Department of Biosurgery and Surgical Technology, Imperial College London, London, UK.
Scand J Surg. 2013;102(4):221-6. doi: 10.1177/1457496913496494. Epub 2013 Sep 20.
The mastery of manual skills that are indispensable for the performance of surgical tasks is a competence specific to surgery. One way of facilitating this acquisition is to move the training out of the operating room and all of its restrictions. Surgical training out of the operating room, also called simulation, has spread widely in the past decade, especially in laparoscopic and endoscopic surgery.
This review assesses the role of virtual reality (VR) simulators in laparoscopic surgery and their actual impact on technical skills.
There is a wealth of simulators, ranging from low- to high-fidelity simulators incorporating haptic feedback. They comprise basic tasks, procedural modules, and full procedures. Virtual reality simulators have shown acceptable fidelity and validity evidence. Moreover, training out of the operating room on virtual reality simulators has demonstrated its positive impact on basic skills during real laparoscopic procedures in patients. The benefit of virtual reality over simple video trainers remains unclear for teaching basic skills. However, virtual reality simulators provide automatic feedback that permitted to design structured competency-based curricula and allow deliberate practice. Finally, advanced procedures and patient-specific models have been designed on virtual reality simulators, and further investigations are still awaited to appraise their educational value.
掌握手术操作所必需的手动技能是外科特有的能力。促进这种能力的一种方法是将培训从手术室及其所有限制中转移出来。手术室外的手术培训，也称为模拟，在过去十年中得到了广泛的应用，尤其是在腹腔镜和内窥镜手术中。
本综述评估了虚拟现实 (VR) 模拟器在腹腔镜手术中的作用及其对技术技能的实际影响。
目前有大量的模拟器，从低到高保真模拟器都包含触觉反馈。它们包括基本任务、程序模块和完整程序。虚拟现实模拟器具有可接受的保真度和有效性证据。此外，在手术室外使用虚拟现实模拟器进行培训已证明其对患者实际腹腔镜手术中的基本技能有积极影响。虚拟现实相对于简单的视频训练器在教授基本技能方面的优势尚不清楚。然而，虚拟现实模拟器提供了自动反馈，允许设计基于能力的结构化课程，并允许进行刻意练习。最后，在虚拟现实模拟器上设计了高级程序和患者特定模型，仍需要进一步研究来评估其教育价值。
