Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Department of Urology, Yokohama Sakae Kyosai Hospital, Yokohama, Japan.
Asian J Endosc Surg. 2022 Apr;15(2):313-319. doi: 10.1111/ases.13005. Epub 2021 Oct 26.
To determine whether training laparoscopic nephrectomy (LN) with a virtual reality (VR) simulator improves the performance of porcine LN.
Twelve urological residents were assigned to two groups: a training and a non-training group. All participants performed baseline assessments of LN skills and time on the LapPASS® simulator. The training group received preoperative LapPASS® training. Both groups then performed LN using a porcine model. The operations were videotaped and evaluated using the Global Operative Assessment of Laparoscopic Skills (GOALS) system. After porcine LN, the training group performed a final LN with the LapPASS® simulator.
There was no significant difference in the operation time required for porcine LN. There were no significant differences in the total A (autonomy), B (bimanual dexterity), D (depth perception), or T (tissue handling) GOALS scores. However, the total E (efficiency) score in the training group was higher than that in the non-training group (P = .030). The final LN score with LapPASS® was significantly higher than the baseline (P = .004).
The results of this study demonstrated that VR LN training improved performance in an actual operation. VR-based procedural simulation could become a vital part of the laparoscopic training program for residents.
为了确定使用虚拟现实（VR）模拟器进行腹腔镜肾切除术（LN）培训是否可以提高猪 LN 的手术效果。
将 12 名泌尿科住院医师分为两组：培训组和非培训组。所有参与者均进行了 LN 技能的基线评估和 LapPASS®模拟器上的时间评估。培训组接受了术前 LapPASS®培训。然后，两组均使用猪模型进行 LN。手术过程进行了录像，并使用全球腹腔镜手术技能评估（GOALS）系统进行了评估。在完成猪 LN 后，培训组使用 LapPASS®模拟器进行了最后的 LN。
猪 LN 所需的手术时间没有显著差异。A（自主性）、B（双手灵巧性）、D（深度感知）或 T（组织处理）GOALS 评分的总分没有显著差异。然而，培训组的总 E（效率）评分高于非培训组（P=0.030）。使用 LapPASS®进行的最后一次 LN 评分明显高于基线（P=0.004）。
本研究结果表明，VR LN 培训可提高实际手术中的表现。基于 VR 的程序模拟可能成为住院医师腹腔镜培训计划的重要组成部分。
