Department of Medical Technology, SINTEF Technology and Society, PB 4760 Sluppen, 7465 Trondheim, Norway.
Surg Endosc. 2013 Feb;27(2):364-77. doi: 10.1007/s00464-012-2503-1. Epub 2012 Sep 7.
Simulation of procedural tasks has the potential to bridge the gap between basic skills training outside the operating room (OR) and performance of complex surgical tasks in the OR. This paper provides an overview of procedural virtual reality (VR) simulation currently available on the market and presented in scientific literature for laparoscopy (LS), flexible gastrointestinal endoscopy (FGE), and endovascular surgery (EVS).
An online survey was sent to companies and research groups selling or developing procedural VR simulators, and a systematic search was done for scientific publications presenting or applying VR simulators to train or assess procedural skills in the PUBMED and SCOPUS databases.
The results of five simulator companies were included in the survey. In the literature review, 116 articles were analyzed (45 on LS, 43 on FGE, 28 on EVS), presenting a total of 23 simulator systems. The companies stated to altogether offer 78 procedural tasks (33 for LS, 12 for FGE, 33 for EVS), of which 17 also were found in the literature review. Although study type and used outcomes vary between the three different fields, approximately 90 % of the studies presented in the retrieved publications for LS found convincing evidence to confirm the validity or added value of procedural VR simulation. This was the case in approximately 75 % for FGE and EVS.
Procedural training using VR simulators has been found to improve clinical performance. There is nevertheless a large amount of simulated procedural tasks that have not been validated. Future research should focus on the optimal use of procedural simulators in the most effective training setups and further investigate the benefits of procedural VR simulation to improve clinical outcome.
程序性任务模拟具有弥合手术室（OR）外基本技能培训与 OR 中复杂手术任务执行之间差距的潜力。本文概述了目前市场上可用于腹腔镜检查（LS）、柔性胃肠内镜检查（FGE）和血管内手术（EVS）的程序性虚拟现实（VR）模拟器，并介绍了相关科学文献。
向销售或开发程序性 VR 模拟器的公司和研究小组发送了在线调查，并在 PUBMED 和 SCOPUS 数据库中对呈现或应用 VR 模拟器来培训或评估程序性技能的科学出版物进行了系统搜索。
调查中纳入了五家模拟器公司的结果。在文献综述中，分析了 116 篇文章（45 篇关于 LS，43 篇关于 FGE，28 篇关于 EVS），总共介绍了 23 个模拟器系统。这些公司总共表示提供了 78 个程序性任务（33 个用于 LS，12 个用于 FGE，33 个用于 EVS），其中 17 个也在文献综述中发现。尽管这三个不同领域的研究类型和使用结果存在差异，但检索出版物中约 90%的 LS 研究提出了令人信服的证据，证实了程序性 VR 模拟的有效性或附加价值。在 FGE 和 EVS 中，大约 75%的情况也是如此。
使用 VR 模拟器进行程序性培训已被发现可提高临床绩效。然而，仍有大量模拟程序性任务尚未得到验证。未来的研究应侧重于在最有效的培训设置中最佳使用程序性模拟器，并进一步研究程序性 VR 模拟对改善临床结果的益处。
