Validation of a virtual intracorporeal suturing simulator
- 36 Downloads
Intracorporeal suturing is one of the most important and difficult procedures in laparoscopic surgery. Practicing on a FLS trainer box is effective but requires large number of consumables, and the scoring is somewhat subjective and not immediate. A virtualbasic laparoscopic skill trainer (VBLaST©) was developed to simulate the five tasks of the FLS Trainer Box. The purpose of this study is to evaluate the face and content validity of the VBLaST suturing simulator (VBLaST-SS©).
Twenty-five medical students and residents completed an evaluation of the simulator. The participants were asked to perform the standard intracorporeal suturing task on both VBLaST-SS© and the traditional FLS box trainer. The performance scores on each system were calculated based on time (s), deviations to the black dots (mm), and incision gap (mm). The participants were then asked to finish a 13-item questionnaire with ratings from 1 (not realistic/useful) to 5 (very realistic/useful) regarding the face validity of the simulator. A Wilcoxon signed rank test was performed to identify differences in performance on the VBLaST-SS© compared to that of the traditional FLS box trainer.
Three questions from the face validity questionnaire were excluded due to lack of response. Ratings to 8 of the remaining 10 questions (80%) averaged above 3.0 out of 5. Average intracorporeal suturing completion time on the VBLaST-SS© was 421 (SD = 168 s) seconds compared to 406 (175 s) seconds on the box trainer (p = 0.620). There was a significant difference between systems for the incision gap (p = 0.048). Deviation in needle insertion from the black dot was smaller for the box trainer than the virtual simulator (1.68 vs. 7.12, p < 0.001).
Participants showed comparable performance on the VBLaST-SS© and traditional box trainer. Overall, the VBLaST-SS© system showed face validity and has the potential to support training for the suturing skills.
KeywordsVirtual reality Suturing simulation The Fundamentals of Laparoscopic Surgery (FLS) Intracorporeal suturing Face validity
This work was supported by the NIBIB/NIH Grant #5R44EB019802.
Compliance with ethical standards
Yaoyu Fu and Drs. Lora Cavuoto, Di Qi, Karthikeyan Panneerselvam, Gene Yang, Venkata Sreekanth Artikala, Andinet Enquobahrie, Suvranu De have no conflicts of interest or financial ties to disclose. Dr Schwaitzberg has no relevant conflicts related to this manuscript and is a consultant for Activ Surgical, Human Extensions, Arch Therapeutics, Acuitiy Bio, and Nu View Surgical.
- 2.Chellali A, Zhang L, Sankaranarayanan G, Arikatla VS, Ahn W, Derevianko A, Schwaitzberg SD, Jones DB, DeMoya M, Cao CGL (2014) Validation of the VBLaST peg transfer task: a first step toward an alternate training standard. Surg Endosc 28:2856–2862. https://doi.org/10.1007/s00464-014-3538-2 CrossRefGoogle Scholar
- 4.Sankaranarayanan G, Lin H, Arikatla VS, Mulcare M, Zhang L, Derevianko A, Lim R, Fobert D, Cao C, Schwaitzberg SD, Jones DB, De S (2010) Preliminary face and construct validation study of a virtual basic laparoscopic skill trainer. J Laparoendosc Adv Surg Tech 20:153–157. https://doi.org/10.1089/lap.2009.0030 CrossRefGoogle Scholar
- 6.Fried GM, Feldman LS, Vassiliou MC, Fraser SA, Stanbridge D, Ghitulescu G, Andrew CG (2004) Proving the value of simulation in laparoscopic surgery. Ann Surg 240:518–525. https://doi.org/10.1097/01.SLA.0000136941.46529.56 CrossRefGoogle Scholar
- 9.Zhang A, Hünerbein M, Dai Y, Schlag PM, Beller S (2008) Construct validity testing of a laparoscopic surgery simulator (Lap Mentor®): evaluation of surgical skill with a virtual laparoscopic training simulator. Surg Endosc 22:1440–1444. https://doi.org/10.1007/s00464-007-9625-x CrossRefGoogle Scholar
- 13.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. https://doi.org/10.1097/01.SLA.0000028969.51489.B4 CrossRefGoogle Scholar
- 15.Diesen DL, Erhunmwunsee L, Bennett KM, Ben-David K, Yurcisin B, Ceppa EP, Omotosho PA, Perez A, Pryor A (2011) Effectiveness of laparoscopic computer simulator versus usage of box trainer for endoscopic surgery training of novices. J Surg Educ 68:282–289. https://doi.org/10.1016/j.jsurg.2011.02.007 CrossRefGoogle Scholar
- 16.McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB (2011) Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med 86:706–711. https://doi.org/10.1097/ACM.0b013e318217e119 CrossRefGoogle Scholar