Abstract
The purpose of this study is to evaluate the effectiveness of virtual reality (VR) simulation versus dry lab suturing practice at improving suturing performance in robotic surgery. Nineteen novice participants with no prior robotic suturing experience were randomized to two groups, VR simulation and dry lab, which consisted of inanimate training on a da Vinci Si surgical system. Each group underwent baseline suturing evaluation, then trained on the Simbionix™ Suturing Module (SSM) or undertook suturing practice using the da Vinci Surgical System in a dry lab. Final suturing performance was evaluated using the objective suture scoring method. Participants in the VR simulation group were surveyed to assess the face and content validity of the SSM. Both groups experienced significant improvement after training (VR simulation group p = 0.0078; dry lab group p = 0.0039). There was no significant difference in improvement between the two groups after undergoing training with either SSM or in the dry lab. Improvements in composite timing scores were 123 and 172 in the VR simulation and dry lab test groups, respectively (p = 0.36). Face validation varied with respect to the category assessed, but participants confirmed content validity of the SSM in all categories. In this sample of novice operators, there was no significant advantage in training with VR simulation using the SSM over dry lab training in improving suturing performance. Users of the SSM found it useful and relevant as a training tool for improving suturing performance.
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Acknowledgments
All statistical analysis performed by Jocelyn Andrel Sendecki, MSPH of Thomas Jefferson University Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics.
Conflict of interest
Costas D. Lallas declares that he has no conflict of interest. Michael J. Amirian declares that he has no conflict of interest. Samuel M. Lindner declares that he has no conflict of interest. Edouard J. Trabulsi declares that he has no conflict of interest.
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Appendix—Validity Survey
Appendix—Validity Survey
Face Validity:
Draw a vertical line on the visual analog scale (VAS) for the following.
(1 = totally unlike surgery. 5 = identical to actual surgery)
Commentary:
Content Validity:
Draw a vertical line on the VAS to indicate simulator usefulness in training for the following. (1 = not relevant or useful. 5 = very relevant and useful)
Commentary:
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Amirian, M.J., Lindner, S.M., Trabulsi, E.J. et al. Surgical suturing training with virtual reality simulation versus dry lab practice: an evaluation of performance improvement, content, and face validity. J Robotic Surg 8, 329–335 (2014). https://doi.org/10.1007/s11701-014-0475-y
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DOI: https://doi.org/10.1007/s11701-014-0475-y