Abstract
Background
Haptics is an expensive addition to virtual reality (VR) simulators, and the added value to training has not been proven. This study evaluated the benefit of haptics in VR laparoscopic surgery training for novices.
Methods
The Simbionix LapMentor II haptic VR simulator was used in the study. Randomly, 33 laparoscopic novice students were placed in one of three groups: control, haptics-trained, or nonhaptics-trained group. The control group performed nine basic laparoscopy tasks and four cholecystectomy procedural tasks one time with haptics engaged at the default setting. The haptics group was trained to proficiency in the basic tasks and then performed each of the procedural tasks one time with haptics engaged. The nonhaptics group used the same training protocol except that haptics was disengaged. The proficiency values used were previously published expert values. Each group was assessed in the performance of 10 laparoscopic cholecystectomies (alternating with and without haptics). Performance was measured via automatically collected simulator data.
Results
The three groups exhibited no differences in terms of sex, education level, hand dominance, video game experience, surgical experience, and nonsurgical simulator experience. The number of attempts required to reach proficiency did not differ between the haptics- and nonhaptics-training groups. The haptics and nonhaptics groups exhibited no difference in performance. Both training groups outperformed the control group in number of movements as well as path length of the left instrument. In addition, the nonhaptics group outperformed the control group in total time.
Conclusion
Haptics does not improve the efficiency or effectiveness of LapMentor II VR laparoscopic surgery training. The limited benefit and the significant cost of haptics suggest that haptics should not be included routinely in VR laparoscopic surgery training.
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Acknowledgments
We sincerely thank the data collection team including Brian Henry, MD, Mr. Zack Stephan, Ms. Janna Davis, Ms. Maria Boyden, and Mr. John Weber for their determination. Salary support for Mr. Charles Doarn and Dr. Timothy Broderick and the purchase of the Simbionix Lap Mentor II VR simulator were provided by grant W81XWH-07-2-0035 from the United States Army Medical Research and Materiel Command and the Telemedicine and Advanced Technology Research Center.
Disclosures
Timothy J. Broderick has a consulting relationship with Ethicon Endo-Surgery. Jonathan R. Thompson, Anthony C. Leonard, Charles R. Doarn, and Matt J. Roesch have no conflicts of interest or financial ties to disclose.
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Thompson, J.R., Leonard, A.C., Doarn, C.R. et al. Limited value of haptics in virtual reality laparoscopic cholecystectomy training. Surg Endosc 25, 1107–1114 (2011). https://doi.org/10.1007/s00464-010-1325-2
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DOI: https://doi.org/10.1007/s00464-010-1325-2