Why are laparoscopic surgeries trained with VR?
Laparoscopy has been on the rise, in the past decade, as a safer alternative to open surgery. Laparoscopic surgeries entail fewer complications, less pain, and quicker recovery time. This minimally invasive surgical technique consists of inserting trochars into the abdomen through small incisions to remove a damaged organ or a sample of tissue for biopsy.
Laparoscopic surgical skills’ difficulty
Yet, laparoscopic surgery is technically demanding and requires ambidexterity, specific psychomotor skills and abilities that differ from those of conventional surgery. These skills include eye-hand coordination, transferring the two-dimensional video image to a three-dimensional workspace, working with kinematic restrictions imposed by the instruments, minimal tactile feedback and the fulcrum effect. Laparoscopic training is associated with a high learning curve, requiring much training.
Laparoscopic surgery training methods
While it would be ideal to train laparoscopic skills in an operating room, the operating room’s minute cost and public demand deem this an impossibility. Surgeons train their skills with cadavers, animals, and simulators.
1. Cadaver laparoscopic training
It has been criticized for its ineffectivity given the current preservation method of embalming with formalin. Surgeons have raised questions about establishing pneumoperitoneum, the changes in color, strength and fragility of organs and tissues prior to dissecting and the difference in operative experience. Moreover, there are problems of supply, ethics and usage.
2. Animal laparoscopic training
It has been condemned because of the ethics of keeping an animal alive just to continue opening it and extracting different organs, only for them to be euthanized after the surgical workshops are completed. It is a costly procedure given today’s laws which require the presence of a certified vet and the usage of anesthetics. It is also unscalable, given that the more surgeons are trained the more animals are needed.
3. Laparoscopic simulator boxes
Lack objective skills assessment tools that track data for surgeons to improve on. It does not reduce the need for tutors to train and assess in-situ. Although they are cheap alternatives, they do not provide an accurate representation of the organs and tissues that are manipulated.
4. More advanced physical laparascopic simulators
They have the necessary learning assessment platform, but do not provide the immersion of being in an operating room nor the 3D imaging that the surgeon would be looking at during the procedure, and the soft tissue needs to be replaced after every skills training. Yet, they are a useful tool in some cases.
5. Virtual reality laparoscopic simulators
They provide a fully immersive experience with real imaging and the ability to practice each skill unlimitedly. Yet, they have been accused of being expensive. Some companies, like MetaMedicsVR, are out on the mission of democratizing these virtual simulators, lowering their acquisition costs.
Laparoscopic surgery and VR
Virtual reality simulators offer training without supervision in a controlled environment, free of the risks of operating on patients. With a VR simulator, doctors wear a headset (like the Oculus VR) and the movements made are enacted in real time. A VR laparoscopic simulator is useful for:
- Practicing eye-hand coordination, as surgeons look at the imaging displayed on the LCD monitor while suturing, dissecting, and retracting.
- Practicing skills one by one as well as internalizing the sequential steps and protocols of a laparascopic surgery.
- Familiarizing oneself with the operating room, the laparoscopic tools and all the variables that play a role in the surgery, such as noise, lightning and teamwork.
Who can use VR Laparoscopic Training?
Both surgical trainees and experienced doctors benefit from training with a VR laparoscopic simulator.
VR laparoscopic simulators for surgical trainees
Healthcare system changes, such as increasing restrictions on working hours and patient security legislation, have altered the ways in which trainees’ education can be conducted. Laparoscopic surgeries suffer from a high learning curve, which must be mastered before operating on real patients, to ensure a safe and successful procedure.
VR laparoscopic simulators benefit surgical residents as they can practice:
- Any time from anywhere, without waiting for queues or asking a mentor
- As many times as they want, without risking the patient’s life.
- Increase difficulty with each exercise, from a range of different variants
- Learn from their mistakes with the objective data tracked
- Be exposed to different surgical scenarios and respond in real-time.
Experienced surgeons benefit from VR laparoscopic training
- Experienced open surgery doctors who have not been trained to do laparoscopic procedures can benefit from the specialized training of a laparoscopic simulation software.
- Patient-specific simulators allow laparoscopic specialists to perform patient-specific preoperative rehearsals, especially for cases with complex anatomy.
- Experienced surgeons who took medical or family leave benefit from some refreshment before they start being exposed to real patients again.
Laparoscopic VR Simulation Training
VR laparoscopic simulators are used to train specific skills and the sequencing of the surgery.
VR Simulation Training Modules for Laparoscopic Surgery
During laparoscopic surgery, there are several inflection points that must be mastered. Each may be trained separately in a VR laparoscopic simulator online.
- Direct Trocar Insertion Technique
- Camera Navigation
- Hepatocystic triangle element identification and dissection of the hepatocystic triangle
- Organ and tissue separation
VR Laparoscopic Surgery Simulation Training
It is also important to understand the protocol and stages of surgery. From the surgeon’s washing and sterile dressing to communicating in the operating room and using the appropriate laparoscopic tools when needed in the correct order. Training the sequencing of the surgery, internalizing all the procedures is highly convenient with an online simulator.
VR Laparoscopic Simulation Categories
Laparoscopic surgeries are applied to different areas, among which appendectomy, colectomy, hernia, cholecystectomy, colorectal are most common.
When looking at how VR simulators impact the efficacy of these surgeries:
- Sroka reported that training laparoscopic surgery fundamentals in a simulator improved the performance of laparoscopic cholecystectomy.
- In urology, Lucas evaluated whether training on a VR laparoscopic simulator improved the performance of laparoscopic nephrectomy and concluded that the scores of the training group were significantly higher.
- For pediatric laparoscopic inguinal hernia repair, Korzeniowski, has developed a virtual reality simulator prototype to overcome the steep learning curve of the small operating environment.
- Kemal’s training simulator distinguishes different modules for full training of laparoscopic procedures such as cholecystectomy, tubal sterilization and myomectomy, all showing improvement for inexperienced trainees’ learning curve and transferability of training.
Starting with VR Laparoscopic Simulator
If you want to start using a VR laparoscopic simulator to train skills such as hand-eye coordination, cutting, clipping, bi-manual dexterity or even a full surgical procedure, whether that is a laparoscopic colectomy, cholecystectomy, or appendectomy, contact a trusted provider. MetaMedicsVR personalizes VR laparoscopic training simulator to the needs of your surgeons and institutions.
Book a slot with them today and revolutionize your training methods!