparoscopy Colectomy Colonic neoplasms Education Credentialing Clinical skills 



Drs. Sergio Eduardo Alonso Araujo, Conor Patrick Delaney, Victor Edmond Seid, Antonio Rocco Imperiale, Alexandre Bruno Bertoncini, Sergio Carlos Nahas, and Ivan Cecconello have no conflicts of interest or financial ties to disclose.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Sergio E. A. Araujo
    • 1
    • 2
    • 6
    Email author
  • Conor P. Delaney
    • 3
    • 4
  • Victor E. Seid
    • 2
  • Antonio R. Imperiale
    • 2
  • Alexandre B. Bertoncini
    • 2
  • Sergio C. Nahas
    • 1
    • 2
  • Ivan Cecconello
    • 1
    • 5
  1. 1.Department of GastroenterologyUniversity of Sao Paulo Medical SchoolSão PauloBrazil
  2. 2.Colorectal Surgery DivisionUniversity of Sao Paulo Medical CenterSão PauloBrazil
  3. 3.Case Western Reserve University Center for Skills and SimulationClevelandUSA
  4. 4.Digestive Health Institute University Hospitals Case Medical CenterCase Western Reserve UniversityClevelandUSA
  5. 5.Digestive Surgery DivisionUniversity of Sao Paulo Medical CenterSão PauloBrazil
  6. 6.São PauloBrazil

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