Department of Trauma Surgery & Emergency Department, University Medical Center Regensburg, Regensburg, Germany.
SZENARIS GmbH, Bremen, Germany.
J Hand Surg Am. 2022 Dec;47(12):1225.e1-1225.e7. doi: 10.1016/j.jhsa.2021.09.008. Epub 2021 Nov 30.
Surgical simulations are becoming increasingly relevant in musculoskeletal training. They provide the opportunity to develop surgical skills in a controlled environment while reducing the risks for patients. For K-wire internal fixation in musculoskeletal surgery, a force feedback virtual reality (VR) simulator was developed. The aim of this study was to evaluate training results using this technology and compare the results with that of standard teaching on cadavers.
Twenty participants attending an AO Trauma Course during 2020 were randomly allocated in 2 groups. On day 1, group A was trained by senior surgeons using a cadaver and group B was trained by the VR simulator for K-wire insertion in the distal radius. On day 2, all participants performed K-wire insertion on the cadaver model, without assistance, to validate the training effect.
On a surgical skills test, group B performed better than group A. In group B, the entry point of the first K-wire was closer to the targeted styloid process of the radius, and the protrusion of the K-wires into soft tissue was less than that in group A.
Training with the VR simulator for K-wire insertion resulted in better surgical skills than training by a surgeon and cadaver model.
Training with the VR simulator provides the opportunity to improve and refine surgical skills without the risk of harming patients. It offers easier access, unlimited repetitions, and is more cost-effective compared with training sessions with cadavers.
手术模拟在肌肉骨骼训练中变得越来越重要。它们提供了在受控环境中发展手术技能的机会,同时降低了患者的风险。对于肌肉骨骼手术中的 K 线内固定,开发了一种力反馈虚拟现实(VR)模拟器。本研究的目的是使用该技术评估培训结果,并将结果与尸体标准教学进行比较。
2020 年参加 AO 创伤课程的 20 名参与者被随机分配到 2 组。第 1 天,A 组由资深外科医生使用尸体进行培训,B 组使用 VR 模拟器进行桡骨远端 K 线插入培训。第 2 天,所有参与者在无辅助的情况下在尸体模型上进行 K 线插入,以验证培训效果。
在手术技能测试中,B 组的表现优于 A 组。在 B 组中,第一根 K 线的进针点更接近桡骨的目标茎突,K 线进入软组织的突出程度小于 A 组。
与外科医生和尸体模型培训相比,使用 VR 模拟器进行 K 线插入培训可获得更好的手术技能。
使用 VR 模拟器进行培训提供了在不伤害患者的情况下提高和完善手术技能的机会。与尸体培训相比,它具有更容易获得、无限重复和更具成本效益的优势。