Department of Cancer and Surgery, St. Marys Hospital, Imperial College London, London, UK.
Surgery. 2012 Jun;151(6):779-84. doi: 10.1016/j.surg.2012.03.014.
Laparoscopic bariatric surgery is a safe and effective way of treating morbid obesity. However, the operations are technically challenging and training opportunities for junior surgeons are limited. This study aims to assess whether virtual reality (VR) simulation is an effective adjunct for training and assessment of laparoscopic bariatric technical skills.
Twenty bariatric surgeons of varying experience (Five experienced, five intermediate, and ten novice) were recruited to perform a jejuno-jejunostomy on both cadaveric tissue and on the bariatric module of the Lapmentor VR simulator (Simbionix Corporation, Cleveland, OH). Surgical performance was assessed using validated global rating scales (GRS) and procedure specific video rating scales (PSRS). Subjects were also questioned about the appropriateness of VR as a training tool for surgeons.
Construct validity of the VR bariatric module was demonstrated with a significant difference in performance between novice and experienced surgeons on the VR jejuno-jejunostomy module GRS (median 11-15.5; P = .017) and PSRS (median 11-13; P = .003). Content validity was demonstrated with surgeons describing the VR bariatric module as useful and appropriate for training (mean Likert score 4.45/7) and they would highly recommend VR simulation to others for bariatric training (mean Likert score 5/7). Face and concurrent validity were not established.
This study shows that the bariatric module on a VR simulator demonstrates construct and content validity. VR simulation appears to be an effective method for training of advanced bariatric technical skills for surgeons at the start of their bariatric training. However, assessment of technical skills should still take place on cadaveric tissue.
腹腔镜减重手术是治疗病态肥胖的一种安全有效的方法。然而，手术技术具有挑战性，初级外科医生的培训机会有限。本研究旨在评估虚拟现实（VR）模拟是否是培训和评估腹腔镜减重技术技能的有效辅助手段。
招募了 20 名不同经验水平的减重外科医生（5 名经验丰富、5 名中级和 10 名初级），在尸体组织和 Lapmentor VR 模拟器（Simbionix Corporation，克利夫兰，俄亥俄州）的减重模块上进行空肠空肠吻合术。使用经过验证的综合评定量表（GRS）和特定手术视频评分量表（PSRS）评估手术表现。还询问了研究对象关于 VR 作为外科医生培训工具的适宜性。
VR 减重模块的构建效度得到了证明，初级和经验丰富的外科医生在 VR 空肠空肠吻合术 GRS（中位数 11-15.5；P =.017）和 PSRS（中位数 11-13；P =.003）上的表现有显著差异。内容效度也得到了证明，外科医生认为 VR 减重模块对培训非常有用且合适（平均李克特评分 4.45/7），他们非常推荐 VR 模拟用于减重培训（平均李克特评分 5/7）。但尚不能确定 VR 模拟的表面效度和同时效度。
本研究表明，VR 模拟器上的减重模块具有构建效度和内容效度。VR 模拟似乎是一种有效的方法，可用于培训外科医生在开始减重培训时的高级减重技术技能。然而，技术技能的评估仍应在尸体组织上进行。
