The First School of Clinical Medicine, Nanjing Medical University, Nanjing, , China; Department of General Surgery, Wuxi People's Hospital Affiliated to Nanjing Medical University, China.
The First School of Clinical Medicine, Nanjing Medical University, Nanjing, , China.
Int J Surg. 2021 Mar;87:105859. doi: 10.1016/j.ijsu.2020.11.022. Epub 2020 Dec 9.
Virtual reality becomes popular in laparoscopic surgery especially in the training process. An assessment on the learning curve of virtual reality compared to other methods of training or no training needed to be carried out.
A systematic literature search between 2000 and 2020 was performed through PubMed, Cochrane library's Central, Embase, Clinicaltrials.gov, and Web of Science. All randomized controlled studies included kept the consistency of participants at the baseline and set the same time or repetitions of training. This systematic review and meta-analysis was under the guidance of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Assessing the methodological quality of systematic reviews(AMSTAR).
Twenty-three randomized controlled studies and five non-randomized concurrent controlled studies were included among 2692 searched studies. Virtual reality was recommended to be applied among no experience medical students or novice surgeons in the laparoscopic training. It had steeper learning curve compared to no training and traditional trainers. While there was no significant difference between virtual reality and box training or video training in the aspect of learning curve. Moreover, it seemed effective to improve the initial stage of learning curve in actual surgery.
Virtual reality was not the first choice to be applied into laparoscopic training and it had its applicable surgeons or medical students. The superiority of virtual reality in the skill transfer from training room into operating room needed to be confirmed and complemented with further analyses. More importantly, the cost-effectiveness of virtual reality in the training process and patient safety were badly in need of discussion.
虚拟现实在腹腔镜手术中越来越受欢迎，尤其是在培训过程中。需要对虚拟现实与其他培训方法或无需培训的学习曲线进行评估。
通过 PubMed、Cochrane 图书馆中央、Embase、Clinicaltrials.gov 和 Web of Science 进行了 2000 年至 2020 年的系统文献检索。所有纳入的随机对照研究都保持了参与者在基线时的一致性，并设置了相同的培训时间或重复次数。本系统评价和荟萃分析遵循系统评价和荟萃分析的首选报告项目（PRISMA）和评估系统评价方法学质量（AMSTAR）的指导。
在 2692 项检索研究中，共纳入 23 项随机对照研究和 5 项非随机同期对照研究。虚拟现实被推荐用于无经验的医学生或腹腔镜培训中的新手外科医生。与无培训和传统培训师相比，它具有更陡峭的学习曲线。然而，在学习曲线方面，虚拟现实与箱式训练或视频训练之间没有显著差异。此外，它似乎在实际手术的学习曲线初始阶段有效。
虚拟现实并不是腹腔镜培训的首选方法，它适用于特定的外科医生或医学生。虚拟现实从培训室到手术室的技能转移的优势需要进一步分析来证实和补充。更重要的是，虚拟现实在培训过程中的成本效益和患者安全急需讨论。
