The Rise of new age technologies in laparoscopic training models: a systematic review
Christopher Katsinas
Background
Minimally invasive surgery (MIS) has many benefits, such as: reduced post-operative pain, improved aesthetic outcomes and shorter length-of-stay. The challenge of laparoscopic surgery is the high risk of complications before acceptable levels of operator proficiency. Simulation systems, being box trainers (BT) and virtual reality simulators (VRS) aim to improve upon this training process. This review determines if VRS offers advantages over BT and traditional training models.
Aim
To determine whether VRS is the future of laparoscopic training models in comparison to BT and traditional surgical training models.
Outcomes: Primary
Economy of movement (EOM), the time of task completion (TTC), errors and a validated laparoscopic assessment score (VLAS). Secondary. transferability of skills (TOS), measurement of learning curve (LC), assessment of knowledge retention (KR)
Methods
6227 search records utilising search terms on PubMed database. 108 search results remaining after preliminary criteria was met. 14 results remained after remaining inclusion criteria applied. All 14 papers were read in full and included in this systematic review.
Results: Primary Outcomes
EOM. No significant difference between VRS and BT groups. TTC. Compared to control, both VRS and BT had statistically significant improvements. There was conflicting evidence between them significant between VRS and BT. Errors. There was a global reduction in error scores for both VRS and BT groups with no significant difference. VLAS. GOALS score reported a significant difference between BT group score and VRS group. OSA-LS reported no difference between VRS and BT groups, but a significant difference to control. Secondary Outcomes. TOS. Transfer-effectiveness ratio for VRS 2.31 VS 1.13 for BT.LC. There was no significant difference between VRS and BT trained groups. KR. There was no significant difference between VRS and BT trained groups
Conclusions
The results of our systematic review point towards an inconclusive answer to this question, with large discrepancies between what the articles have reported.