Jensen Katrine, Bjerrum Flemming, Hansen Henrik Jessen, Petersen René Horsleben, Pedersen Jesper Holst, Konge Lars
Department of Cardiothoracic Surgery 2152, University Hospital of Copenhagen, Copenhagen, Denmark Centre for Clinical Education (CEKU) 5404, University of Copenhagen and Capital Region, Copenhagen, Denmark
JMC Simulation Unit, The Juliane Marie Centre 4704, University Hospital of Copenhagen, Copenhagen, Denmark.
Interact Cardiovasc Thorac Surg. 2015 Oct;21(4):420-6. doi: 10.1093/icvts/ivv183. Epub 2015 Jul 10.
The aims of this study were to develop virtual reality simulation software for video-assisted thoracic surgery (VATS) lobectomy, to explore the opinions of thoracic surgeons concerning the VATS lobectomy simulator and to test the validity of the simulator metrics.
Experienced VATS surgeons worked with computer specialists to develop a VATS lobectomy software for a virtual reality simulator. Thoracic surgeons with different degrees of experience in VATS were enrolled at the 22nd meeting of the European Society of Thoracic Surgeons (ESTS) held in Copenhagen in June 2014. The surgeons were divided according to the number of performed VATS lobectomies: novices (0 VATS lobectomies), intermediates (1-49 VATS lobectomies) and experienced (>50 VATS lobectomies). The participants all performed a lobectomy of a right upper lobe on the simulator and answered a questionnaire regarding content validity. Metrics were compared between the three groups.
We succeeded in developing the first version of a virtual reality VATS lobectomy simulator. A total of 103 thoracic surgeons completed the simulated lobectomy and were distributed as follows: novices n = 32, intermediates n = 45 and experienced n = 26. All groups rated the overall user realism of the VATS lobectomy scenario to a median of 5 on a scale 1-7, with 7 being the best score. The experienced surgeons found the graphics and movements realistic and rated the scenario high in terms of usefulness as a training tool for novice and intermediate experienced thoracic surgeons, but not very useful as a training tool for experienced surgeons. The metric scores were not statistically significant between groups.
This is the first study to describe a commercially available virtual reality simulator for a VATS lobectomy. More than 100 thoracic surgeons found the simulator realistic, and hence it showed good content validity. However, none of the built-in simulator metrics could significantly distinguish between novice, intermediate experienced and experienced surgeons, and further development of the simulator software is necessary to develop valid metrics.
本研究的目的是开发用于电视辅助胸腔镜手术（VATS）肺叶切除术的虚拟现实模拟软件，探讨胸外科医生对VATS肺叶切除术模拟器的看法，并测试模拟器指标的有效性。
经验丰富的VATS外科医生与计算机专家合作，为虚拟现实模拟器开发VATS肺叶切除术软件。2014年6月在哥本哈根举行的第22届欧洲胸外科医师学会（ESTS）会议上招募了具有不同VATS经验程度的胸外科医生。根据所进行的VATS肺叶切除术数量将外科医生分为：新手（0例VATS肺叶切除术）、中级（1 - 49例VATS肺叶切除术）和经验丰富者（>50例VATS肺叶切除术）。参与者均在模拟器上进行了右上叶肺叶切除术，并回答了关于内容效度的问卷。比较三组之间的指标。
我们成功开发了第一版虚拟现实VATS肺叶切除术模拟器。共有103名胸外科医生完成了模拟肺叶切除术，分布如下：新手n = 32，中级n = 45，经验丰富者n = 26。所有组对VATS肺叶切除术场景的整体用户真实感在1 - 7分的量表上的中位数评分为5分，7分为最佳分数。经验丰富的外科医生认为图形和动作逼真，并认为该场景作为新手和中级经验胸外科医生的训练工具很有用，但作为经验丰富外科医生的训练工具不太有用。组间指标得分无统计学意义。
这是第一项描述用于VATS肺叶切除术的商用虚拟现实模拟器的研究。100多名胸外科医生认为该模拟器逼真，因此显示出良好的内容效度。然而，模拟器的任何内置指标都无法显著区分新手、中级经验和经验丰富的外科医生，因此需要进一步开发模拟器软件以开发有效的指标。
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