Kantamaneni Ketan, Jalla Krishi, Renzu Mahvish, Jena Rahul, Kannan Amudhan, Jain Ruchi, Muralidharan Suchitra, Yanamala Vijaya Lakshmi, Zubair Zainab, Dominic Jerry Lorren, Win Myat, Tara Anjli, Ruo Sheila W, Alfonso Michael
General Surgery, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
General Surgery, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Gannavaram, IND.
Cureus. 2021 Aug 17;13(8):e17239. doi: 10.7759/cureus.17239. eCollection 2021 Aug.
Latest advancements in science lead to drastic improvements in patient health care. Techniques and technology evolved in surgery over the years have resulted in the improvement of patient outcomes by leaps and bounds. Open surgeries previously done for procedures like appendectomy and cholecystectomy evolved into laparoscopic minimally invasive procedures. Such procedures pose few challenges to the surgeons, like lack of tissue feedback and fulcrum effect of the abdominal wall. But training surgeons for such an advanced skill is still following conventional methods. These procedures can be effectively trained using Virtual Reality (VR), which can simulate operations outside the operating room (OR). To maximize the outcomes of VR training, knowledge on various strategies affecting the skills acquisition and retention in VR training is essential. This review collected information from PubMed, EMBASE, Cochrane Library (CENTRAL) databases. Data from the previous ten years are included in the review. This included documents, clinical trials, meta-analysis, randomized controlled trials, reviews, systematic reviews, letters to editors, and grey literature. After an advanced Medical Subject Headings (MeSH) search, we got 59,532 results, and after the application of filters, 189 results showed up. Out of these, studies that were not exclusively relevant to the use of VR in laparoscopic surgery were manually excluded, and a total of 35 articles were included in the study. VR is found to be an excellent training modality with promising outcomes. It helps the surgeons perform the surgery accurately at a faster pace and improves confidence and multitasking ability in OR. Instructor feedback from mentors and deliberate practice of trainees, and early introduction of haptics in VR resulted in the most effective outcomes of the VR training. Box trainers are also compared with VR trainers as they are the cheaper modalities of training. However, this area needs more research to conclude if box trainers can act as a cheaper alternative to VR training providing similar outcomes.
科学领域的最新进展极大地改善了患者的医疗保健状况。多年来外科手术技术和科技的发展使患者的治疗效果有了飞跃式的提升。以前用于阑尾切除术和胆囊切除术等手术的开放手术已演变成腹腔镜微创手术。这类手术给外科医生带来的挑战较少，比如缺乏组织反馈和腹壁的支点效应。但培训外科医生掌握这种先进技能仍采用传统方法。使用虚拟现实（VR）可以有效地培训这类手术，它能够在手术室（OR）之外模拟手术。为了使VR培训的效果最大化，了解影响VR培训中技能获取和保留的各种策略至关重要。本综述从PubMed、EMBASE、Cochrane图书馆（CENTRAL）数据库收集信息。综述纳入了过去十年的数据。这包括文献、临床试验、荟萃分析、随机对照试验、综述、系统评价、给编辑的信以及灰色文献。经过高级医学主题词（MeSH）检索，我们得到了59532条结果，应用筛选条件后，出现了189条结果。其中，与VR在腹腔镜手术中的应用不完全相关的研究被人工排除，共有35篇文章纳入本研究。研究发现VR是一种出色的培训方式，效果令人期待。它帮助外科医生更快、更准确地进行手术，并提高在手术室中的信心和多任务处理能力。导师的指导反馈和学员的刻意练习，以及在VR中尽早引入触觉技术，带来了VR培训最有效的结果。还将箱式训练器与VR训练器进行了比较，因为它们是更便宜的培训方式。然而，这个领域还需要更多研究来确定箱式训练器是否可以作为一种更便宜的替代方案，提供与VR培训相似的效果。
