Effect of virtual reality training on laparoscopic surgery: randomised controlled trial

doi:10.1136/bmj.b1802

Published 14 May 2009, doi:10.1136/bmj.b1802
Cite this as: BMJ 2009;338:b1802

Research

Effect of virtual reality training on laparoscopic surgery: randomised controlled trial

Christian R Larsen, clinical research fellow¹, Jette L Soerensen, assistant professor and consultant², Teodor P Grantcharov, assistant professor and consultant³, Torur Dalsgaard, consultant⁴, Lars Schouenborg, consultant⁴, Christian Ottosen, consultant⁴, Torben V Schroeder, professor and consultant⁵, Bent S Ottesen, managing director and professor at the Juliane Marie Centre⁶

¹ Department of Gynecology, Juliane Marie Centre for Children, Women and Reproduction, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, DK-2100 OE, Copenhagen, Denmark, ² Department of Obstetrics, Juliane Marie Centre, Copenhagen, ³ Division of General Surgery, St Michael’s Hospital, Toronto, ON, Canada, ⁴ Department of Gynecology, Juliane Marie Centre, Copenhagen, ⁵ Department of Vascular Surgery, Abdominal Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, ⁶ Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark

Correspondence to: C R Larsen crl{at}dadlner.dk

Objective To assess the effect of virtual reality training onan actual laparoscopic operation.

Design Prospective randomised controlled and blinded trial.

Setting Seven gynaecological departments in the Zeeland regionof Denmark.

Participants 24 first and second year registrars specialisingin gynaecology and obstetrics.

Interventions Proficiency based virtual reality simulator trainingin laparoscopic salpingectomy and standard clinical education(controls).

Main outcome measure The main outcome measure was technicalperformance assessed by two independent observers blinded totrainee and training status using a previously validated generaland task specific rating scale. The secondary outcome measurewas operation time in minutes.

Results The simulator trained group (n=11) reached a mediantotal score of 33 points (interquartile range 32-36 points),equivalent to the experience gained after 20-50 laparoscopicprocedures, whereas the control group (n=10) reached a mediantotal score of 23 (22-27) points, equivalent to the experiencegained from fewer than five procedures (P<0.001). The mediantotal operation time in the simulator trained group was 12 minutes(interquartile range 10-14 minutes) and in the control groupwas 24 (20-29) minutes (P<0.001). The observers’ inter-rateragreement was 0.79.

Conclusion Skills in laparoscopic surgery can be increased ina clinically relevant manner using proficiency based virtualreality simulator training. The performance level of noviceswas increased to that of intermediately experienced laparoscopistsand operation time was halved. Simulator training should beconsidered before trainees carry out laparoscopic procedures.

Trial registration ClinicalTrials.gov NCT00311792 [ClinicalTrials.gov] .

Click on image to view video

This video follows Sofie Leisby, a trainee surgeon, through laparoscopic surgery—from practising in VR to a real life procedure.

© Larsen et al 2009
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Rapid Responses:

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