Middleton Kellie K, Hamilton Travis, Tsai Pei-Chien, Middleton Dana B, Falcone John L, Hamad Giselle
Department of Surgery, University of Pittsburgh Medical Center, 3945 Forbes Avenue, Suite 325, Pittsburgh, PA, 15213, USA,
Surg Endosc. 2013 Nov;27(11):4224-31. doi: 10.1007/s00464-013-3027-z. Epub 2013 Jun 13.
Video games have been shown to improve eye-hand coordination, spatial visualization, manual dexterity, and rapid mental processing, which are important in the acquisition of laparoscopic skills. This study investigated the relationship between playing Nintendo(®) Wii™ and virtual reality (VR) laparoscopic surgery simulator performance. We hypothesized that playing the Wii would improve surgical skills performance on a VR laparoscopic simulator and hoped to elucidate which tasks, in particular, would be most beneficial for nondominant hand training.
This was a single-blinded, randomized, prospective study conducted with 23 student volunteers. VR laparoscopic skills were assessed at baseline on a Simbionix LapMentor™ Surgical Simulator (Simbionix Ltd., Israel) and after the gaming period of 2 weeks. Simulator performance metrics were compared between groups using nonparametric statistics and an alpha of 0.05.
Compared with the control group, the Wii-playing group demonstrated greater improvement of six measures, including accuracy on the eye-hand coordination task (p = 0.04), faster completion time (p = 0.04), decreased number of left-handed movements (p = 0.03), decreased left handed total path length (p = 0.03), decreased total number of grasping attempts (p = 0.04), and improved left-handed economy of movement (p = 0.05) for the bimanual clipping and grasping task. When comparing the number of measures improved upon by the Wii-playing group and the control group for all three tasks, the Wii-playing group consistently outperformed the control group in 18 measures compared with the control group's improvement in 6.
This study further characterizes the association between video game playing and surgical performance. Improvements following the intervention were made in the most basic of surgical skills, most notably with the nondominant hand, suggesting that short-term playing of the Wii could improve bimanual dexterity and expedite the acquisition of basic surgical skills.
电子游戏已被证明能改善眼手协调能力、空间视觉能力、手部灵活性以及快速心理处理能力，这些能力在腹腔镜手术技能的掌握中至关重要。本研究调查了玩任天堂Wii与虚拟现实（VR）腹腔镜手术模拟器表现之间的关系。我们假设玩Wii能提高VR腹腔镜模拟器上的手术技能表现，并希望阐明哪些任务对非优势手训练最为有益。
这是一项针对23名学生志愿者进行的单盲、随机、前瞻性研究。在基线时，使用Simbionix LapMentor™手术模拟器（以色列Simbionix有限公司）评估VR腹腔镜技能，并在2周的游戏期后再次评估。使用非参数统计方法比较两组之间的模拟器性能指标，显著性水平为0.05。
与对照组相比，玩Wii的组在六项指标上有更大改善，包括眼手协调任务的准确性（p = 0.04）、更快的完成时间（p = 0.04）、左手动作次数减少（p = 0.03）、左手总路径长度减少（p = 0.03）、抓握尝试总数减少（p = 0.04）以及双手夹取和抓握任务中左手动作经济性提高（p = 0.05）。在比较玩Wii的组和对照组在所有三项任务上改善的指标数量时，玩Wii的组在18项指标上始终优于对照组，而对照组仅在6项指标上有所改善。
本研究进一步描述了电子游戏与手术表现之间的关联。干预后在最基本的手术技能方面有了改善，最显著的是在非优势手方面，这表明短期玩Wii可以提高双手灵活性并加快基本手术技能的掌握。
