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Face, content, and construct validity of the virtual immersive operating room simulator for training laparoscopic procedures

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Abstract

Background

The aim of this work is to present the face, content, and construct validation of the virtual immersive operating room simulator (VIORS) for procedural training of surgeons’ laparoscopic psychomotor skills and evaluate the immersive training experience.

Methods

The VIORS simulator consists of an HMD Oculus Rift 2016 with a visor on a 1080 × 1200 pixel OLED screen, two positioning sensors with two adapted controls to simulate laparoscopic instruments, and an acrylic base to simulate the conventional laparoscopic setup. The immersion consists of a 360° virtual operating room environment, based on the EndoSuite at Hospital Infantil de Mexico Federico Gomez, which reproduces a configuration of equipment, instruments, and common distractions in the operating room during a laparoscopic cholecystectomy procedure. Forty-five surgeons, residents, and medicine students participated in this study: 27 novices, 13 intermediates, and 5 experts. They completed a questionnaire on the realism and operating room immersion, as well as their capabilities for laparoscopic procedural training, scored in the 5-point Likert scale. The data of instrument movement were recorded and analyzed using 13 movement analysis parameters (MAPs). The experience during training with VIORS was evaluated through NASA-TLX.

Results

The participants were enthusiastic about the immersion and sensation levels of the VIORS simulator, with positive scores on the realism and its capabilities for procedural training using VIORS. The results proved that the VIORS simulator was able to differentiate between surgeons with different skill levels. Statistically significant differences were found in nine MAPs, demonstrating their construct validity for the objective assessment of the procedural laparoscopic performance. At cognitive level, the inversion experience proves a moderate mental workload when the laparoscopic procedure is carried out.

Conclusion

The VIORS simulator has been successfully presented and validated. The VIORS simulator is a useful and effective device for the training of procedural laparoscopic psychomotor skills.

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Acknowledgements

The authors would like to thank all medical students, residents and surgeons for their enthusiastic and kindly participation in this study. Special thanks to David Medina-Álvarez from Centro Médico Nacional 20 de Noviembre ISSSTE, for his technical assistance in the organization and recruitment of all participants with the VIORS laparoscopic simulator in the study.

Funding

This work has been carried out with the support of the UNAM-DGAPA-PAPIME program with project number PE217020, and UNAM-DGAPA-PAPIIT program with Project Number IT200820.

Author information

Author notes

  1. Fernando Pérez-Escamirosa and Damaris Areli García-Cabra have contributed equally to this work.

Authors and Affiliations

  1. Instituto de Ciencias Aplicadas y Tecnología (ICAT), Universidad Nacional Autónoma de México (UNAM), Circuito Exterior S/N, Ciudad Universitaria, Coyoacán, 04510, Mexico City, Mexico

    Fernando Pérez-Escamirosa & Damaris Areli García-Cabra

  2. Departamento de Informática Biomédica, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Circuito Interior, Av. Universidad 3000, Ciudad Universitaria, Coyoacán, 04510, Mexico City, Mexico

    Fernando Pérez-Escamirosa

  3. Facultad de Medicina, Universidad Veracruzana, Campus Minatitlán, Managua, Nueva Mina, 96760, Veracruz, Minatitlán, Mexico

    Damaris Areli García-Cabra

  4. Servicio de Cirugía Pediátrica, Hospital Infantil de México Federico Gómez, Calle Dr. Márquez No. 162, Cuauhtémoc, Doctores, 06720, Mexico City, Mexico

    José Ricardo Ortiz-Hernández & Ricardo Manuel Ordorica-Flores

  5. Sección de Bioelectrónica, Departamento de Ingeniería Eléctrica, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV–IPN), Av. IPN 2508, Col. San Pedro Zacatenco, 07360, Mexico City, México

    Salvador Montoya-Alvarez & Arturo Minor-Martínez

  6. División de Ingeniería en Computación, Facultad de Estudios Superiores Aragón, Universidad Nacional Autónoma de México (UNAM), Av. Hacienda de Rancho Seco S/N, Impulsora Popular Avícola, 57130, Netzahualcóyotl, Estado de Mexico, Mexico

    Eduardo Alfredo Ruíz-Vereo

  7. División de Estudios de Posgrado, Facultad de Medicina, Unidad de Simulación de Posgrado, Universidad Nacional Autónoma de México (UNAM), Circuito de los Posgrados S/N, C.U., Coyoacán, 04510, Mexico City, Mexico

    Jesús Tapia-Jurado

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  1. Fernando Pérez-Escamirosa
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Corresponding author

Correspondence to Fernando Pérez-Escamirosa.

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Disclousure

Drs. Fernando Pérez-Escamirosa, Damaris Areli García-Cabra, José Ricardo Ortiz-Hernández, Salvador Montoya-Alvarez, Eduardo Alfredo Ruíz-Vereo, Ricardo Manuel Ordorica-Flores, Arturo Minor-Martínez, and Jesus Tapia-Jurado have no conflicts of interest or financial ties to disclose.

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Pérez-Escamirosa, F., García-Cabra, D.A., Ortiz-Hernández, J.R. et al. Face, content, and construct validity of the virtual immersive operating room simulator for training laparoscopic procedures. Surg Endosc 37, 2885–2896 (2023). https://doi.org/10.1007/s00464-022-09797-4

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