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Simulation-based VATS resection of the five lung lobes: a technical skills test

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Abstract

Background

Video-Assisted Thoracoscopic Surgery (VATS) lobectomy is an advanced procedure and to maximize patient safety it is important to ensure the competency of thoracic surgeons before performing the procedure. The objective of this study was to investigate validity evidence for a virtual reality simulator-based test including multiple lobes of the lungs.

Method

VATS experts from the department of Cardiothoracic Surgery at Rigshospitalet, Copenhagen, Denmark, worked with Surgical Science (Gothenburg, Sweden) to develop VATS lobectomy modules for the LapSim® virtual reality simulator covering all five lobes of the lungs. Participants with varying experience in VATS were recruited and classified as either novice, intermediate, or experienced surgeons. Each participant performed VATS lobectomy on the simulator for three different randomly chosen lobes. Nine predefined simulator metrics were automatically recorded on the simulator.

Results

Twenty-two novice, ten intermediate, and nine experienced surgeons performed the test resulting in a total of 123 lobectomies. Analysis of Variances (ANOVA) found significant differences between the three groups for parameters: blood loss (p < 0.001), procedure time (p < 0.001), and total instrument path length (p = 0.03). These three metrics demonstrated high internal consistency and significant test–retest reliability was found between each of them. Relevant pass/fail levels were established for each of the three metrics, 541 ml, 30 min, and 71 m, respectively.

Conclusion

This study provides validity evidence for a simulator-based test of VATS lobectomy competence including multiple lobes of the lungs. The test can be used to ensure basic competence at the end of a simulation-based training program for thoracic surgery trainees.

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Authors and Affiliations

  1. Department of Cardiothoracic Surgery, University Hospital of Copenhagen-Rigshospitalet, Copenhagen, Denmark

    Tamim Ahmad Haidari, Henrik Jessen Hansen & René Horsleben Petersen

  2. Department of Gastrointestinal Surgery, University Hospital of Copenhagen-Rigshospitalet, Copenhagen, Denmark

    Flemming Bjerrum

  3. Copenhagen Academy for Medical Education and Simulation, University of Copenhagen-Rigshospitalet, Copenhagen, Denmark

    Flemming Bjerrum & Lars Konge

  4. Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    Tamim Ahmad Haidari, Lars Konge & René Horsleben Petersen

Authors
  1. Tamim Ahmad Haidari
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  2. Flemming Bjerrum
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Correspondence to Tamim Ahmad Haidari.

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Disclosures

René Horsleben Petersen: Speaker fee Medtronic. Henrik Jessen Hansen: Speaker fee Medtronic, Medela, and BD/Bard. Tamim Ahmad Haidari, Flemming Bjerrum, and Lars Konge have no conflicts of interests to disclose.

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Haidari, T.A., Bjerrum, F., Hansen, H.J. et al. Simulation-based VATS resection of the five lung lobes: a technical skills test. Surg Endosc 36, 1234–1242 (2022). https://doi.org/10.1007/s00464-021-08392-3

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  • DOI: https://doi.org/10.1007/s00464-021-08392-3

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