Ilumens, Université Paris Descartes, 45 Rue des Saints-Pères, 75006, Paris, France.
Department of Anesthesia, Robert Debré Hospital, 48 boulevard Sérurier, Paris, 75019, France.
Obes Surg. 2019 Apr;29(4):1309-1316. doi: 10.1007/s11695-018-03680-9.
Novice surgeons experience high levels of physical and mental workload during the early stages of their curriculum and clinical practice. Laparoscopic sleeve gastrectomy is the first bariatric procedure worldwide. Feasibility and safety of single-port sleeve gastrectomy (SPSG) has been demonstrated. An immersive virtual reality (VR) simulation was developed to provide a repetitive exercise to learn this novel technique. The primary objective of this study was to evaluate the impact of the VR training tool on mental and physical workload in novice surgeons. The secondary objective included an evaluation of the VR simulator.
A monocentric-controlled trial was conducted. Ten participants were divided into two groups, the VR group and the control group (without VR training). Surgery residents participated in a first real case of SPSG and a second case 1 month later. The VR group underwent a VR training between the two surgeries. Mental and physical loads were assessed with self-assessment questionnaires: NASA-TLX, Borg scale, and manikin discomfort test. The VR simulator was evaluated through presence, cybersickness, and usability questionnaires.
This study showed a decrease of the mental demand and effort dimensions of NASA-TLX between the first and the second surgery in the VR group (P < .05). During the second surgery, a marginally significant difference was shown concerning the mental demand between the two groups. Postural discomfort of the VR group decreased with practice (P < .01), mainly between the first and the second surgery (P < .05). Furthermore, participants characterized the VR simulator as realistic, usable, and very useful to learned surgery.
This exploratory study showed an improvement in mental and physical workload when novice surgeons trained with VR (repetitive practice, gesture improvement, reduction of stress, etc.). Virtual reality appears to be a promising perspective for surgical training.
新手外科医生在课程早期和临床实践中经历着较高的身心工作负荷。腹腔镜袖状胃切除术是全球首例减重手术。经证实，单孔袖状胃切除术（SPSG）具有可行性和安全性。一种沉浸式虚拟现实（VR）模拟训练被开发出来，为学习这种新技术提供重复的练习。本研究的主要目的是评估 VR 培训工具对新手外科医生身心工作负荷的影响。次要目标包括对 VR 模拟器的评估。
进行了一项单中心对照试验。10 名参与者分为两组，VR 组和对照组（无 VR 培训）。外科住院医师参与了首例 SPSG 手术和 1 个月后的第二例手术。VR 组在两次手术之间接受 VR 培训。使用自我评估问卷评估精神和体力负荷：NASA-TLX、Borg 量表和模拟人不适测试。通过存在、晕动病和可用性问卷评估 VR 模拟器。
本研究显示，VR 组在第一次和第二次手术之间，NASA-TLX 的精神需求和努力维度均有所下降（P<.05）。在第二次手术中，两组之间的精神需求存在边际显著差异。随着练习，VR 组的姿势不适减少（P<.01），主要是在第一次和第二次手术之间（P<.05）。此外，参与者认为 VR 模拟器具有真实性、可用性和非常有用，可以学习手术。
这项探索性研究表明，新手外科医生接受 VR 培训后，身心工作负荷得到改善（重复练习、改善姿势、减轻压力等）。虚拟现实似乎是一种有前途的手术培训方法。
